Applications in Rectal and Anal Cancer

  • Claus Rödel
  • Rolf Sauer
Part of the Medical Radiology book series (MEDRAD)


Rectal Cancer Clin Oncol Maximum Tolerate Dose Radiat Oncol Biol Phys Anal Cancer 
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  1. Allal A, Kurtz JM, Pipard G et al (1993) Radiochemotherapy versus radiotherapy alone for anal cancer: a retrospective comparison. Int J Radiat Oncol Biol Phys 27:59–66PubMedGoogle Scholar
  2. Andre T, Boni C, Mounedji-Boudiaf L et al (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350:2343–2351PubMedCrossRefGoogle Scholar
  3. Aschele C, Friso ML, Pucciarelli S et al (2005) A phase I–II study of weekly oxaliplatin, 5-fluorouracil continuous infusion and preoperative radiotherapy in locally advanced rectal cancer. Ann Oncol 16:1140–1146PubMedCrossRefGoogle Scholar
  4. Bartelink H, Roelofsen F, Eschwege F et al (1997) Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups. J Clin Oncol 15:2040–2049PubMedGoogle Scholar
  5. Baumann M, Krause M (2004) Targeting the epidermal growth factor receptor in radiotherapy: radiobiological mechanisms, preclinical and clinical results. Radiother Oncol 72:257–266PubMedCrossRefGoogle Scholar
  6. Blackstock AW, Hess S, Chaney S et al (1999) Oxaliplatin: in vitro evidence of its radiation sensitizing activity: preclinical observations relevant to clinical trials. Int J Radiat Oncol Biol Phys 45:253–254CrossRefGoogle Scholar
  7. Bosset JF, Roelofsen F, Morgan DA et al (2003) Shortened irradiation scheme, continuous infusion of 5-fluorouracil and fractionation of mitomycin C in locally advanced anal carcinomas. Results of a phase II study of the European Organization for Research and Treatment of Cancer. Radiotherapy and Gastrointestinal Cooperative Groups. Eur J Cancer 39:45–51PubMedCrossRefGoogle Scholar
  8. Bosset JF, Calais G, Mineur L et al (2005a) Enhanced tumorocidal effect of chemotherapy with preoperative radiotherapy for rectal cancer: preliminary results-EORTC 22921. J Clin Oncol 23:5620–5627PubMedCrossRefGoogle Scholar
  9. Bosset JF, Calais G, Mineur L et al (2005b) Preoperative radiation (Preop RT) in rectal cancer: effect and timing of additional chemotherapy (CT) 5-year results of the EORTC 22921 trial. Proc Am Soc Clin Oncol, Abstract 3505Google Scholar
  10. 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
  11. Byfield JE, Calabro-Jones P, Klisak I et al (1982) Pharmacologic requirements for obtaining sensitization of human tumor cells in vitro to combined 5-fluorouracil or ftorafur and X rays. Int J Radiat Oncol Biol Phys 8:1923–1933PubMedGoogle Scholar
  12. Cafiero F, Gipponi M, Lionetto R (2003) Randomised clinical trial of adjuvant postoperative RT vs sequential postoperative RT plus 5-FU and levamisole in patients with stage II–III resectable rectal cancer: a final report. J Surg Oncol 83:140–146PubMedCrossRefGoogle Scholar
  13. Carraro S, Roca EL, Cartelli C et al (2002) Radiochemotherapy with short daily infusion of low-dose oxaliplatin, leucovorin, and 5-FU in T3–T4 unresectable rectal cancer: a phase II IATTGI study. Int J Radiat Oncol Biol Phys 54:397–402PubMedCrossRefGoogle Scholar
  14. Cividalli A, Ceciarelli F, Livdi E et al (2002) Radiosensitization by oxaliplatin in a mouse adenocarcinoma: influence of treatment schedule. Int J Radiat Oncol Biol Phys 52:1092–1098PubMedCrossRefGoogle Scholar
  15. Cummings BJ, Keane TJ, O’Sullivan B et al (1991) Epidermoid anal cancer: treatment by radiation alone or by radiation and 5-fluorouracil with and without mitomycin C. Int J Radiat Oncol Biol Phys 21:1115–1125PubMedGoogle Scholar
