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Short course radiotherapy rectal cancer

Amy Downing, Adam W Glaser, Paul J Finan, Penny Wright, James D Thomas, Alexandra Gilbert, Jessica Corner, Mike Richards, Eva Ja Morris, David Sebag-Montefiore
BACKGROUND: There is a growing population of cancer survivors at risk of treatment-related morbidity. This study investigates how potentially curative rectal cancer treatment influences subsequent function and health-related quality of life (HRQL) using data from a large-scale survey of patient-reported outcomes. METHODS: All individuals 12-36 months post-diagnosis of colorectal cancer in England were sent a survey in January 2013. The survey responses were linked with cancer registration, hospital admissions and radiotherapy data through the National Cancer Registration and Analysis Service...
December 13, 2018: International Journal of Radiation Oncology, Biology, Physics
Ti-Hao Wang, Chia-Jen Liu, Tze-Fan Chao, Tzeng-Ji Chen, Yu-Wen Hu
AIM: To investigate second primary malignancy (SPM) risk after radiotherapy in rectal cancer survivors. METHODS: We used Taiwan's National Health Insurance Research Database to identify rectal cancer patients between 1996 and 2011. Surgery-alone, preoperative short course, preoperative long course, and post-operative radiotherapy groups were defined. The overall and site-specific SPM incidence rates were compared among the radiotherapy groups by multivariate Cox regression, taking chemotherapy and comorbidities into account...
October 28, 2018: World Journal of Gastroenterology: WJG
Roberta Fusco, Mario Sansone, Vincenza Granata, Robert Grimm, Ugo Pace, Paolo Delrio, Fabiana Tatangelo, Gerardo Botti, Antonio Avallone, Biagio Pecori, Antonella Petrillo
PURPOSE: To assess preoperative short-course radiotherapy (SCR) tumor response in locally advanced rectal cancer (LARC) by means of Standardized Index of Shape (SIS) by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) parameters derived from diffusion-weighted MRI (DW-MRI). MATERIALS AND METHODS: Thirty-four patients with LARC who underwent MRI scans before and after SCR followed by delayed surgery, retrospectively, were enrolled...
October 25, 2018: Abdominal Radiology
Anna Gasinska, Beata Biesaga, Anna Janecka Widla, Zbigniew Darasz
BACKGROUND/AIMS: This is a retrospective analysis of 103 patients having locally advanced rectal cancer who received short-course radiotherapy (SCRT). The objective of the study was to check whether a polymorphism in the RAD51 gene (135 G>C), Ku70 protein expression, and tumor microenvironment: proliferation rate measured by BrdUrdLI and Ki-67LI, hypoxia (glucose transporter-1 expression), P53 protein expression, and DNA ploidy can influence DNA repair capacity, the factors contributing to patient overall survival (OS) and the incidence of recurrences and metastases...
October 5, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Yongjun Yu, Yuwei Li, Chen Xu, Zhao Zhang, Xipeng Zhang
BACKGROUND: rectal cancer (RC) is one of the most prevalent malignancies worldwide and different preoperative radiotherapies may lead to different outcomes. This meta-analysis aimed to compare the effectiveness of long-course (LC) and short-course radiotherapy (SC), with or without chemotherapy, for locally advanced rectal cancer. METHODS: studies published up to March 31st 2018 were retrieved from PubMed, Medline, Cochrane and EMABSE. Randomized control or consort control trials that reported the outcomes of short or long course radiotherapy were eligible...
October 4, 2018: Revista Española de Enfermedades Digestivas
Iosief Abraha, Cynthia Aristei, Isabella Palumbo, Marco Lupattelli, Stefano Trastulli, Roberto Cirocchi, Rita De Florio, Vincenzo Valentini
BACKGROUND: This is an update of the original review published in 2007.Carcinoma of the rectum is a common malignancy, especially in high income countries. Local recurrence may occur after surgery alone. Preoperative radiotherapy (PRT) has the potential to reduce the risk of local recurrence and improve outcomes in rectal cancer. OBJECTIVES: To determine the effect of preoperative radiotherapy for people with localised resectable rectal cancer compared to surgery alone...
October 3, 2018: Cochrane Database of Systematic Reviews
R Glynne-Jones, M R Hall, A Lopes, S Pearce, V Goh, S Bosompem, J Bridgewater, I Chau, H Wasan, B Moran, L Melcher, N P West, P Quirke, W-L Wong, S Beare, N Hava, M Duggan, M Harrison
Background: Chemoradiation (CRT) or short-course radiotherapy (SCRT) are standard treatments for locally advanced rectal cancer (LARC). We evaluated the efficacy/safety of two neoadjuvant chemotherapy (NACT) regimens as an alternative prior to total mesorectal excision (TME). Methods/design: This multi-centre, phase II trial in patients with magnetic resonance imaging (MRI) defined high-risk LARC (>cT3b, cN2+ or extramural venous invasion) randomised patients (1:1) to FOLFOX + Bevacizumab (Arm 1) or FOLFOXIRI + bevacizumab (Arm 2) every 14 days for 6 cycles prior to surgery...
