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neoadjuvant chemoradiotherapy

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https://www.readbyqxmd.com/read/28217301/risk-factors-for-perineal-wound-infection-after-abdominoperineal-resection-of-advanced-lower-rectal-cancer
#1
Takatoshi Nakamura, Takeo Sato, Kazushige Hayakawa, Yoko Takayama, Masanori Naito, Takahiro Yamanashi, Atsuko Tsutsui, Hirohisa Miura, Masahiko Watanabe
PURPOSE: Abdominoperineal resection (APR) of advanced lower rectal cancer carries a high incidence of perineal wound infection. The aim of this study was to retrospectively evaluate risk factors for perineal wound infection after APR. METHODS: The study group comprised 154 patients who underwent APR for advanced lower rectal cancer in our department from January 1990 through December 2012. The following 15 variables were studied as potential risk factors for perineal wound infection: sex, age, body-mass index, American Society of Anesthesiologists score, diabetes mellitus, preoperative albumin level, preoperative hemoglobin level, neoadjuvant chemoradiotherapy(NCRT), surgical procedure (open surgery vs...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28214653/neoadjuvant-chemotherapy-followed-by-concurrent-chemoradiotherapy-versus-concurrent-chemoradiotherapy-alone-in-locoregionally-advanced-nasopharyngeal-carcinoma-a-phase-iii-multicentre-randomised-controlled-trial
#2
Su-Mei Cao, Qi Yang, Ling Guo, Hai-Qiang Mai, Hao-Yuan Mo, Ka-Jia Cao, Chao-Nan Qian, Chong Zhao, Yan-Qun Xiang, Xiu-Ping Zhang, Zhi-Xiong Lin, Wei-Xiong Li, Qing Liu, Fang Qiu, Rui Sun, Qiu-Yan Chen, Pei-Yu Huang, Dong-Hua Luo, Yi-Jun Hua, Yi-Shan Wu, Xing Lv, Lin Wang, Wei-Xiong Xia, Lin-Quan Tang, Yan-Fang Ye, Ming-Yuan Chen, Xiang Guo, Ming-Huang Hong
BACKGROUND: The role of neoadjuvant chemotherapy (NACT) for locoregionally advanced nasopharyngeal carcinoma (NPC) is unclear. We aimed to evaluate the feasibility and efficacy of NACT followed by concurrent chemoradiotherapy (CCRT) versus CCRT alone in locoregionally advanced NPC. METHODS: Patients with stage III-IVB (excluding T3N0-1) NPC were randomly assigned to receive NACT followed by CCRT (investigational arm) or CCRT alone (control arm). Both arms were treated with 80 mg/m(2) cisplatin every 3 weeks concurrently with radiotherapy...
February 16, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28213876/update-on-neoadjuvant-regimens-for-patients-with-operable-oesophageal-gastrooesophageal-junction-adenocarcinomas-and-squamous-cell-carcinomas
#3
REVIEW
Samantha J Cox, Sean M O'Cathail, Bernadette Coles, Tom Crosby, Somnath Mukherjee
Survival outcomes following multimodal treatment of operable oesophageal and gastrooesophageal cancer remain disappointingly poor. Although an appreciation of the impact of both tumour location and histological subtype is now shaping the design of clinical trials, there has been a lack of consensus of the optimal neoadjuvant treatment strategy. This update article will review recent advances in the use of both neoadjuvant chemotherapy and chemoradiotherapy. The emerging role of PET imaging to direct appropriate neoadjuvant treatment regimens and the additive benefit of biological agents are also discussed...
January 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28211482/neoadjuvant-chemotherapy-followed-by-concurrent-chemoradiotherapy-versus-concurrent-chemoradiotherapy-alone-in-nasopharyngeal-carcinoma-patients-with-cervical-nodal-necrosis
#4
Mei Lan, Chunyan Chen, Ying Huang, Li Tian, Zhijun Duan, Fei Han, Junfang Liao, Meiling Deng, Terence T Sio, Anussara Prayongrat, Lie Zheng, Shaoxiong Wu, Taixiang Lu
The effectiveness of neoadjuvant chemotherapy (NACT) followed by concurrent chemoradiotherapy (CCRT) compared with CCRT alone in nasopharyngeal carcinoma (NPC) patients who presented with cervical nodal necrosis (CNN) is unknown. A total of 792 patients with stage T1-4N1-3M0 NPC and presented with CNN based on magnetic resonance imaging were retrospectively reviewed. Propensity score matching method was used to balance treatment arms for baseline characteristics. Eventually, 508 patients were propensity-matched on a 1:1 basis to create two groups (NACT + CCRT and CCRT groups)...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28188501/effect-of-extending-the-original-eligibility-criteria-for-the-cross-neoadjuvant-chemoradiotherapy-on-toxicity-and-survival-in-esophageal-cancer
#5
E C de Heer, J B Hulshoff, D Klerk, J G M Burgerhof, D J A de Groot, J Th M Plukker, G A P Hospers
BACKGROUND: Patients with curable esophageal cancer (EC) who proceed beyond the original Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study (CROSS) eligibility criteria are also treated with neoadjuvant chemoradiotherapy (nCRT). This study assessed the effect that extending the CROSS eligibility criteria for nCRT has on treatment-related toxicity and overall survival (OS) in EC. METHODS: The study enrolled 161 patients with locally advanced EC (T1N1-3/T2-4aN0-3/M0) treated with the CROSS schedule followed by esophagectomy...
