HYPOFRACTIONATED RADIOTHERAPY WITH CONCURRENT 5-FLUOROURACIL RADIOSENSITIZATION FOR RECURRENT OR LOCALLY ADVANCED COLORECTAL-CANCER - A PHASE-II STUDY

In a pilot study we treated 19 patients suffering from recurrent or lo cally advanced inoperable colorectal cancer, with concurrent hypofract ionated radiotherapy (4-5 Gy/fraction, 2 fractions per week) and 5-Flu orouracil bolus, 1 hour before RT at doses of 300 mg/m(2). For 16 pati ents treated with radical intent the Normalised Total Dose for alpha/b eta=10 Gy ranged between 56-74 Gy (median 62 Gy). The schedule used wa s very well tolerated. Moderate grade II haematological toxicity was o bserved in 11% of cases and diarrhoea grade II/III resulting in 2-4 we eks treatment delay was observed in 26% of cases. One case with bowel perforation and one with painful subcutaneous fibrosis was observed du ring 12-27 months of follow-up. Out of 16 patients treated with radica l intent 4 (25%) showed complete response and the overall response rat e was 56% (9/16). The one year symptom free survival was obtained in 1 1/16 (69%) radically treated patients. It is concluded that hypofracti onated radiochemotherapy with 5-Fluorouracil for recurrent or locally advanced colorectal cancer is an effective regimen and has acceptable acute and late toxicity. Further investigation is required.