A phase II study of oxaliplatin with 5-FU/folinic acid and concomitant radiotherapy as a preoperative treatment in patients with locally advanced rectal cancer

Objective: To evaluate the activity and safety of adding oxaliplatin to a standard chemoradiotherapy schema, including 5-fluorouracil (5-FU)/folinic acid (FA), in locally-advanced rectal cancer (LARC). Methods: Two cycles of oxaliplatin 130 mg/m2 plus FA 20 mg/m2 bolus for 5 days and 5-FU 350 mg/m2 continuous infusion for 5 days were given during week 1 and 4 of pelvic radiotherapy 46 Gy. Patients with a T3/4 and/or node-positive rectal tumour were eligible. Surgery was performed 4–6 weeks after radiotherapy. The primary endpoint was to determine the rate of pathological response. Secondary endpoints were to assess the rate of clinical response and the safety profile. Results: Between March 2005 and January 2009, a total of 35 patients were enrolled. The pathological downstaging rate was 79% with a pathological complete response rate of 17%. The overall clinical response rate (assessed by computed tomography or transrectal ultrasound) was 77%. Grade 3 diarrhoea and Grade 3 neutropaenia were reported in 14% and 11% of the patients, respectively. Eleven patients did not undergo surgery: four of them refused the operation, and seven patients were inoperable due to disease progression. In 24 patients who had surgery, a sphincter-preserving procedure could be performed in 29%. At the median follow-up time of 28.1 months, 25 patients (71%) survived with no evidence of disease. Conclusion: The promising results in terms of pathological response, and the associated good safety profile of a regimen of oxaliplatin plus 5-FU/FA with concomitant radiotherapy, suggest that the regimen could be used in LARC.

Vibriocidal antibody and antibodies to Vibrio cholerae lipopolysaccharide, cell-bound haemagglutinin and toxin in Thai population.

Vibriocidal antibody and antibodies to Vibrio cholerae lipopolysaccharide (anti-LPS), cell-bound haemagglutinin (anti-CHA) and toxin (anti-CT) were determined in Thai individuals of various age groups who lived in areas with high (H) and low (L) cholera endemicity. The enzyme-linked immunosorbent assay (ELISA) was performed to detect levels of class specific anti-LPS, anti-CHA and anti-CT. It was found that Thai individuals acquired the vibriocidal antibody early in life. Fifty percent of individuals aged 5 to 15 years old had detectable titre while more than 80% of adults had titres ranged from 1:5 to 1:125 or higher. Thai adults who lived in area with high cholera endemicity had significantly higher vibriocidal antibody levels than their counterparts who lived in area with low cholera endemicity. Lipopolysaccharide was not the only antigen responsible for stimulating the vibriocidal antibody production. Adult levels of all classes of anti-CHA from L were higher than those of H while the anti-LPS in the forms of total immunoglobulins, IgG and IgA were similar but IgM of L was higher than that of H. The levels of all classes of anti-CT from H seemed to increase with age except at the school age (5 years to 15 years old) when there were marked decreases of all antibody classes. Total immunoglobulin and IgM anti-CT at adult age of H and L were not different, although IgG anti-CT of L was higher than that of H and IgA anti-CT of H was higher than that of L.