Capecitabine and Oxaliplatin or Standard Follow-Up Care in Treating Patients Who Have Undergone Surgery for Locally Advanced Rectal Cancer

This is an interventional treatment trial for Colorectal Cancer focused on measuring adenocarcinoma of the rectum, stage III rectal cancer, stage II rectal cancer Read More

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma of the rectum

  • Within 15 cm of the anal verge
  • Locally advanced disease

• Underwent complete resection of primary tumor within the past 12 weeks

  • ypT0-4, N0-2 with definitive histology at surgery
  • Circumferential resection margin > 1 mm
  • No gross evidence of residual disease

• Received neoadjuvant fluoropyrimidine-based chemoradiotherapy with ≥ 45 Gy planned total radiation dose, given in 1 of the following fashions:

  • Prolonged fluorouracil IV during radiotherapy
  • Low-dose leucovorin calcium and fluorouracil (days 1-5 and 29-33) concurrently with radiotherapy
  • Oral capecitabine concurrently with radiotherapy
• No evidence of metastatic disease

PATIENT CHARACTERISTICS:

• WHO performance status 0-1
• Absolute neutrophil count ≥ 1,500/mm³
• Platelet count ≥ 100,000/mm³
• Creatinine clearance ≥ 50 mL/min
• Bilirubin ≤ 1.25 times upper limit of normal (ULN)
• AST and ALT ≤ 1.25 times ULN
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for ≥ 3 months after completion of study treatment
• No known dihydropyrimidine dehydrogenase deficiency
• No hypersensitivity to platinum compounds
• No preexisting peripheral neuropathy ≥ grade 1
• No lack of physical integrity of the upper gastrointestinal tract
• No malabsorption syndrome

• No other serious uncontrolled medical condition or concurrent medical illness that would compromise life expectancy and/or preclude study compliance, including any of the following:

  • Serious uncontrolled infections
  • Significant cardiac disease (e.g., uncontrolled angina, congestive heart failure, cardiomyopathy, or arrhythmias) or myocardial infarction within the past 12 months
  • Interstitial pneumonia or symptomatic lung fibrosis
• No other malignancies except adequately treated in situ carcinoma of the cervix or basal cell or squamous cell carcinoma of the skin, unless disease-free for ≥ 10 years
• No history of uncontrolled seizures, CNS disorders, or psychiatric disability that would preclude study compliance

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics

• No prior chemotherapy exceeding 6 weeks in duration

  • Prior chemotherapy given as part of neoadjuvant treatment (i.e., chemoradiotherapy) may last a maximum of 11-12 weeks
• No prior oxaliplatin
• Prior mitomycin C, irinotecan hydrochloride, or cetuximab allowed
• No concurrent warfarin, antiviral agents, or phenytoin