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Rectal Cancer and complete response

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https://www.readbyqxmd.com/read/28727901/carbon-ion-radiotherapy-for-isolated-para-aortic-lymph-node-recurrence-from-colorectal-cancer
#1
Yuka Isozaki, Shigeru Yamada, Shohei Kawashiro, Shigeo Yasuda, Naomi Okada, Daniel Ebner, Hiroshi Tsuji, Tadashi Kamada, Hisahiro Matsubara
BACKGROUND: The safety and effectiveness of carbon-ion radiotherapy (CIRT) for isolated para-aortic lymph node (PALN) metastasis was evaluated retrospectively. METHODS: CIRT for isolated PALN metastasis from CRC was performed in 34 cases from June 2006 to August 2015 in our institute. A median dose of 52.8 Gy(RBE) (range, 48-52.8 Gy(RBE)) was delivered with a median daily dose of 4.4 Gy(RBE) (range, 4.0-4.4 Gy(RBE)). RESULTS: The median follow-up duration for all patients was 24...
July 20, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28717704/significance-of-magnetic-resonance-imaging-assessed-tumor-response-for-locally-advanced-rectal-cancer-treated-with-preoperative-long-course-chemoradiation
#2
Mohamed Salah Fayaz, Gerges Attia Demian, Wael Moftah Fathallah, Heba El-Sayed Eissa, Mustafa Shawki El-Sherify, Sadeq Abozlouf, Thomas George, Suzanne Mona Samir
PURPOSE: To study the predictive and prognostic value of magnetic resonance imaging (MRI)-assessed tumor response after long-course neoadjuvant therapy for locally advanced rectal cancer. METHODS: This study included 79 patients who had T3 or T4 and/or N+ rectal cancer treated with long-course neoadjuvant chemoradiation. MRI-assessed tumor regression grade (mrTRG) was assessed in 64 patients. MRIs were reviewed by the study radiologist. Surgical and pathologic reports for those who underwent surgery were reviewed...
August 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28711936/a-nomogram-predicting-pathological-complete-response-to-neoadjuvant-chemoradiotherapy-for-locally-advanced-rectal-cancer-implications-for-organ-preservation-strategies
#3
Yanwu Sun, Pan Chi, Huiming Lin, Xingrong Lu, Ying Huang, Zongbin Xu, Shenghui Huang, Xiaojie Wang
PURPOSE: To determine predictors of pathological complete response (pCR) in locally advanced rectal cancer patients treated with neoadjuvant chemoradiotherapy (nCRT), and develop a predictive nomogram. METHODS: A total of 522 locally advanced rectal cancer patients undergoing nCRT and curative resection between 2008 and 2014 were included. Uni- and multivariate analysis was performed to identify predictors of pCR. A nomogram was developed and validated by internal (n=425) and external validation (n=97)...
June 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28698447/-a-case-of-perianal-squamous-cell-carcinoma-with-left-inguinal-lymph-node-metastasis-that-showed-a-complete-response-more-than-five-years-after-chemotherapy-and-concomitant-proton-beam-therapy
#4
Nobuyasu Suzuki, Ayaka Azami, Yukitoshi Todate, Takeshi Tada, Mitsuru Waragai, Michitaka Honda, Atai Sato, Yoshinao Takano, Tsuyoshi Abe, Tatsuya Nakamura, Yasushi Teranishi
We report a case of perianal squamous cell carcinoma and left inguinal lymph node metastasis that showed a complete response more than 5 years after chemotherapy and concomitant proton beam therapy. A 34-year-old woman was referred to our hospital for an anal tumor and a left inguinal tumor. A digital rectal examination revealed a tumor in the anterior wall of the anal canal. In addition, the left inguinal lymph nodes were swollen, leading us to suspect metastases. Biopsy specimens confirmed poorly differentiated squamous cell carcinoma...
