[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-436520-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-436520-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","the-impact-of-adding-mitomycin-c-to-radiotherapy-plus-oral-tegafur-uracil-on-advanced-stage-rectal-cancer-letter-to-the-editor","The impact of adding mitomycin-C to radiotherapy plus oral tegafur-uracil on advanced-stage rectal cancer - Letter to the Editor","","Letter to the editor analyzing a study on neoadjuvant concurrent chemoradiotherapy (CCRT) for advanced-stage rectal cancer with added mitomycin-C (MMC) and oral tegafur-uracil. The authors discuss down-staging outcomes, noting that although statistical significance was not reached, associations with disease-free survival (DFS) and overall survival (OS) were reported, alongside increased low-grade adverse events (AEs). The letter questions the supporting data for recommendations on older patients and impaired bone marrow function, probes unclear drivers of down-staging, and highlights confusion created by anastomosis leak rate differences and similar recurrence patterns.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/the-impact-of-adding-mitomycin-c-to-radiotherapy-plus-oral-tegafur-uracil-on-advanced-stage-rectal-cancer-letter-to-the-editor/436520/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/the-impact-of-adding-mitomycin-c-to-radiotherapy-plus-oral-tegafur-uracil-on-advanced-stage-rectal-cancer-letter-to-the-editor/436520.png","ImageObject",300,407,{"name":42,"@type":43},"Damian","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-04","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the main purpose of adding mitomycin-C to standard neoadjuvant CCRT in the referenced study?","Question",{"text":63,"@type":64},"The study aimed to assess the feasibility and effectiveness of adding MMC to standard neoadjuvant concurrent chemoradiation combined with radiotherapy and oral tegafur-uracil, focusing on tumor response and survival outcomes (DFS/OS) as well as adverse events.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why do the letter authors question the recommendation about using MMC-CCRT with caution?",{"text":68,"@type":64},"They state that the article does not provide data supporting the recommendation for older patients or those with impaired bone marrow function, and it also lacks a defined cutoff value and identification criteria for these groups.",{"name":70,"@type":61,"acceptedAnswer":71},"What findings raised confusion about the benefit of MMC added to CCRT?",{"text":72,"@type":64},"The letter notes that down-staging was not statistically significant compared with CCRT alone, and that radiation dose and treatment interval were also not significant; additionally, the anastomosis leak rate was higher in the CCRT group while recurrence rates seemed similar, suggesting limited additional benefit of MMC for recurrence reduction.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},436520,1791093261,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":30,"preview_page_count":4},137451208677,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","J Chin MedAssoc  \nLETTER TO THE EDITOR  \nThe impact of adding mitomycin-C to radiotherapy plus oral tegafur-uracil on advanced-stage rectal cancer  \nYiu-Tai Lia, Wen-Hsun Changb,c,d,*  \naDepartment of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan, ROC; bDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; cInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; dDepartment of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC  \nDear Editor,  \nWe read the recent publication in the Journal of the Chinese Medical Association entitled “The effect of Mitomycin-C in neoadjuvant concurrent chemoradiotherapy for rectal cancer.” with an interest.1 The authors attempted to evaluate the feasibility and effectiveness of the additional use of mitomycin-C (MMC) in the standard neoadjuvant concurrent chemoradiation (CCRT) with a combination of radiotherapy and oral tegafururacil.1 Their primary and secondary aims were tumor response and either disease-free survival (DFS) or overall survival (OS) rates and adverse events (AEs) .1 The authors found that MMC + CCRT group had down-staged the advanced rectal cancer with an odds ratio (OR) of 1.52 (95% confidence interval [CI], 0.99-2.35).1 Although the aforementioned finding did not reach statistical significance, the authors found down-stage was associated with favorable DFS (OR, 2 .2; 95% CI, 1.53-3. 1) and OS rates (OR, 1.73; 95% CI, 1.23-2.43) .1 However, based on an increased low-grade AEs in MMC-CCRT group, the authors recommended that MMC-CCRT treatment should be used with caution in older patients and those with impaired bone marrow function. We applauded their success.  \nWe totally agreed that aged patients and patients with impaired bone marrow function may be at increased risk of poor compliance during the treatment; however, this concept may not be limited to cancer treatment, but also can be applicable to all other chronically ill patients.2–5 We did not find any data in the current article to support the authors’ recommendation. Moreover, the authors did not mention the cutoff value to define the aged population or provide information about what’s the criteria for identification of impaired bone marrow function.  \nSince MMC-CCRT treatment did not reach the statistically significant difference to result in a down-staging effect for  \nadvanced-stage rectal cancer compared with CCRT treatment alone, and radiation dose and the interval between completing CCRT and surgery also failed to reach the statistically significant difference for the down-staging effect, we are wondering to know which factor was really associated with down-staging effect in their study.  \nFinally, it is interesting to find that the anastomosis leak rate was statistically significantly increased in the CCRT group compared to MMC-CCRT. Additionally, failure rates (recurrence rates) seemed to be similar between the MMC-CCRT and CCRT groups. If the recurrence rate was similar between both groups, it can be easily expected that MMC-CCRT did not provide any additional benefit in the reduction of recurrence. All make the audience confused about the role of adding MMC to CCRT for the treatment of advanced-stage rectal cancer.  \nThe aforementioned questions do not influence the authors’excellent works. We would like to thank the authors’ favorable responses.  \nREFERENCES  \n1. Wang LW, Liu YS, Jiang JK. The effect of mitomycin-C in neoadjuvant concurrent chemoradiotherapy for rectal cancer. J Chin Med Assoc 2022;85:1120–5 .  \n2. Wang PH, Yang ST, Liu CH, Chang WH, Lee FK, Lee WL. Endometrial cancer: Part I. Basic concept. Taiwan J Obstet Gynecol 2022;61:951–9 .  \n3. Chang WH, Liu CH. Different genders should be considered for the extraglycemic benefits of oral antidiabetic drugs. J Chin Med Assoc 2022;85:959 .  \n4. Lee WL, Wang PH, Yang ST, Liu CH, Chang WH, Lee FK. To do one and to get more: Part I. Diabetes and ","cbCaijGyWvriMx1B","https://ap.wps.com/l/cbCaijGyWvriMx1B","pdf",283386,"English","# Letter to the Editor\n## Study summary and reported findings\n## Concerns about patient risk recommendations and missing criteria\n## Questions about factors driving down-staging\n## Recurrence and anastomosis leak rate observations\n## Closing remarks and references","[{\"question\":\"What was the main purpose of adding mitomycin-C to standard neoadjuvant CCRT in the referenced study?\",\"answer\":\"The study aimed to assess the feasibility and effectiveness of adding MMC to standard neoadjuvant concurrent chemoradiation combined with radiotherapy and oral tegafur-uracil, focusing on tumor response and survival outcomes (DFS/OS) as well as adverse events.\"},{\"question\":\"Why do the letter authors question the recommendation about using MMC-CCRT with caution?\",\"answer\":\"They state that the article does not provide data supporting the recommendation for older patients or those with impaired bone marrow function, and it also lacks a defined cutoff value and identification criteria for these groups.\"},{\"question\":\"What findings raised confusion about the benefit of MMC added to CCRT?\",\"answer\":\"The letter notes that down-staging was not statistically significant compared with CCRT alone, and that radiation dose and treatment interval were also not significant; additionally, the anastomosis leak rate was higher in the CCRT group while recurrence rates seemed similar, suggesting limited additional benefit of MMC for recurrence reduction.\"}]","The impact of adding mitomycin-C to radiotherapy plus oral tegafur-uracil on advanced-stage rectal cancer - Letter to the Editor | PDF",1790678258]