Safety Study of Capecitabine With Radiation in Elderly Rectal Cancer

It is proved that preoperative concurrent chemo-radiotherapy can improve both local control and overall survival in stage II/III rectal cancer patients. But elderly patients, especially patients over 75 years were hardly involved in related clinical trials considered of their fragility.

Several retrospective study showed that old rectal cancer patients would also benefit from concurrent chemo-radiation, with acceptable toxicity. Several new drug, such as capecitabine, also seem to be safety for elderly cancer patients. But few prospective study has been carried out.

The investigators designed this phase I study, to explore the maximum tolerant dose of capecitabine in preoperative concurrent chemoradiation for elderly stage II/III rectal cancer patients, as well as to evaluate safety.

Inclusion criteria

• rectal adenocarcinoma, clinical stage II/III(T3-4 or N+, AJCC 7th).
• KPS status no less than 70; Charlson comorbidity no more than 3.
• life expectancy more than 6 months.
• hemoglobin >= 100g/L, white blood cell >= 3.5*10E9/L, neutrophil >= 1.5*10E9/L, platelet >= 100*10E9/L.Creatin normal, Total bilirubin normal, AST and AST normal, AKP normal.
• do not have allergy history to thymidine phosphorylase.
• do not receive surgery ( except palliative colostomy) or chemotherapy or other anti-cancer treatment
• no previously pelvic irradiation history
• informed consent signed

Exclusion criteria

• other cancer history, except curable non-melanoma skin cancer or cervix in-situ carcinoma
• previous pelvic irradiation history
• receiving surgery (except palliative colostomy), chemotherapy or other anti-cancer treatment
• allergy history to thymidine phosphorylase
• active infection existed
• severe complication, such as acute myocardial infarction in 6 months, uncontrolled diabetes ( Plasma glucose concentrations in any time of a day≥11.1mmol/L）, severe cardiac arrhythmia， etc.
• anticipate other clinical trials in four weeks before enrollment