Đáp ứng điều trị và tác dụng không mong muốn của hóa chất dẫn đầu kết hợp hóa xạ trị trước mổ ung thư trực tràng giữa - dưới tiến triển

Abstract

This study evaluated treatment response, factors associated with response, and adverse events of total neoadjuvant therapy consisting of induction FOLFIRINOX followed by chemoradiotherapy with capecitabine in patients with locally advanced mid-lower rectal cancer. A longitudinal descriptive study without a control group was conducted on 85 patients treated at Hanoi Medical University Hospital, Military Hospital 103, and K Hospital from January 2019 to December 2025. Mean age was 55.7 ± 10.3 years old and 71.8% were male. Complete endoscopic response was observed in 21.2% of patients, while pathological complete response was achieved in 28.2%. In multivariable analysis, post-treatment endoscopic tumor status was the only factor significantly associated with pCR. FOLFIRINOX-related toxicities were mostly grade I-II. Grade ≥ III toxicities included leukopenia 2.4%, neutropenia 11.7%, thrombocytopenia 1.2%, and anemia 2.4%. Adverse events during concurrent chemoradiotherapy were predominantly grade I–II. These findings suggest that this strategy provides a relatively high pCR rate with acceptable toxicity in clinical practice.