Pre-operative chemoradiotherapy with oral tegafur-uracil and leucovorin for rectal cancer

Ling Wei Wang, Shung Haur Yang, Jen Kou Lin, Tzu Chen Lin, Wing Kai Chan, Wei Shone Chen, Huann Sheng Wang, Jeng Kae Jiang, Rheun Chuan Lee, A. Fen Yau Li, Yee Chao, Kwan Hwa Chi, Sang Hue Yen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background: To evaluate the efficacy and toxicity of pre-operative radiotherapy (RT) combined with oral tegafur-uracil (UFUR) plus leucovorin (LV) in rectal cancer. Patients: Sixty-five patients with rectal adenocarcinoma (clinical staged T2-4N0-2M0) received pelvic RT of 45 Gy in 20 fractions over 28 days. Concurrent chemotherapy consisted of UFUR (200 mg/m2/day) and LV (45 mg/day) on day 1-28. UFUR (250 mg/m2/day) and LV were continued on day 36-63. Surgery was performed on day 70. Results: Sixty-three patients completed the concurrent chemoradiotherapy (CCRT) and 56 received curative or palliative surgery. Among the 52 patients receiving curative resection, downstaging (DS) occurred in 39 (75%), pathological complete response in 13 (25%), and sphincter preservation was achieved in 16 of 29 (55%) with lower-seated tumors. With a median follow-up time of 33 months, local failure developed in 4 (8%) and distant metastases occurred in 7 (14%). The 3-year overall survival was 92% and disease-free survival 76%. For all 65 patients, grade 3-4 diarrhea developed in 6 (9%) and grade 3-4 leucopenia observed in 2 (3%). Conclusions: Oral UFUR + LV administered with pre-operative RT are effective in tumor DS, pathological complete response, and sphincter preservation with tolerable toxicity in rectal cancer.

Original languageEnglish
Pages (from-to)256-263
Number of pages8
JournalJournal of Surgical Oncology
Issue number4
StatePublished - 15 Mar 2005


  • Leucovorin
  • Pre-operative chemoradiotherapy
  • Rectal cancer
  • Tegafururacil


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