June 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28685354/a-multicenter-phase-2-study-on-the-feasibility-and-efficacy-of-neoadjuvant-chemotherapy-without-radiotherapy-for-locally-advanced-rectal-cancer
#5
Suguru Hasegawa, Saori Goto, Takuya Matsumoto, Koya Hida, Kenji Kawada, Ryo Matsusue, Takashi Yamaguchi, Ryuta Nishitai, Dai Manaka, Shigeru Kato, Yoshio Kadokawa, Satoshi Yamanokuchi, Junichiro Kawamura, Masazumi Zaima, Takahisa Kyogoku, Akiyoshi Kanazawa, Yukiko Mori, Masashi Kanai, Shigemi Matsumoto, Yoshiharu Sakai
BACKGROUND: This prospective multicenter phase 2 study aimed to evaluate the feasibility and efficacy of neoadjuvant chemotherapy (NAC) without radiotherapy for locally advanced rectal cancer (LARC). METHODS: Patients with LARC (cStage II and III) were included in the study. Those with cT4b tumor were excluded. Six cycles of modified FOLFOX6 (mFOLFOX6) plus either bevacizumab or cetuximab, depending on KRAS status, were administered before surgery. The primary end point of the study was the R0 resection rate...
July 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28676107/study-protocol-multi-parametric-magnetic-resonance-imaging-for-therapeutic-response-prediction-in-rectal-cancer
#6
Trang Thanh Pham, Gary Liney, Karen Wong, Robba Rai, Mark Lee, Daniel Moses, Christopher Henderson, Michael Lin, Joo-Shik Shin, Michael Bernard Barton
BACKGROUND: Response to neoadjuvant chemoradiotherapy (CRT) of rectal cancer is variable. Accurate imaging for prediction and early assessment of response would enable appropriate stratification of management to reduce treatment morbidity and improve therapeutic outcomes. Use of either diffusion weighted imaging (DWI) or dynamic contrast enhanced (DCE) imaging alone currently lacks sufficient sensitivity and specificity for clinical use to guide individualized treatment in rectal cancer...
July 4, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28675024/are-we-predicting-disease-progress-of-the-rectal-cancer-patients-without-surgery-after-neoadjuvant-chemoradiotherapy
#7
Bo Young Oh, Jung Wook Huh, Woo Yong Lee, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Ho-Kyung Chun
Purpose: There are patients who do not undergo surgery, regardless of tumor response for neoadjuvant chemoradiotherapy (nCRT) in rectal cancer. However, there have been few reports focused on how oncologic outcomes are worse in these patients. We sought to investigate oncologic outcomes for these non-operated patients with rectal cancer after nCRT. Materials and Methods: A total of 1,063 records of patients with rectal cancer who were treated with nCRT from January 2002 to December 2013 were retrospectively reviewed...
July 3, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28655076/-diagnosis-and-treatment-strategy-for-clinical-complete-responders-after-chemoradiotherapy-for-rectal-cancer-is-watch-and-wait-policy-safe
#8
H W Yao, Y H Liu
Neo-adjuvant chemoradiotherapy (NACRT) combined with total mesorectal excision (TME) surgery is the main treatment for locally advanced middle-low rectal cancer, and NACRT significantly improves the local control rate of rectal cancer. According to the current guidelines, patients who receive clinical complete response (cCR) after NACRT are recommended for treatment with TME surgery. A few studies have shown that the watch-and-wait (WAW) policy is safe and could ensure anorectal function and quality of life in patients with cCR...
July 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28643307/-application-of-magnetic-resonance-in-non-operative-treatment-strategy-for-rectal-cancer
#9
Yi Wang, Gong Chen
The primary curative modality for localized rectal cancer is total mesorectal excision (TME). Local control rate of rectal cancer has been improved after neoadjuvant chemoradiotherapy and even pathological complete response (pCR) has been demonstrated in a significant minority. Patients who achieve pCR to neoadjuvant chemoradiotherapy have an excellent prognosis compared with those without pCR. If the patients with complete response to neoadjuvant chemoradiation can be demonstrated by clinical findings and medical imaging (cCR), a non-operative management (NOM) strategy may be pursued to preserve sphincter function and avoid complications induced by TME, which is a new tendency in the treatment of rectal cancer in recent years...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28641310/potentiating-the-effects-of-radiotherapy-in-rectal-cancer-the-role-of-aspirin-statins-and-metformin-as-adjuncts-to-therapy
#10
K J Gash, A C Chambers, D E Cotton, A C Williams, M G Thomas
BACKGROUND: Complete tumour response (pCR) to neo-adjuvant chemo-radiotherapy for rectal cancer is associated with a reduction in local recurrence and improved disease-free and overall survival, but is achieved in only 20-30% of patients. Drug repurposing for anti-cancer treatments is gaining momentum, but the potential of such drugs as adjuncts, to increase tumour response to chemo-radiotherapy in rectal cancer, is only just beginning to be recognised. METHODS: A systematic literature search was conducted and all studies investigating the use of drugs to enhance response to neo-adjuvant radiation in rectal cancer were included...