February 10, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28188188/locally-advanced-colon-cancer-evaluation-of-current-clinical-practice-and-treatment-outcomes-at-the-population-level
#6
Charlotte E L Klaver, Lieke Gietelink, Willem A Bemelman, Michel W J M Wouters, Theo Wiggers, Rob A E M Tollenaar, Pieter J Tanis
Background: The goal of this study was to evaluate current clinical practice and treatment outcomes regarding locally advanced colon cancer (LACC) at the population level. Methods: Data were used from the Dutch Surgical Colorectal Audit from 2009 to 2014. A total of 34,527 patients underwent resection for non-LACC and 6,918 for LACC, which was defined as cT4 and/or pT4 stage. LACC was divided into those with multivisceral resection (LACC-MV; n=3,385) and without (LACC-noMV; n=1,595). Guideline adherence, treatment strategy, and short-term outcomes were evaluated...
February 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28179343/role-of-18-f-fdg-pet-ct-in-esophageal-squamous-cell-carcinoma-after-neoadjuvant-chemoradiotherapy
#7
Ken Sasaki, Yasuto Uchikado, Hiroshi Okumura, Itaru Omoto, Yoshiaki Kita, Takaaki Arigami, Yoshikazu Uenosono, Tetsuhiro Owaki, Kosei Maemura, Shoji Natsugoe
AIM: The aim of this study was to assess the role of (18)F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) in predicting pathological response and survival in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (nCRT). PATIENTS AND METHODS: Thirty patients with advanced ESCC received nCRT followed by surgery, and underwent FDG-PET/CT twice before and after nCRT. We compared the results of FDG-PET/CT with the pathological results and prognosis...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28177997/outcome-and-salvage-surgery-following-watch-and-wait-for-rectal-cancer-after-neoadjuvant-therapy-a-systematic-review
#8
REVIEW
Joseph C Kong, Glen R Guerra, Satish K Warrier, Robert G Ramsay, Alexander G Heriot
BACKGROUND: Currently there is no reliable test to predict pathological complete response following neoadjuvant chemoradiotherapy for rectal cancer. However, there is increasing interest in using clinical complete response as a surrogate marker, allowing a subset of patients with locally advanced rectal cancer to be allocated into a "watch and wait" pathway. Little is known about the oncological safety of the "watch and wait" approach or the rate of salvage surgery in cases of tumor regrowth...
March 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28177891/tumour-infiltrating-regulatory-t-cell-density-before-neoadjuvant-chemoradiotherapy-for-rectal-cancer-does-not-predict-treatment-response
#9
Melanie J McCoy, Chris Hemmings, Chidozie C Anyaegbu, Stephanie J Austin, Tracey F Lee-Pullen, Timothy J Miller, Max K Bulsara, Nikolajs Zeps, Anna K Nowak, Richard A Lake, Cameron F Platell
Neoadjuvant (preoperative) chemoradiotherapy (CRT) decreases the risk of rectal cancer recurrence and reduces tumour volume prior to surgery. However, response to CRT varies considerably between individuals and factors associated with response are poorly understood. Foxp3+ regulatory T cells (Tregs) inhibit anti-tumour immunity and may limit any response to chemotherapy and radiotherapy. We have previously reported that a low density of Tregs in the tumour stroma following neoadjuvant CRT for rectal cancer is associated with improved tumour regression...
February 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/28159930/compared-planning-dosimetry-of-tomo-vmat-and-imrt-in-rectal-cancer-with-different-simulated-positions
#10
Jang-Chun Lin, Jo-Ting Tsai, Li-Jhen Chen, Ming-Hsien Li, Wei-Hsiu Liu
OBJECTIVES: To compare treatment plans for helical tomotherapy (TOMO), volumetric modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) for locally advanced rectal cancer (LARC). MATERIALS AND METHODS: This retrospective study from December 2010 to June 2013 included 20 patients with LARC who received neoadjuvant concurrent chemoradiotherapy (CCRT) with radiation doses of greater than 50.4 Gy. Dosimetric quality was evaluated based on doses to organs at risk (OARs), including small bowel, urinary bladder and bilateral femoral head, over the same coverage of the clinical target volume (CTV)...
