PURPOSE: To determine if @entity1487 ( @entity1487 ) plus high-dose @entity4181 (LV) enhances local response in @entity1 receiving preoperative radiation therapy (RT) for @entity188 , we compared the degree of downstaging in @entity1 receiving preoperative RT with or without chemotherapy. @entity1 AND METHODS: For this comparison, three groups of @entity1 who were treated with identical doses and techniques of preoperative pelvic RT (total dose of 5,040 cGy) were examined. Group 1 included 20 @entity1 with unresectable disease who received combined RT and LV/ @entity1487 . Group 2 included 11 @entity1 with unresectable disease who received preoperative RT. Group 3 included 21 @entity1 with invasive, resectable, primary disease who received preoperative RT. RESULTS: @entity1 with unresectable disease who received LV/ @entity1487 had a higher rate of pathologic complete response (20% v 0%) and a lower incidence of positive nodes (30% v 64%) compared with those who did not receive chemotherapy. Even when the most favorable group of @entity1 was included (group 3), @entity1 who received LV/ @entity1487 still had a higher complete response rate (20% v 6%) and a lower incidence of positive nodes (30% v 53%) compared with those who received RT without LV/ @entity1487 . Of those @entity1 with initially unresectable disease, the resectability rate was higher in those who received LV/ @entity1487 compared with those who did not receive LV/ @entity1487 (90% v 64%). @entity1 who received LV/ @entity1487 experienced slightly more grade 1 to 2 fatigue, @entity3136 , @entity390 , and grade 3 @entity294 , tenesmus, and @entity3833 . CONCLUSIONS: Despite the fact that @entity1 who received chemotherapy (group 1) had more @entity1442 compared with those with resectable disease (group 3), the addition of LV/ @entity1487 increased the resectability and downstaging rates. The ultimate impact of a complete response as well as a decrease in the incidence of pelvic nodes on local control and survival remains to be determined. However, given the enhancement of down-staging in @entity1 with unresectable @entity5 , we are encouraged by the combined modality approach.

Enhancement of radiation-induced downstaging of @entity5 by XXXX and high-dose @entity4181 chemotherapy.

@entity4181 :: ('MESH:D002955', 'Chemical') :: ['leucovorin'] @entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity3136 :: ('MESH:D013280', 'Disease') :: ['stomatitis'] @entity390 :: ('MESH:D009325', 'Disease') :: ['nausea'] @entity5 :: ('MESH:D009369', 'Disease') :: ['rectal cancer'] @entity294 :: ('MESH:D003967', 'Disease') :: ['diarrhea'] @entity188 :: ('MESH:D012004', 'Disease') :: ['adenocarcinoma of the rectum'] @entity1442 :: ('MESH:D020178', 'Disease') :: ['advanced disease'] @entity3833 :: ('MESH:D053159', 'Disease') :: ['dysuria'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-FU', 'fluorouracil']
@entity1487 :: (MESH:D005472,Chemical) :: ['fluorouracil']