  16. Dobrowsky W, Dobrowsky E, Rauth AM (1992) Mode of interaction of 5-fluorouracil, radiation, and mitomycin C: in vitro studies. Int J Radiat Oncol Biol Phys 22:875–880PubMedGoogle Scholar
  17. Doci R, Zucali R, La Monica G et al (1996) Primary chemoradiation therapy with fluorouracil and cisplatin for cancer of the anus: results in 35 consecutive patients. J Clin Oncol 14:3121–3125PubMedGoogle Scholar
  18. Dunst J, Reese T, Sutter T et al (2002) Phase I trial evaluating the concurrent combination of radiotherapy and capecitabine in rectal cancer. J Clin Oncol 20:3983–3991PubMedCrossRefGoogle Scholar
  19. Eng C, Crane CH, Rosner GL et al (2005) A phase II study of capecitabine plus oxaliplatin and radiation therapy, XELOX-XRT, in squamous cell carcinoma (SCCA) of the anal canal: a preliminary analysis. Proc Am Soc Clin Oncol, Abstract 4271Google Scholar
  20. Fernandez-Martos C, Aparicio J, Bosch C et al (2004) Preoperative uracil, tegafur, and concomitant radiotherapy in operable rectal cancer: a phase II multicenter study with 3 years’ follow-up. J Clin Oncol 22:3016–3022PubMedCrossRefGoogle Scholar
  21. Ferrara N, Davis-Smyth T (1997) The biology of vascular endothelial growth factor. Endocrinol Rev 18:4–25CrossRefGoogle Scholar
  22. Ferrigno R, Nakamura RA, Dos Santos Novaes PE et al (2005) Radiochemotherapy in the conservative treatment of anal carcinoma: retrospective analysis of results and radiation dose effectiveness. Int J Radiat Oncol Biol Phys 61:1136–1142PubMedCrossRefGoogle Scholar
  23. Flam M, John M, Pajak TF et al (1996) Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a phase III randomized intergroup study. J Clin Oncol 14:2527–2539PubMedGoogle Scholar
  24. Freyer G, Bossard N, Romestaing P et al (2001) Addition of oxaliplatin to continuous fluorouracil, l-folinic acid, and concomitant radiotherapy in rectal cancer: the Lyon R 97-03 phase I trial. J Clin Oncol 19:2433–2438PubMedGoogle Scholar
  25. Frykholm GJ, Glimelius B, Pahlman L (1993) Preoperative or postoperative irradiation in adenocarcinoma of the rectum: final treatment results of a randomized trial and an evaluation of late secondary effects. Dis Colon Rectum 36:564–572PubMedCrossRefGoogle Scholar
  26. Frykholm GJ, Påhlman L, Glimelius B (2001) Combined chemo-and radiotherapy vs radiotherapy alone in the treatment of primary, nonresectable adenocarcinoma of the rectum. Int J Radiat Oncol Biol Phys 50:427–434PubMedCrossRefGoogle Scholar
  27. Gambacorta MA, Valentini V, Coco C et al (2004) Chemoradiation with raltitrexed and oxaliplatin in preoperative treatment of stage II–III resectable rectal cancer: phase I and II studies. Int J Radiat Oncol Biol Phys 60:139–148PubMedCrossRefGoogle Scholar
  28. Gastrointestinal Tumor Study Group (1985) Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med 312:1465–1472CrossRefGoogle Scholar
  29. Gastrointestinal Tumor Study Group (1992) Radiation therapy and fluorouracil with or without semustine for the treatment of patients with surgical adjuvant adenocarcinoma of the rectum. J Clin Oncol 10:549–557Google Scholar
  30. Gerard JP, Chapet O, Nemoz C et al (2003) Preoperative concurrent radiochemotherapy in locally advanced rectal cancer with high-dose radiation and oxaliplatin-containing regimen: the Lyon R0-04 phase II trial. J Clin Oncol 21:1119–1124PubMedCrossRefGoogle Scholar
  31. Gerard JP, Bonnetain F, Conroy T et al (2005) Preoperative (preop) radiotherapy (RT) + 5 FU/folinic acid (FA) in T3–4 rectal cancers: results of the FFCD 9203 randomized trial. Proc Am Soc Clin Oncol, Abstract 3504Google Scholar
