- In patients with locally advanced rectal cancer undergoing capecitabine-based radiochemotherapy (cbRCT) with intensification, a radiotherapy (RT) boost had fewer adverse effects and a similar rate of pathological complete response compared with oxaliplatin.
Why this matters
- Radiotherapy dose intensification strategies could be adopted as reference treatments for this population.
- INTERACT trial of 534 patients presenting with low-located cT2N0-2M0, cT3N0–2M0 (up to 12 cm from anal verge), randomly assigned to receive:
- Either Xelac, a radiotherapy boost to the bulky site: 45 Gy/1.8 Gy/die, 5 sessions/week to the pelvis, +10 Gy at 1 Gy twice/week to the bulky site+concurrent capecitabine (1650 mg/mq/die).
- Or Xelox: 45 Gy to the pelvis+5.4 Gy/1.8 Gy/die, 5 sessions/week to the bulky site+concurrent capecitabine (1300 mg/mq/die) and oxaliplatin (130 mg/mq on days 1, 19, 38).
- Funding: Catholic University of the Sacred Heart.
- Toxicity was greater in the Xelox group, including grade ≥3 hematologic (P=.01) and neurologic toxicology (P<.001>
- Cumulative major response (tumor regression grade 1-2) was more common in the Xelac group (61.7% vs 52.3%; P=.039).
- Pathologic response rates and 5-year DFS rates were similar between the 2 groups.
- No nonintensified control.