Chemoradiation with capecitabine followed by surgery is standard care for locally advanced rectal cancer (LARC). Severe diarrhea is considered a dose-limiting toxicity of adding capecitabine to radiation therapy. The aim of this study was to describe the risk factors and the impact of body composition on severe diarrhea in patients with LARC during preoperative chemoradiation with capecitabine. A single centre retrospective cohort study was conducted in a tertiary referral centre. All patients treated with preoperative chemoradiation with capecitabine for LARC from 2009 to 2015 were included. Patients with locally recurrent rectal cancer who received chemoradiation for the first time were included as well. Logistic regression analyses were performed to identify risk factors for severe diarrhea. A total of 746 patients were included. Median age was 64 years (interquartile range 57–71) and 477 patients (64%) were male. All patients received a radiation dosage of 25 × 2 Gy during a period of five weeks with either concomitant capecitabine administered on radiation days or continuously during radiotherapy. In this cohort 70 patients (9%) developed severe diarrhea. In multivariable logistic regression analyses female sex (OR: 4.42, 95% CI 2.54–7.91) and age ≥ 65 (OR: 3.25, 95% CI 1.85–5.87) were the only risk factors for severe diarrhea. Female patients and patients aged sixty-five or older had an increased risk of developing severe diarrhea during preoperative chemoradiation therapy with capecitabine. No relation was found between body composition and severe diarrhea.

中文翻译：

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直肠癌术前卡培他滨放化疗患者身体成分与严重腹泻的关系：一项单中心队列研究

卡培他滨放化疗后手术是局部晚期直肠癌 (LARC) 的标准治疗。严重腹泻被认为是在放射治疗中加入卡培他滨的剂量限制性毒性。本研究的目的是描述 LARC 患者术前卡培他滨放化疗期间的危险因素和身体成分对严重腹泻的影响。在三级转诊中心进行了一项单中心回顾性队列研究。纳入了 2009 年至 2015 年接受卡培他滨治疗 LARC 的所有术前放化疗患者。首次接受放化疗的局部复发直肠癌患者也包括在内。进行逻辑回归分析以确定严重腹泻的危险因素。共纳入 746 名患者。中位年龄为 64 岁（四分位距为 57-71），477 名患者（64%）为男性。所有患者在 5 周内接受了 25 × 2 Gy 的辐射剂量，同时在辐射日或在放疗期间连续使用卡培他滨。在该队列中，70 名患者 (9%) 出现严重腹泻。在多变量逻辑回归分析中，女性 (OR: 4.42, 95% CI 2.54–7.91) 和年龄≥ 65 (OR: 3.25, 95% CI 1.85–5.87) 是严重腹泻的唯一危险因素。女性患者和 65 岁或以上患者在术前卡培他滨放化疗期间发生严重腹泻的风险增加。未发现身体成分与严重腹泻之间存在关联。所有患者在 5 周内接受了 25 × 2 Gy 的辐射剂量，同时在辐射日或在放疗期间连续使用卡培他滨。在该队列中，70 名患者 (9%) 出现严重腹泻。在多变量逻辑回归分析中，女性 (OR: 4.42, 95% CI 2.54–7.91) 和年龄≥ 65 (OR: 3.25, 95% CI 1.85–5.87) 是严重腹泻的唯一危险因素。女性患者和 65 岁或以上患者在术前卡培他滨放化疗期间发生严重腹泻的风险增加。未发现身体成分与严重腹泻之间存在关联。所有患者在 5 周内接受了 25 × 2 Gy 的辐射剂量，同时在辐射日或在放疗期间连续使用卡培他滨。在该队列中，70 名患者 (9%) 出现严重腹泻。在多变量逻辑回归分析中，女性 (OR: 4.42, 95% CI 2.54–7.91) 和年龄≥ 65 (OR: 3.25, 95% CI 1.85–5.87) 是严重腹泻的唯一危险因素。女性患者和 65 岁或以上患者在术前卡培他滨放化疗期间发生严重腹泻的风险增加。未发现身体成分与严重腹泻之间存在关联。在该队列中，70 名患者 (9%) 出现严重腹泻。在多变量逻辑回归分析中，女性 (OR: 4.42, 95% CI 2.54–7.91) 和年龄≥ 65 (OR: 3.25, 95% CI 1.85–5.87) 是严重腹泻的唯一危险因素。女性患者和 65 岁或以上患者在术前卡培他滨放化疗期间发生严重腹泻的风险增加。未发现身体成分与严重腹泻之间存在关联。在该队列中，70 名患者 (9%) 出现严重腹泻。在多变量逻辑回归分析中，女性 (OR: 4.42, 95% CI 2.54–7.91) 和年龄≥ 65 (OR: 3.25, 95% CI 1.85–5.87) 是严重腹泻的唯一危险因素。女性患者和 65 岁或以上患者在术前卡培他滨放化疗期间发生严重腹泻的风险增加。未发现身体成分与严重腹泻之间存在关联。