  32. Giacchetti S, Itzhaki M, Gruia G et al (1999) Long-term survival of patients with unresectable colorectal cancer liver metastases following infusional chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin and surgery. Ann Oncol 10:663–669PubMedCrossRefGoogle Scholar
  33. Giacchetti S, Perpoint B, Zidani R et al (2000) Phase III multicenter randomized trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first-line treatment of metastatic colorectal cancer. J Clin Oncol 18:136–147PubMedGoogle Scholar
  34. Giralt J, Heras M de las, Cerezo L et al (2005) The expression of epidermal growth factor receptor results in a worse prognosis for patients with rectal cancer treated with preoperative radiotherapy: a multicenter, retrospective analysis. Radiother Oncol 74:101–108PubMedCrossRefGoogle Scholar
  35. Grabenbauer GG, Kessler H, Matzel KE et al (2005) Tumor site predicts outcome after radiochemotherapy in squamouscell carcinoma of the anal region: long-term results of 101 patients. Dis Colon Rectum 48:1742–1751PubMedCrossRefGoogle Scholar
  36. Heidelberger C, Chaudhuri NK, Danneberg P et al (1957) Fluorinated pyrimidines, a new class of tumour-inhibitory compounds. Nature 179:663–666PubMedCrossRefGoogle Scholar
  37. Heidelberger C, Griesbach L, Montag BJ et al (1958) Studies on fluorinated pyrimidines. II. Effects on transplanted tumors. Cancer Res 18:305–317PubMedGoogle Scholar
  38. Hofheinz RD, Gerstenberg-Helldorf B von, Wenz F et al (2005) Phase I trial of capecitabine and weekly irinotecan in combination with radiotherapy for neoadjuvant therapy of rectal cancer. J Clin Oncol 23:1350–1357PubMedCrossRefGoogle Scholar
  39. Kim JC, Kim TW, Kim JH et al (2005) Preoperative concurrent radiotherapy with capecitabine before total mesorectal excision in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 63:346–353PubMedCrossRefGoogle Scholar
  40. Kim JS, Cho MJ, Song KS et al (2002) Preoperative chemoradiation using oral capecitabine in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 54:403–408PubMedCrossRefGoogle Scholar
  41. Klautke G, Feyerherd P, Ludwig K et al (2005) Intensified concurrent radiochemotherapy with 5-fluorouracil and irinotecan as neoadjuvant treatment in patients with locally advanced rectal cancer. Br J Cancer 92:1215–1220PubMedCrossRefGoogle Scholar
  42. Kopp R, Rothbauer E, Mueller E et al (2003) Reduced survival of rectal cancer patients with increased tumor epidermal growth factor receptor levels. Dis Colon Rectum 46:1391–1399PubMedCrossRefGoogle Scholar
  43. Kouloulias V, Plataniotis G, Kouvaris J et al (2005) Radiochemotherapy combined with intracavitary hyperthermia for anal cancer: feasibility and long-term results from a phase II randomized trial. Am J Clin Oncol 28:91–99PubMedCrossRefGoogle Scholar
  44. Krook JE, Moertel CG, Gunderson LL et al (1991) Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 324:709–715PubMedCrossRefGoogle Scholar
  45. Le LH, Chetty R, Moore MJ (2005) Epidermal growth factor receptor expression in anal canal carcinoma. Am J Clin Pathol 124:20–23PubMedCrossRefGoogle Scholar
  46. Lee JH, Ahn JH, Bahng H et al (2002) Randomized trial of postoperative adjuvant therapy in stage II and III rectal cancer to define the optimal sequence of chemotherapy and radiotherapy: a preliminary report. J Clin Oncol 20:1751–1758PubMedCrossRefGoogle Scholar
  47. Loi S, Ngan SY, Hicks RJ et al (2005) Oxaliplatin combined with infusional 5-fluorouracil and concomitant radiotherapy in inoperable and metastatic rectal cancer: a phase I trial. Br J Cancer 92:655–661PubMedCrossRefGoogle Scholar