September 2018: Heliyon
Bin Ma, Peng Gao, Yongxi Song, Xuanzhang Huang, Hongchi Wang, Qingzhou Xu, Shan Zhao, Zhenning Wang
BACKGROUND: To assess whether preoperative short-course radiotherapy (PSRT) could be the treatment of choice compared to preoperative long-course chemoradiotherapy (PLCRT) METHODS: The PubMed, Embase, and Web of Science Databases were searched to conduct a systematic review and meta-analysis. Perioperative and survival outcomes between PSRT and PLCRT were selected as end points for our meta-analysis. In addition, health-related quality-of-life outcomes were also systematically reviewed between PSRT and PLCRT...
August 11, 2018: Clinical Colorectal Cancer
I Masson, G Delpon, V Vendrely
Intensity-modulated radiation therapy is recommended in anal squamous cell carcinoma treatment and is increasingly used in rectal cancer. It adapts the dose to target volumes, with a high doses gradient. Intensity-modulated radiation therapy allows to reduce toxicity to critical normal structures and to consider dose-escalation studies or systemic treatment intensification. Image-guided radiation therapy is a warrant of quality for intensity-modulated radiation therapy, especially for successful delivery of the dose as planned...
October 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Chris Beekman, Baukelien van Triest, Suzanne van Beek, Jan-Jakob Sonke, Peter Remeijer
PURPOSE: Day-to-day shape variation in the rectum CTV results in considerable geometric uncertainties during rectal cancer radiotherapy. To ensure coverage a large CTV-to-PTV margin is required. The purpose of this study was to increase the accuracy of treatment delivery by building a population based library of planning CTVs for rectal cancer patients and to evaluate its potential for rectum PTV margin and PTV volume reduction. METHODS: Analysis was done retrospectively on 33 early-stage rectal cancer patients with daily repeat CTs who received short-course pre-operative radiotherapy in 5 fractions of 5 Gy...
October 2018: Medical Physics
Simon Gollins, Nicholas West, David Sebag-Montefiore, Shabbir Susnerwala, Stephen Falk, Nick Brown, Mark Saunders, Philip Quirke, Ruby Ray, Philip Parsons, Gareth Griffiths, Tim Maughan, Richard Adams, Chris Hurt
BACKGROUND: Neoadjuvant chemotherapy (NAC) allows earlier treatment of rectal cancer micro-metastases but is not standard of care. There are currently no biomarkers predicting long-term progression-free survival (PFS) benefit from NAC. PATIENTS AND METHODS: In this single arm phase II trial, patients with non-metastatic magnetic resonance imaging (MRI)-defined operable rectal adenocarcinoma at high risk of post-operative metastatic recurrence, received 8 weeks of oxaliplatin/fluorouracil NAC then short-course preoperative radiotherapy (SCPRT) before immediate surgery...
September 2018: British Journal of Cancer
D P Schaap, A Ogura, J Nederend, M Maas, J S Cnossen, G J Creemers, I van Lijnschoten, G A P Nieuwenhuijzen, H J T Rutten, M Kusters
BACKGROUND: Lateral nodal disease in rectal cancer remains a subject of debate and is treated differently in the East and the West. The predictive value of lateral lymph node and MRI-detected extramural vascular invasion (mrEMVI) features on oncological outcomes was assessed in this study. METHODS: In this retrospective cohort study, data on patients with cT3-4 rectal cancer within 8 cm from the anal verge were considered over a 5-year period (2009-2013). Lateral lymph node size, malignant features and mrEMVI features were evaluated and related to oncological outcomes...
August 6, 2018: British Journal of Surgery
Clayton A Smith, Lisa A Kachnic
Locally advanced rectal cancer (LARC) carries higher risks of local and distant recurrence when treated with surgical resection alone. Multiple treatment strategies have been investigated to reduce recurrence risk and improve survival. Currently, there are 3 primary strategies for managing LARC: (1) preoperative long-course radiotherapy (RT) combined with radiosensitizing chemotherapy, which is better tolerated than postoperative chemoradiotherapy and provides tumor downstaging and improved pathologic complete response (pCR), followed by postoperative chemotherapy; (2) preoperative short-course RT alone as an alternative strategy for reducing the risk of local recurrence, followed by adjuvant postoperative chemotherapy; and (3) total neoadjuvant therapy with induction chemotherapy followed by chemoradiotherapy to improve pCR and reduce the difficulty of delivering chemotherapy in the postoperative setting...
July 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Xin Wang, Bobo Zheng, Xinlan Lu, Ruhai Bai, Linlin Feng, Quan Wang, Yan Zhao, Shuixiang He
BACKGROUND AND PURPOSE: The role of preoperative short-course radiotherapy (SCRT) in rectal cancer treatment, when compared to long-course radiochemotherapy (LCRT), is still controversial. Thus the meta-analysis with trial sequential analysis (TSA) was performed to evaluate the long-term survival of SCRT and LCRT as therapeutic regimens for locally advanced rectal cancer. MATERIAL AND METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched up to August 2017 for eligible studies...
