الفهرس 
Neoadjuvant chemoradiation followed by surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery in locally advanced rectal carcinomas
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Abstract
Introduction:Upfront neoadjuvant chemoradiation followed by surgery and adjuvant chemotherapy is the standard of care for loclly advanced rectal cancers. However this strategy is associated with high rates of distant failure. Neoadjuvant chemotherapy before chemoradiation is investigated aiming for early treatment of micrometastasis and reducing rates of distant failure. Patients and methods: We randomly assigned patients with clinically T3 or T4 or node-positive disease to neoadjuvant chemoradiation with or without induction chemotherapy. Thirty-one patients received upfront chemoradiation followed by surgery and adjuvant chemotherapy (arm I), while 30 patients received induction chemotherapy, followed by concurrent chemoradiation then surgery (arm II). Systemic chemotherapy in both arms consisted of four cycles of XELOX ( xeloda1000 mg/m2 BID, D1-14 and oxaliplatin 130 mg/m2 D1). Concurrent chemotherapy in arm I consisted of 5-FU (325 mg/m2 D1-5 during 1st and last weeks of radiation) and cisplatin(6 mg/m2 during 1st 20 days of radiation). Concurrent chemotherapy in arm II was capcitabine at a dose of 825 mg/m2 BID all through radiation period