January 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/28157723/integrated-care-pathway-for-rectal-cancer-treatment-health-care-resource-utilization-costs-and-outcomes
#11
Silvia T Kobayashi, Maria D P E Diz, Alessandro G Campolina, Patricia C De Soárez, Ulysses Ribeiro, Sergio C Nahas, Karina G M C Vasconcelos, Fernanda Capareli, Ivan Cecconello, Paulo M Hoff
AIM: Managed Flow C20 (MFC20) is an integrated care pathway (ICP) for rectal cancer implemented at a public teaching hospital. This study aims to quantify resource utilization and estimate direct costs and outcomes associated with the use of this ICP. METHODS: We evaluated consecutive rectal cancer patients treated with neoadjuvant chemoradiotherapy (nCRT) followed by surgery, comparing the period before the ICP implementation (Pre-MFC20 group) and after (MFC20 group)...
February 2, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28152166/effectiveness-of-esophagectomy-in-patients-with-thoracic-esophageal-squamous-cell-carcinoma-receiving-definitive-radiotherapy-or-concurrent-chemoradiotherapy-through-intensity-modulated-radiation-therapy-techniques
#12
Yu-Chun Yen, Jer-Hwa Chang, Wei-Cheng Lin, Jeng-Fong Chiou, Yin-Chun Chang, Chia-Lun Chang, Han-Lin Hsu, Jyh-Ming Chow, Kevin Sheng-Po Yuan, Alexander T H Wu, Szu-Yuan Wu
BACKGROUND: Few large, prospective, randomized studies have investigated the effectiveness of esophagectomy in patients with thoracic esophageal squamous cell carcinoma (TESCC) who receive definitive radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) through modern, intensity modulated-RT (IMRT) techniques. The therapeutic effects of esophagectomy in patients with TESCC were evaluated using modern clinical staging and RT techniques and suitable RT doses. METHODS: The authors analyzed data from patients with TESCC from the Taiwan Cancer Registry database...
February 2, 2017: Cancer
https://www.readbyqxmd.com/read/28152117/survival-rates-using-individualized-bioselection-treatment-methods-in-patients-with-advanced-laryngeal-cancer
#13
Gregory T Wolf, Emily Bellile, Avraham Eisbruch, Susan Urba, Carol R Bradford, Lisa Peterson, Mark E Prince, Theodoros N Teknos, Douglas B Chepeha, Norman D Hogikyan, Scott A McLean, Jeffery Moyer, Jeremy M G Taylor, Francis P Worden
Importance: Use of chemoradiotherapy for advanced laryngeal cancer led to a major shift in treatment as an alternative to laryngectomy. Despite widespread adoption of chemoradiotherapy, survival rates have not improved and the original premise of matching neoadjuvant chemotherapy tumor response to determine subsequent treatment has not been followed. Objective: To determine whether improved survival could be achieved by incorporating a single cycle of neoadjuvant chemotherapy to select patients with advanced disease for either laryngectomy or concurrent chemoradiotherapy...