  48. Magne N, Fischel JL, Formento P et al (2003) Oxaliplatin-5-fluorouracil and ionizing radiation. Importance of the sequence and influence of p53 status. Oncology 64:280–287PubMedCrossRefGoogle Scholar
  49. Martenson JA, Lipsitz SR, Lefkopoulou M et al (1995) Results of combined modality therapy for patients with anal cancer (E7283). An Eastern Cooperative Oncology Group study. Cancer 76:1731–1736PubMedCrossRefGoogle Scholar
  50. Mehta VK, Cho C, Ford JM et al (2003) Phase II trial of preoperative 3D conformal radiotherapy, protracted venous infusion 5-fluorouracil, and weekly CPT-11, followed by surgery for ultrasound-staged T3 rectal cancer. Int J Radiat Oncol Biol Phys 55:132–137PubMedCrossRefGoogle Scholar
  51. Miller EJ, Quan SH, Thaler HT (1991) Treatment of squamous cell carcinoma of the anal canal. Cancer 67:2038–2041PubMedCrossRefGoogle Scholar
  52. Minsky BD, Cohen AM, Kemeny N et al (1992) Enhancement of radiation-induced downstaging of rectal cancer by fluorouracil and high-dose leucovorin chemotherapy. J Clin Oncol 10:79–84PubMedGoogle Scholar
  53. Moertel CG, Childs DS Jr, Reitemeier RJ et al (1969) Combined 5-fluorouracil and supervoltage radiation therapy of locally unresectable gastrointestinal cancer. Lancet 2:865–867PubMedCrossRefGoogle Scholar
  54. Ngan SY, Michael M, Mackay J et al (2004) A phase I trial of preoperative radiotherapy and capecitabine for locally advanced, potentially resectable rectal cancer. Br J Cancer 91:1019–1024PubMedGoogle Scholar
  55. Nigro ND, Vaitkevicius VK, Considine B Jr (1974) Combined therapy for cancer of the anal canal: a preliminary report. Dis Colon Rectum 17:354–356PubMedGoogle Scholar
  56. NIH Consensus Conference (1990) Adjuvant therapy for patients with colon and rectal cancer. J Am Med Assoc 264:1444–1450CrossRefGoogle Scholar
  57. O’Connell MJ, Martenson JA, Wieand HS et al (1994) Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med 331:502–507PubMedCrossRefGoogle Scholar
  58. Rich TA, Kirichenko AV (2001) Camptothecin schedule and timing of administration with irradiation. Oncology (Williston Park) 15:37–41PubMedGoogle Scholar
  59. Rich TA, Ajani JA, Morrison WH et al (1993) Chemoradiation therapy for anal cancer: radiation plus continuous infusion of 5-fluorouracil with or without cisplatin. Radiother Oncol 27:209–215PubMedCrossRefGoogle Scholar
  60. Rödel C, Grabenbauer GG, Papadopoulos T et al (2003) Phase I/II trial of capecitabine, oxaliplatin, and radiation for rectal cancer. J Clin Oncol 21:3098–3104PubMedCrossRefGoogle Scholar
  61. Roh MS, Petrelli N, Wieand S et al (2001) Phase III randomized trial of preoperative versus postoperative multimodality therapy in patients with carcinoma of the rectum (NSABP R-03). Proc Am Soc Clin Oncol 20:123aGoogle Scholar
  62. Sauer R, Becker H, Hohenberger W et al (2004) Preoperative versus postoperative radiochemotherapy for rectal cancer. N Engl J Med 351:1731–1740PubMedCrossRefGoogle Scholar
  63. Sawada N, Ishikawa T, Sekiguchi F et al (1999) X-ray irradiation induces thymidine phosphorylase and enhances the efficacy of capecitabine (Xeloda) in human cancer xenografts. Clin Cancer Res 5:2948–2953PubMedGoogle Scholar
  64. Schuller J, Cassidy J, Dumont E et al (2000) Preferential activation of capecitabine in tumor following oral administration to colorectal cancer patients. Cancer Chemother Pharmacol 45:291–297PubMedCrossRefGoogle Scholar