July 11, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28639302/prospective-validation-of-pathologic-complete-response-models-in-rectal-cancer-transferability-and-reproducibility
#11
Johan van Soest, Elisa Meldolesi, Ruud van Stiphout, Roberto Gatta, Andrea Damiani, Vincenzo Valentini, Philippe Lambin, Andre Dekker
PURPOSE: Multiple models have been developed to predict pathologic complete response (pCR) in locally advanced rectal cancer patients. Unfortunately, validation of these models normally omit the implications of cohort differences on prediction model performance. In this work, we will perform a prospective validation of three pCR models, including information whether this validation will target transferability or reproducibility (cohort differences) of the given models. METHODS: We applied a novel methodology, the cohort differences model, to predict whether a patient belongs to the training or to the validation cohort...
June 22, 2017: Medical Physics
https://www.readbyqxmd.com/read/28638791/magnetic-resonance-imaging-for-diagnosis-and-neoadjuvant-treatment-evaluation-in-locally-advanced-rectal-cancer-a-pictorial-review
#12
REVIEW
Gulgun Engin, Rasul Sharifov
High-resolution pelvic magnetic resonance imaging (MRI) is the primary method for staging rectal cancer. MRI is highly accurate in the primary staging of rectal cancer; however, it has not proven to be effective in re-staging, especially in complete response evaluation after neoadjuvant therapy. Neoadjuvant chemoradiotherapy produces many changes in rectal tumors and on adjacent area, as a result, local tumor extent may not be accurately determined. However, adding diffusion-weighted sequences to the standard approach can improve diagnostic accuracy...
June 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28627602/molecular-profiling-of-locally-advanced-rectal-adenocarcinoma-using-microrna-expression-review
#13
Cory Pettit, Steve Walston, Patrick Wald, Amy Webb, Terence M Williams
Treatment for locally-advanced rectal cancer (LARC) typically consists of neoadjuvant chemoradiation followed by total mesorectal excision. Recently, there has been growing interest in non-operative management for patients who are medically-inoperable or wish to avoid surgical morbidity and permanent colostomy. Approximately 50% of patients who receive pre-operative neoadjuvant chemoradiation develop some degree of pathologic response. Approximately 10-20% of patients are found to have a complete pathologic response, a finding which has frequently been shown to predict better clinical outcomes, including local-regional control, distant metastasis and survival...
June 14, 2017: International Journal of Oncology
https://www.readbyqxmd.com/read/28621318/natural-killer-like-signature-observed-post-therapy-in-locally-advanced-rectal-cancer-is-a-determinant-of-pathological-response-and-improved-survival
#14
Matthew Alderdice, Philip D Dunne, Aidan J Cole, Paul G O'Reilly, Darragh G McArt, Vicky Bingham, Marc-Aurel Fuchs, Stephen McQuaid, Maurice B Loughrey, Graeme I Murray, Leslie M Samuel, Mark Lawler, Richard H Wilson, Manuel Salto-Tellez, Vicky M Coyle
Around 12-15% of patients with locally advanced rectal cancer undergo a pathologically complete response (tumor regression grade 4) to long-course preoperative chemoradiotherapy; the remainder exhibit a spectrum of tumor regression (tumor regression grade 1-3). Understanding therapy-related transcriptional alterations may enable better prediction of response as measured by progression-free and overall survival, in addition to aiding the development of improved strategies based on the underlying biology of the disease...
June 16, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28620444/clinical-utility-of-pretreatment-prediction-of-chemoradiotherapy-response-in-rectal-cancer-a-review
#15
REVIEW
Byong Chul Yoo, Seung-Gu Yeo
Approximately 20% of all patients with locally advanced rectal cancer experience pathologically complete responses following neoadjuvant chemoradiotherapy (CRT) and standard surgery. The utility of radical surgery for patients exhibiting good CRT responses has been challenged. Organ-sparing strategies for selected patients exhibiting complete clinical responses include local excision or no immediate surgery. The subjects of this tailored management are patients whose presenting disease corresponds to current indications of neoadjuvant CRT, and their post-CRT tumor response is assessed by clinical and radiological examinations...