February 2, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28149883/focusing-the-management-of-rectal-cancer
#14
COMMENT
Rachel Dbeis, Neil J Smart, Ian R Daniels
Rectal cancer treatment has undergone major changes over the last 15 years with a focus on individualized care based around MRI assessment of the relationship of the tumour to the mesorectal fascia, improved surgical techniques and targeted use of pre-operative oncological therapies in patients with locally advanced disease. The recognition that some tumours responded completely to pre-operative chemoradiotherapy, and the selective use of a non-operative policy has led to a quest to further identify those patients and their tumour in whom this approach could be used, irrespective of MRI stage...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28133087/-a-case-of-carcinoma-associated-with-an-anal-fistula-repaired-using-a-hatchet-flap-after-neoadjuvant-chemoradiotherapy
#15
Masatoshi Kuroda, Eiji Ikeda, Nobuji Yokoyama, Masaichi Kenmotsu, Shoji Takagi, Toshihisa Yamano
The patient was a 53-year-old man who complained of perianal pain. He had a 20-year history of an anal fistula. There was a 10 cm tumor with mucin-like discharge on the left side of the anus. His CEA level was high, at 7.3 ng/mL, and T2-weighted MRI revealed a multilocular cystic tumor with high signal intensity. The second biopsy result indicated mucinous adenocarcinoma. We performed neoadjuvant chemoradiotherapy. The chemotherapy regimen was TS-1 with radiation therapy, along with 4-port irradiation(50.4 Gy)of the primary tumor, located at the interior of the pelvis and inguinal lymph nodes...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133017/-the-local-control-effect-of-surgical-treatment-after-neoadjuvant-chemoradiotherapy-for-rectal-adenocarcinoma-with-inguinal-lymph-node-metastasis
#16
Koji Ueta, Kimihiro Yamashita, Yasuo Sumi, Kiyonori Kanemitsu, Masashi Yamamoto, Shingo Kanaji, Taro Oshikiri, Tetsu Nakamura, Satoshi Suzuki, Yoshihiro Kakeji
No consensus has been reached with regard to the optimal treatment strategy and the prognosis of patients with advanced rectal cancer and inguinal lymph node metastasis. We, therefore, retrospectively analyzed the outcomes of 41 patients with locally advanced rectal cancer who underwent surgery after neoadjuvant chemoradiotherapy(NACRT). Six patients, with clinical inguinal lymph node metastasis determined by pretreatment imaging, underwent inguinal lymph node dissections after NACRT. Five patients survived without a relapse...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28130593/functional-outcome-following-rectal-surgery-predisposing-factors-for-low-anterior-resection-syndrome
#17
Daniel Ll Hughes, Julie Cornish, Chris Morris
PURPOSE: Developments in surgical techniques and neoadjuvant treatment have enabled an increasing proportion of patients with rectal cancer to undergo sphincter-sparing resections. The avoidance of a permanent stoma can come at the cost of poor bowel function which can significantly impact patients' quality of life. The objective of this study was to identify the incidence and risk factors for the development of bowel dysfunction following rectal cancer surgery. METHODS: Patients undergoing anterior resection for rectal cancer between January 2009 and January 2015 were identified from a rectal cancer database at a single centre...
January 27, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28112647/a-retrospective-analysis-of-factors-affecting-early-stoma-complications
#18
Umit Koc, Kerem Karaman, Ismail Gomceli, Tahsin Dalgic, Ilter Ozer, Murat Ulas, Metin Ercan, Erdal Bostanci, Musa Akoglu
Despite advances in surgical techniques and products for stoma care, stoma-related complications are still common. A retrospective analysis was performed of the medical records of 462 consecutive patients (295 [63.9%] female, 167 [36.1 %] male, mean age 55.5 ± 15.1 years, mean body mass index [BMI] 25.1 ± 5.2) who had undergone stoma creation at the Gastroenterological Surgery Clinic of Turkiye Yuksek İhtisas Teaching and Research Hospital between January 2008 and December 2012 to examine the incidence of early (ie, within 30 days after surgery) stoma complications and identify potential risk factors...
January 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28105657/a-nomogram-to-predict-distant-metastasis-after-neoadjuvant-chemoradiotherapy-and-radical-surgery-in-patients-with-locally-advanced-rectal-cancer
#19
Yanwu Sun, Huiming Lin, Xingrong Lu, Ying Huang, Zongbin Xu, Shenghui Huang, Xiaojie Wang, Pan Chi
PURPOSE: To compare distant metastasis (DM) in locally advanced rectal cancer (LARC) patients treated with neoadjuvant chemoradiotherapy (nCRT) and surgery alone, and to develop a predictive nomogram for DM following nCRT. METHODS: Propensity-scoring match analysis was performed to compare DM in LARC treated with nCRT (n = 375) and surgery alone (n = 375). Cox regression was performed to identify predictors of DM following nCRT. A nomogram was developed and validated by internal (n = 425) and external validation (n = 97)...
January 20, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28105157/prognostic-impact-of-the-tumor-infiltrating-regulatory-t-cell-foxp3-activated-cytotoxic-t-lymphocyte-granzyme-b-ratio-on-resected-left-sided-pancreatic-cancer
#20
Ho Kyoung Hwang, Hyoung-Il Kim, Se Hoon Kim, Junjeong Choi, Chang Moo Kang, Kyung Sik Kim, Woo Jung Lee
Among the subsets of tumor-infiltrating lymphocytes (TILs), activated cytotoxic T lymphocytes (granzyme B(+)) have an antitumor effect, while regulatory T lymphocytes [forkhead box P3 (Foxp3)(+)] suppress the antitumor immune response. The aim of the present study was to investigate the possible associations between TIL subsets and survival outcomes in patients with left-sided pancreatic ductal adenocarcinoma (PDAC). From January 2000 to December 2008, 30 patients who underwent curative distal pancreatectomy without neoadjuvant chemoradiotherapy due to left-sided PDAC were enrolled in the present study...
December 2016: Oncology Letters
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