International Journal of Colorectal Disease

, Volume 23, Issue 3, pp 251–255 | Cite as

A COX-2 inhibitor combined with chemoradiation of locally advanced rectal cancer: a phase II trial

  • Anders JakobsenEmail author
  • John Pløen Mortensen
  • Claus Bisgaard
  • Jan Lindebjerg
  • Søren Rafael Rafaelsen
  • Vagn Ove Bendtsen
Original Article


Background and aim

The aim of this study was to investigate the possible effect of a COX-2 inhibitor in addition to chemoradiation of locally advanced rectal cancer.

Materials and methods

The study included 35 patients with rectal adenocarcinoma. All patients had a tumor localised ≤10 cm from the anal verge and a circumferential margin ≤5 mm on a magnetic resonance scan. The patients were scheduled to receive external radiation with a tumor dose of 60 Gy supplemented with an endorectal boost of 5 Gy. Concurrent with radiation, the patients received uracil-tegafur 300 mg/m2 daily. Celexocib was scheduled throughout the radiation period in a dose of 400 mg × 2 daily.


A macular papular rash was seen in 17 (49%) of the patients leading to stop of medication with celecoxib. Thirty-three patients were operated, and all patients responded to treatment. Complete pathological remission was found in 21% of the patients and further 24% had only microscopic residual tumor cells. The results did not suggest any difference according to the accomplishment of the COX-2 medication.


The addition of a COX-2 inhibitor to chemotherapy-enhanced radiation treatment of rectal cancer was not feasible due to a high incidence of rash in the present study.


Rectal cancer COX-2 inhibitor Chemoradiation 


Conflict of interest statement

We declare that no actual or potential conflict of interest exists.


  1. 1.
    Wibe A, Rendedal PR, Svensson E et al (2002) Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancer. Br J Surg 89:327–334PubMedCrossRefGoogle Scholar
  2. 2.
    Beets-Tan RG, Beets GL, Vliegen RF et al (2001) Accuracy of magnetic resonance imaging in prediction of tumour-free resection margin in rectal cancer surgery. Lancet 357:497–504PubMedCrossRefGoogle Scholar
  3. 3.
    Roh MS, Colangelo L, Wieand HS, et al (2004) Response to preoperative multimodality therapy predicts survival in patients with carcinoma of the rectum. Abstract 3505, ASCO 2004 annual MeetingGoogle Scholar
  4. 4.
    Bosset JF, Collette L, Calais G et al (2006) Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med 355(11):1114–1123PubMedCrossRefGoogle Scholar
  5. 5.
    Conroy T, Bonnetain O, Chapet O, et al (2004) Preoperative (preop) radiotherapy (RT) + 5FU/folinic acid (FA) in T3, 4 rectal cancers: Preliminary results of the FFCD 9203 randomized trial. ASCO Abstract 3626, (American Society of Clinical Oncology) ConferenceGoogle Scholar
  6. 6.
    Bujko K, Nowacki MP, Nasierowska-Guttmejer A et al (2004) Sphincter preservation following preoperative radiotherapy for rectal cancer: report of a randomised trial comparing short-term radiotherapy vs. conventionally fractionated radiochemotherapy. Radiother Oncol 72:15–24PubMedCrossRefGoogle Scholar
  7. 7.
    Davis TW, Hunter N, Trifan OC et al (2003) COX-2 inhibitors as radiosensitizing agents for cancer therapy. Am J Clin Oncol 26:S58–S61PubMedCrossRefGoogle Scholar
  8. 8.
    Jakobsen A, Mortensen JP, Bisgaard C et al (2006) Preoperative chemoradiation of locally advanced T3 rectal cancer combined with an endorectal boost. Int J Radiat Oncol Biol Phys 64(2):461–465 Epub 2005 Oct 13, Feb 1PubMedCrossRefGoogle Scholar
  9. 9.
    Hansen JW, Jakobsen A (2006) The importance of applicator design for intraluminal brachytherapy of rectal cancer. Med Phys 33(9):3220–3224 SepPubMedCrossRefGoogle Scholar
  10. 10.
    Ohneseit PA, Krebiehl G, Dittmann K et al (2007) Inhibition of cyclooxygenase-2 activity by celecoxib does not lead to radiosensitization of human prostate cancer cells in vitro. Radiother Oncol 82:229–238PubMedCrossRefGoogle Scholar
  11. 11.
    Ganswindt U, Budach W, Jendrossek V et al (2006) Combination of celecoxib with percutaneous radiotherapy in patients with localised prostate cancer—a phase I study. Radiat Oncol 10(1):9CrossRefGoogle Scholar
  12. 12.
    Berger P, Dwyer D, Corallo CE (2002) Toxic epidermal necrolysis after celecoxib therapy. Pharmacotherapy 22(9):1193–1195PubMedCrossRefGoogle Scholar
  13. 13.
    Leese PT, Hubbard RD, Karim A, et al (2000) Effects of Celecoxib, a novel cyclooxygenasec2 inhibitor, on platelet function in healthy adults: a randomized, controlled trial. J Clin Pharmacol 40(2):124–132Google Scholar
  14. 14.
    Dawson SJ, Michael M, Biagi J et al (2007) A phase I/II trial of celecoxib with chemotherapy and radiotherapy in the treatment of patients with locally advanced oesophageal cancer. Invest New Drugs 25:123–129PubMedCrossRefGoogle Scholar
  15. 15.
    Liao ZX (2003) A phase I study combining thoracic radiation (RT) with celecoxib in patients with non-small cell lung cancer (NSCLC). Abstract 867, ASCO Annual MeetingGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Anders Jakobsen
    • 1
    Email author
  • John Pløen Mortensen
    • 1
  • Claus Bisgaard
    • 2
  • Jan Lindebjerg
    • 3
  • Søren Rafael Rafaelsen
    • 4
  • Vagn Ove Bendtsen
    • 5
  1. 1.Department of Oncology, Danish Colorectal Cancer Group South, Vejle HospitalUniversity of Southern DenmarkVejleDenmark
  2. 2.Department of Surgery, Danish Colorectal Cancer Group South, Vejle HospitalUniversity of Southern DenmarkVejleDenmark
  3. 3.Department of Pathology, Danish Colorectal Cancer Group South, Vejle HospitalUniversity of Southern DenmarkVejleDenmark
  4. 4.X-ray Department, Danish Colorectal Cancer Group South, Vejle HospitalUniversity of Southern DenmarkVejleDenmark
  5. 5.Department of SurgerySlagelse HospitalSlagelseDenmark

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