Assessment of Response to Concomitant Chemoradiation with Capecitabine in Locally Advanced Rectal Carcinoma: A Descriptive Observational Study from Nishtar Hospital, Multan

Abstract

Objective: To assess the response of preoperative concomitant chemo-radiation with capecitabine in patients
with locally advanced rectal carcinoma.
Study Design: A descriptive observational study.
Place and Duration of Study: This study was conducted at the Department of Oncology, Nishtar Hospital,
Multan, Pakistan from 5^th November 2024 to 5^th May 2025.
Methods: A total of 100 patients aged 18-70 years old, diagnosed with stage 3 or 4 non-metastatic rectal
adenocarcinoma, were included. Protracted radiotherapy at 50.4 Gray was delivered over 5.5 weeks, with 1.8
Gray per session, five days a week. An 825 mg/m2 dose of Capecitabine was administered orally twice a day
through the radiotherapy course, including weekends, along with the start of radiotherapy. Surgery was
performed 4-6 weeks after the concurrent treatment and the technique was chosen according to the surgeon's
discretion. Adjuvant chemotherapy of four cycles of IV 5-FU (400 mg/m2) and leucovorin (20 mg/ m2) was
started four to six weeks postoperatively.
Results: Frequent grade I and II toxicity included anemia (70%), abdominal pain (50%), proctitis (42%), and
nausea (46%). Capecitabine treatment was stopped in 25 patients due to grade III and IV diarrhea (37%),
abdominal pain (14%), and proctitis (33%), but it did not have a significant impact on compliance. The
radiotherapy compliance was 90% and 93% capecitabine dose was administered as the total dose. A pathologic
complete response was reached in 8 patients (8%). Tumor downstaging was achieved in 55% of patients, and
nodal down staging was observed in 50% of patients.
Conclusion: Concurrent chemoradiotherapy with capecitabine is a safe and well-tolerated treatment in
patients with locally advanced rectal cancer. It has comparable efficacy to 5-FU chemotherapy and can be used
as an alternative to achieve similar outcomes.

How to cite this: Nasir F, Bashir A, Hassan MJ, Jamil T. Assessment of Response to Concomitant Chemoradiation with Capecitabine in Locally Advanced Rectal Carcinoma: A Descriptive Observational Study from Nishtar Hospital, Multan. Life and Science. 2025; 6(4): 483-489. doi: http://doi.org/10.37185/LnS.1.1.933