March 2017: EPMA Journal
https://www.readbyqxmd.com/read/28601342/organ-preservation-for-rectal-cancer-greccar-2-a-prospective-randomised-open-label-multicentre-phase-3-trial
#16
Eric Rullier, Philippe Rouanet, Jean-Jacques Tuech, Alain Valverde, Bernard Lelong, Michel Rivoire, Jean-Luc Faucheron, Mehrdad Jafari, Guillaume Portier, Bernard Meunier, Igor Sileznieff, Michel Prudhomme, Frédéric Marchal, Marc Pocard, Denis Pezet, Anne Rullier, Véronique Vendrely, Quentin Denost, Julien Asselineau, Adélaïde Doussau
BACKGROUND: Organ preservation is a concept proposed for patients with rectal cancer after a good clinical response to neoadjuvant chemotherapy, to potentially avoid morbidity and side-effects of rectal excision. The objective of this study was to compare local excision and total mesorectal excision in patients with a good response after chemoradiotherapy for lower rectal cancer. METHODS: We did a prospective, randomised, open-label, multicentre, phase 3 trial at 15 tertiary centres in France that were experts in the treatment of rectal cancer...
June 7, 2017: Lancet
https://www.readbyqxmd.com/read/28594714/tailored-treatment-strategy-for-locally-advanced-rectal-carcinoma-based-on-the-tumor-response-to-induction-chemotherapy-preliminary-results-of-the-french-phase-ii-multicenter-greccar4-trial
#17
Philippe Rouanet, Eric Rullier, Bernard Lelong, Philippe Maingon, Jean-Jacques Tuech, Denis Pezet, Florence Castan, Stéphanie Nougaret
BACKGROUND: Preoperative radiochemotherapy and total mesorectal excision are the standard-of-care for locally advanced rectal carcinoma, but some patients could be over- or undertreated. OBJECTIVE: This study aimed to assess the feasibility of radiochemotherapy tailored based on the tumor response to induction chemotherapy (FOLFIRINOX) to obtain a minimum R0 resection rate of 90% in the 4 arms of the study. DESIGN: This study is a multicenter randomized trial (NCT01333709)...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28583790/transanal-endoscopic-microsurgery-after-neoadjuvant-radiochemotherapy-for-locally-advanced-extraperitoneal-rectal-cancer
#18
G Rizzo, G Zaccone, M Magnocavallo, C Mattana, D P Pafundi, M A Gambacorta, V Valentini, C Coco
PURPOSE: The aim of this study is to provide a prospective analysis of post-operative and oncological outcomes in patients affected by locally advanced rectal cancer (LARC), who obtained a major/complete clinical response after pre-operative radio-chemotherapy (RCT) and were treated with local excision (LE) by trans-anal endoscopic microsurgery (TEM) to confirm a pathological complete response (pCR) after to neo-adjuvant RCT. METHODS: All patients with LARC treated by pre-operative RCT and full-thickness LE by TEM (2000-2014) were included in the study...
May 25, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28583726/results-of-short-term-radiotherapy-followed-by-radical-surgery-for-rectal-cancer-a-long-term-unicenter-observational-study
#19
Yolanda Saralegui, José M Enríquez-Navascués, Juan Pablo Ciria, Mikel Osorio, Adelaida Lacasta, Garazi Elorza, Maddi Garmendia, Carlos Placer
INTRODUCTION: Short-term radiotherapy (STR) for rectal cancer (RC) has rarely been used in Spain. The aim of the present study is to describe oncological results after RTC and surgery for RC. METHODS: This is a retrospective analysis of a consecutive series of patients treated with STR and surgery for RC (1999-2012). Epidemiological data, staging, complications of STR, STR-surgery interval, surgical approach, rate of anastomotic/perineal wound dehiscence, and pathological data (regression degree and staging) were collected...
May 2017: Cirugía Española
https://www.readbyqxmd.com/read/28576182/evolving-role-of-radiotherapy-in-the-management-of-rectal-carcinoma
#20
REVIEW
Clayton A Smith, Lisa A Kachnic
Management of locally advanced rectal cancer has evolved over time from surgical resection alone to multimodality therapy with preoperative radiation, chemotherapy, and total mesorectal excision resulting in excellent local control rates. Refinements in neoadjuvant therapies and their sequencing have improved pathologic complete response rates such that consideration of selective radiation and nonoperative management are now active clinical trial questions. Advances in radiation treatment planning and delivery techniques may allow for further reduction in acute treatment-related toxicity in select patient populations...
July 2017: Surgical Oncology Clinics of North America
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