2018: PloS One
Daniëlle D Huijts, Julia T van Groningen, Onno R Guicherit, Jan Willem T Dekker, Leti van Bodegom-Vos, Esther Bastiaannet, Johannes A Govaert, Michel W Wouters, Perla J Marang-van de Mheen
Background: It is unclear whether emergency weekend colon and rectal cancer surgery are associated with worse outcomes (ie, weekend effect) because previous studies mostly used administrative data, which may insufficiently adjust for case-mix. Materials and Methods: Prospectively collected data from the 2012-2015 Dutch ColoRectal Audit (n=5,224) was used to examine differences in 30-day mortality and severe complication and failure-to-rescue rates for emergency weekend (Saturday and Sunday) versus Monday surgery, stratified for colon and rectal cancer...
June 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Haoyan Wu, Chao Fang, Libin Huang, Chuanwen Fan, Cun Wang, Lie Yang, Yuan Li, Zongguang Zhou
BACKGROUND: The safety and efficacy of preoperative short-course radiotherapy had been verified in rectal cancer. However, the timing of surgery after radiation had not been well defined. Thus, we performed this meta-analysis to compare the interval time of surgery after short-course radiotherapy in rectal cancer: immediate surgery (<4 weeks) vs delayed surgery (>4 weeks). METHODS: We searched the PubMed, EMBASE, MEDLINE, and Cochrane Library database. The primary endpoints were survival rates and pathological outcomes, and the second endpoints included sphincter preservation rate, R0 resection rate and postoperative complications...
August 2018: International Journal of Surgery
Rogier M P H Crolla, Janneke J C Tersteeg, George P van der Schelling, Jan H Wijsman, Jennifer M J Schreinemakers
BACKGROUND: Radical resection by multivisceral resection of colorectal T4 tumours is important to reduce local recurrence and improve survival. Oncological safety of laparoscopic resection of T4 tumours is controversial. However, robot-assisted resections might have advantages, such as 3D view and greater range of motion of instruments. The aim of this study is to evaluate the initial results of robot-assisted resection of T4 rectal and distal sigmoid tumours. METHODS: This is a cohort study of a prospectively kept database of all robot-assisted rectal and sigmoid resections between 2012 and 2017...
May 16, 2018: Surgical Endoscopy
Nelleke P M Brouwer, Rutger C H Stijns, Valery E P P Lemmens, Iris D Nagtegaal, Regina G H Beets-Tan, Jurgen J Fütterer, Pieter J Tanis, Rob H A Verhoeven, Johannes H W de Wilt
BACKGROUND: This study aims to provide insight in the quality of current daily practice in clinical lymph node staging in colorectal cancer (CRC) in the Netherlands. METHODS: Data of the nationwide population-based Netherlands Cancer Registry between 2003 and 2014 were used to analyze lymph node staging for cM0 CRC patients. Accuracy of clinical lymph node staging was calculated for the period 2011-2014. Analyses were performed for patients without preoperative treatment or treated with short-course radiotherapy (SCRT) followed by resection...
August 2018: European Journal of Surgical Oncology
Alice M Couwenberg, Martijn P W Intven, Johannes P M Burbach, Marleen J Emaus, Wilhelmina M U van Grevenstein, Helena M Verkooijen
BACKGROUND: Organ-sparing approaches, including wait-and-see and local excision, are increasingly being offered to patients with rectal cancer following a good response to neoadjuvant therapy. Preferences regarding these treatment strategies are yet unknown. OBJECTIVE: This study aimed to determine the preferences and utility scores for rectal cancer treatment approaches. DESIGN: This is a cross-sectional study. SETTING: This study was conducted at the Radiation-Oncology Department of the University Medical Center Utrecht...
August 2018: Diseases of the Colon and Rectum
Przemysław Wawok, Wojciech Polkowski, Piotr Richter, Marek Szczepkowski, Janusz Olędzki, Ryszard Wierzbicki, Tomasz Gach, Andrzej Rutkowski, Adam Dziki, Leszek Kołodziejski, Rafał Sopyło, Lucyna Pietrzak, Jacek Kryński, Katarzyna Wiśniowska, Mateusz Spałek, Konrad Pawlewicz, Marcin Polkowski, Teresa Kowalska, Krzysztof Paprota, Małgorzata Jankiewicz, Andrzej Radkowski, Justyna Chalubińska-Fendler, Wojciech Michalski, Krzysztof Bujko
BACKGROUND AND PURPOSE: It is uncertain whether local control is acceptable after preoperative radiotherapy and local excision (LE). An optimal preoperative dose/fractionation schedule has not yet been established. MATERIAL AND METHODS: In a phase III study, patients with cT1-2N0M0 or borderline cT2/T3N0M0 < 4 cm rectal adenocarcinomas were randomised to receive either 5 × 5 Gy plus 1 × 4 Gy boost or chemoradiation: 50.4 Gy in 28 fractions plus 3 × 1...
June 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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