Evidence map›Paper›PMID 29928702›Full record

ArticleClinical and translational radiation oncology2018

Phase I and II trial on infusional 5-fluorouracil and gefitinib in combination with preoperative radiotherapy in rectal cancer: 10-years median follow-up.

Maria Antonietta Gambacorta, Antonino De Paoli, Marco Lupattelli, Giuditta Chiloiro, Angela Pia Solazzo, Brunella Barbaro, Sergio Alfieri, Fabio Maria Vecchio, Jacopo Lenkowicz, Francesco Navarria and 5 more

Open access · goldAbstract read
In one paragraph

Article in Clinical and translational radiation oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 6 institutions in 2 countries.

Maria Antonietta GambacortaPolo scienze oncologiche ed ematologiche, Fondazione Policlinico Universitario Agostino Gemelli Roma, Italy.
Antonino De PaoliDepartment of Radiotherapy, Centro di Riferimento Oncologico, Aviano, Italy.
Marco LupattelliDepartment of Radiotherapy, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera di Perugia, Perugia, Italy.
Giuditta ChiloiroPolo scienze oncologiche ed ematologiche, Fondazione Policlinico Universitario Agostino Gemelli Roma, Italy.
Angela Pia SolazzoDepartment of Radiotherapy, Ospedale San Carlo, Potenza, Italy.
Brunella BarbaroDepartment of Bioimaging and Radiological Sciences, Fondazione Policlinico Universitario "Agostino Gemelli", Università Cattolica del Sacro Cuore, Roma, Italy.
Sergio AlfieriDepartment of Digestive Surgery, Fondazione Policlinico Universitario "Agostino Gemelli", Università Cattolica del Sacro Cuore, Roma, Italy.
Fabio Maria VecchioDepartment of Pathology, Fondazione Policlinico Universitario "Agostino Gemelli", Università Cattolica del Sacro Cuore, Roma, Italy.
Jacopo LenkowiczIstituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy.
Francesco NavarriaDepartment of Radiotherapy, Centro di Riferimento Oncologico, Aviano, Italy.
Elisa PalazzariDepartment of Radiotherapy, Centro di Riferimento Oncologico, Aviano, Italy.
Giulio BertolaDepartment of Surgical Oncology, Centro di Riferimento Oncologico, Aviano, Italy.
Alessandro FrattegianiDepartment of Radiotherapy, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera di Perugia, Perugia, Italy.
Bruce MinskyDepartment of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Vincenzo ValentiniPolo scienze oncologiche ed ematologiche, Fondazione Policlinico Universitario Agostino Gemelli Roma, Italy.
Centro di Riferimento Oncologico · ITUniversità Cattolica del Sacro Cuore · ITAgostino Gemelli University Polyclinic · ITAzienda Ospedaliera di Perugia · ITOspedale San Carlo · ITThe University of Texas MD Anderson Cancer Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this study is to evaluate the long term survival of the addition of gefitinib to chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC). METHODS AND MATERIALS: This previously published multicentre, open-label, phase I-II study, enrolled patients (pts) with LARC to receive CRT with concurrent 5-fluorouracil continuous intravenous infusion and a dose escalation of orally administered gefitinib, followed 6-8 weeks later by surgery. An intra-operative radiotherapy boost of 10 Gy was planned. Adjuvant chemotherapy was administrated in ypN1-2 pts. After a median f/u of >10 years, we analyzed Local Control (LC), Metastasis Free Survival (MFS), Disease Free Survival (DFS), Disease Specific Survival (DSS) and Overall Survival (OS). Predictive endpoints of clinical outcomes were tested by univariate and multivariate analysis. Variables analyzed included: age, gefitinib dose and interruptions, adjuvant CT, surgery type, ypT, ypN, and TRG grade. We have also analyzed late toxicity according to CTCAEv4.

resultsOf the 41 initially enrolled pts, 39 were evaluable (27M, 12F). With a median f/u of 133 months, LC, MFS, DFS, OS and DSS at 5 years were 84%; 71%; 64%; 87% and 92%, respectively. The OS and DSS at 10 years were 61,5% and 76%, respectively. Grade 3-4 late toxicity occurred in 38% of pts: sexual (28,2%) and gastrointestinal toxicities (10,2%).

conclusionLong term outcomes and late toxicity were similar to previously reported series. The addition of gefitinib did not improve outcomes in LARC. Gefitinib is not recommended for rectal cancer patients who received 5-FU based preoperative CRT. Further studies may identify if gefitinib is beneficial in selected group of patients.

Indexed as

ChemoradiotherapyGefitinibLog term follow-upRectal cancer

Identifiers

PMID29928702
PMCPMC6008630
OpenAlexW2793498516

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.