Official websites use. Share sensitive information only on official, secure websites. Considerable variation in intravenous 5-fluorouracil 5-FU metabolism can occur due to the wide range of dihydropyrimidine dehydrogenase DPD enzyme activity, which can affect both tolerability and efficacy. The oral fluoropyrimidine tegafur-uracil UFT is an effective, well-tolerated and convenient alternative to intravenous 5-FU.
We undertook this study in patients with locally advanced rectal cancer to evaluate the efficacy and tolerability of UFT with leucovorin LV and preoperative radiotherapy and to evaluate the utility and limitations of multicenter staging using pre- and post-chemoradiotherapy ultrasound.
We also performed a validated pretherapy assessment of DPD activity and assessed its potential influence on the tolerability of UFT treatment. The primary endpoints included tumor downstaging and the pathologic complete response pCR rate. Most adverse events were mild to moderate in nature. The sensitivity and specificity of ultrasound for staging was poor.
Overall and recurrence-free survival at 3 years was Adjuvant chemotherapy was administered to 36 node-positive patients mean duration days. Preoperative chemoradiotherapy using UFT with LV plus radiotherapy was well tolerated and effective and represents a convenient alternative to 5-FU-based chemoradiotherapy for the treatment of resectable rectal cancer. Pretreatment detection of DPD deficiency should be performed to avoid severe adverse events. The standard approach for the preoperative treatment of rectal cancer is intravenous i.
However, continuous infusion requires specialized pumps, which are inconvenient for patients, and long-term venous access, which makes patients susceptible to infections and thrombosis [ 1 , 2 ] Rich et al , ; Bosset et al , The oral fluoropyrimidine UFT tegafur-uracil is an effective, well-tolerated and convenient alternative to i. Considerable variation in 5-FU metabolism and outcome due to the wide range of dihydropyrimidine dehydrogenase DPD enzyme activity has been observed and this variability can influence both tolerability and response to cancer chemotherapy [ 15 ] Seck et al , We undertook the present multicenter study in patients with locally advanced rectal cancer to evaluate the efficacy and tolerability of UFT with LV and preoperative radiotherapy and to evaluate the utility and limitations of multicenter staging using pre- and post-chemoradiotherapy ultrasound.