  65. Sischy B, Doggett RL, Krall JM et al (1989) Definitive irradiation and chemotherapy for radiosensitization in management of anal carcinoma: interim report on Radiation Therapy Oncology Group study no. 8314. J Natl Cancer Inst 81:850–856PubMedGoogle Scholar
  66. Smalley SR, Benedetti J, Williamson S et al (2003) Intergroup 0144: phase III trial of 5-FU based chemotherapy regimens plus radiotherapy (XRT) in postoperative adjuvant rectal cancer. Bolus 5-FU vs prolonged venous infusion (PVI) before and after XRT + PVI vs bolus 5-FU + leucovorin (LV) + levamisole (LEV) before and after XRT + bolus 5-FU + LV. Proc Am Soc Clin Oncol, Abstract 1006Google Scholar
  67. Souglakos J, Androulakis N, Mavroudis D et al (2003) Multicenter dose-finding study of concurrent capecitabine and radiotherapy as adjuvant treatment for operable rectal cancer. Int J Radiat Oncol Biol Phys 56:1284–1287PubMedCrossRefGoogle Scholar
  68. Staib L, Kornmann M, Roettinger E et al (2004) Adjuvant radiochemotherapy in resectable stage II, III rectal cancer: results of the FOGT-2 trial. Proc Am Soc Clin Oncol, Abstract 3608Google Scholar
  69. Tanum G, Tveit K, Karlsen KO et al (1991) Chemotherapy and radiation therapy for anal carcinoma. Survival and late morbidity. Cancer 67:2462–2466PubMedCrossRefGoogle Scholar
  70. Tepper JE, O’Connell M, Niedzwiecki D et al (2002) Adjuvant therapy in rectal cancer: analysis of stage, sex, and local control-final report of intergroup 0114. J Clin Oncol 20:1744–1750PubMedCrossRefGoogle Scholar
  71. Tveit KM, Guldvog I, Hagen S et al (1997) Randomized controlled trial of postoperative radiotherapy and short-term time-scheduled 5-fluorouracil against surgery alone in the treatment of Dukes B and C rectal cancer. Norwegian Adjuvant Rectal Cancer Project Group. Br J Surg 84:1130–1135PubMedCrossRefGoogle Scholar
  72. Twelves C, Wong A, Nowacki MP et al (2005) Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med 352:2696–2704PubMedCrossRefGoogle Scholar
  73. UKCCCR Anal Cancer Trial Working Party. (1996) Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. Lancet 348:1049–1054CrossRefGoogle Scholar
  74. Van Cutsem E, Hoff PM, Harper P et al (2004) Oral capecitabine vs intravenous 5-fluorouracil and leucovorin: integrated efficacy data and novel analyses from two large, randomised, phase III trials. Br J Cancer 90:1190–1197PubMedCrossRefGoogle Scholar
  75. Voelter V, Stupp R, Matter M et al (2003) Preoperative hyperfractionated accelerated radiotherapy (HART) and concomitant CPT-11 in locally advanced rectal carcinoma: a phase I study. Int J Radiat Oncol Biol Phys 56:1288–1294PubMedCrossRefGoogle Scholar
  76. Willett CG, Chung D, Sahani D et al (2004a) Phase I study of neoadjuvant bevacizumab, 5-fluorouracil, and radiation therapy followed by surgery for patients with primary rectal cancer. Proc Am Soc Clin Oncol, Abstract 3589Google Scholar
  77. Willett CG, Boucher Y, di Tomaso E et al (2004b) Direct evidence that the VEGF-specific antibody bevacizumab has antivascular effects in human rectal cancer. Nat Med 10:145–147PubMedCrossRefGoogle Scholar
  78. Wolmark N, Wieand HS, Hyams DM et al (2000) Randomized trial of postoperative adjuvant chemotherapy with or without radiotherapy for carcinoma of the rectum: National Surgical Adjuvant Breast and Bowel Project Protocol R-02. J Natl Cancer Inst 92:388–396PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2006

Authors and Affiliations

  • Claus Rödel
    • 1
  • Rolf Sauer
    • 2
  1. 1.Klinik and Poliklinik für StrahlentherapieUniversitätsklinikum ErlangenErlangenGermany
  2. 2.Universitätsklinikum ErlangenErlangenGermany

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