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Neoadjuvant rectal cancer

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https://www.readbyqxmd.com/read/28079398/feasibility-evaluation-of-diffusion-weighted-imaging-using-an-integrated-mri-radiotherapy-system-for-response-assessment-to-neoadjuvant-therapy-in-rectal-cancer
#1
Narek Shaverdian, Yingli Yang, Peng Hu, Steven Hart, Ke Sheng, James Lamb, Minsong Cao, Nzhde Agazaryan, David Thomas, Michael Steinberg, Daniel A Low, Percy Lee
OBJECTIVES: To evaluate the feasibility of on-board DWI with an integrated low-field MRI-radiotherapy system to assess responses to neoadjuvant chemoradiation (NAC) in rectal cancer. METHODS: A spin echo-based planar imaging diffusion sequence on a 0.35 T MRI-radiotherapy system was acquired over the course of NAC. The apparent diffusion coefficients (ADC) from the tumor region of interest (ROIs) were calculated. A functional diffusion map (fDM) was created showing a pixel-wise ADC analysis of the ROI over the course of treatment...
January 12, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28078118/less-than-12-lymph-nodes-in-the-surgical-specimen-after-neoadjuvant-chemo-radiotherapy-an-indicator-of-tumor-regression-in-locally-advanced-rectal-cancer
#2
Jaiprakash Gurawalia, Kapil Dev, Sandeep P Nayak, Vishnu Kurpad, Arun Pandey
BACKGROUND: The number of lymph node retrieved in the surgical specimen is important for tumor staging and has paramount impact on prognosis in colorectal cancer and imitates the adequacy of lymph node surgical clearance. The paucity of lymph node yields in patients undergoing resection after preoperative chemo radiotherapy (CRT) in rectal cancer has seen. Lower total number of lymph nodes in the total mesoractal excision (TME) specimen after CRT, could a marker of better tumor response...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28068245/ku70-ku80-and-sclusterin-a-cluster-of-predicting-factors-for-response-to-neoadjuvant-chemoradiation-therapy-in-patients-with-locally-advanced-rectal-cancer
#3
Sabina Pucci, Chiara Polidoro, Alessandro Joubert, Francesca Mastrangeli, Barbara Tolu, Michaela Benassi, Valeria Fiaschetti, Laura Greco, Roberto Miceli, Roberto Floris, Giuseppe Novelli, Augusto Orlandi, Riccardo Santoni
PURPOSE: The identification of predictive biomarkers for neoadjuvant chemoradiation therapy (CRT) is a current clinical need. The heterodimer Ku70/80 plays a critical role in DNA repair and cell death induction after damage. The aberrant expression and localization of these proteins fail to control DNA repair and apoptosis. sClusterin is the Ku70 partner that sterically inhibits Bax-dependent cell death after damage in some pathologic conditions. This study sought to evaluate the molecular relevance of Ku70-Ku80-Clu as a molecular cluster predicting the response to neoadjuvant CRT in patients with locally advanced rectal cancer (LARC)...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28060889/sequential-pet-ct-with-18f-fdg-predicts-pathological-tumor-response-to-preoperative-short-course-radiotherapy-with-delayed-surgery-in-patients-with-locally-advanced-rectal-cancer-using-logistic-regression-analysis
#4
Biagio Pecori, Secondo Lastoria, Corradina Caracò, Marco Celentani, Fabiana Tatangelo, Antonio Avallone, Daniela Rega, Giampaolo De Palma, Maria Mormile, Alfredo Budillon, Paolo Muto, Francesco Bianco, Luigi Aloj, Antonella Petrillo, Paolo Delrio
: Previous studies indicate that FDG PET/CT may predict pathological response in patients undergoing neoadjuvant chemo-radiotherapy for locally advanced rectal cancer (LARC). Aim of the current study is evaluate if pathological response can be similarly predicted in LARC patients after short course radiation therapy alone. METHODS: Thirty-three patients with cT2-3, N0-2, M0 rectal adenocarcinoma treated with hypo fractionated short course neoadjuvant RT (5x5 Gy) with delayed surgery (SCRTDS) were prospectively studied...
2017: PloS One
https://www.readbyqxmd.com/read/28059920/local-excision-techniques-for-rectal-cancer-after-neoadjuvant-chemoradiotherapy-what-are-we-doing
#5
Fraser McLean Smith, Abdul Ahad, Rodrigo Oliva Perez, John Marks, Krzysztof Bujko, Richard J Heald
BACKGROUND: Recent evidence shows that the majority of rectal cancers demonstrate occult tumor scatter after neoadjuvant chemoradiotherapy that can extend for several centimeters under adjacent normal-appearing mucosa beside the residual mucosal abnormality or scar. OBJECTIVE: This systematic review aimed to determine all of the published selection criteria and technical descriptions for local excision to date with regard to this phenomenon. DATA SOURCES: PubMed, MEDLINE, and Embase were searched using the following key words: rectal cancer, local excision, radiotherapy, and neoadjuvant...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059911/transanal-endoscopic-microsurgery-for-early-rectal-cancer-a-single-center-experience
#6
Conor H O'Neill, Joseph Platz, Jesse S Moore, Peter W Callas, Peter A Cataldo
BACKGROUND: There is debate regarding the appropriate use of transanal endoscopic microsurgery for rectal cancer. OBJECTIVE: This study analyzed our single-center experience with transanal endoscopic microsurgery for early rectal cancer. DESIGN: Medical charts of patients who underwent transanal endoscopic microsurgery were reviewed to determine lesion characteristics, as well as operative and treatment characteristics. Complications and recurrences were recorded...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28050622/correlation-between-quantitative-and-semiquantitative-parameters-in-dce-mri-with-a-blood-pool-agent-in-rectal-cancer-can-semiquantitative-parameters-be-used-as-a-surrogate-for-quantitative-parameters
#7
Rebecca A P Dijkhoff, Monique Maas, Milou H Martens, Nikolaos Papanikolaou, Doenja M J Lambregts, Geerard L Beets, Regina G H Beets-Tan
PURPOSE: The aim of this study was to assess correlation between quantitative and semiquantitative parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in rectal cancer patients, both in a primary staging and restaging setting. MATERIALS AND METHODS: Nineteen patients were included with DCE-MRI before and/or after neoadjuvant therapy. DCE-MRI was performed with gadofosveset trisodium (Ablavar(®), Lantheus Medical Imaging, North Billerica, Massachusetts, USA)...
January 3, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28044949/sphincter-sparing-surgery-in-patients-with-mid-and-low-rectal-cancer-risk-factors-for-local-recurrence-and-anastomotic-leakage
#8
Denis Aslan, Florin Grama, Daniel Cristian, Adrian Bordea, Traean Burcoş
: Background: Rectal cancer is a major health problem. The current treatment of distal rectal cancer involves a multimodality approach aimed at achieving an optimal oncologic control and an increased quality of life. PURPOSE: The purpose of this article is to identify the risk factors for local recurrence and anastomotic leakage after sphincter-sparing surgery for low and mid rectal cancer. Material and Methods: We prospectively analyzed a group of 38 patients with low and middle rectal cancer who underwent sphincter-sparing surgery...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28035459/understanding-the-factors-associated-with-reduction-in-the-number-of-lymph-nodes-in-rectal-cancer-patients-treated-by-neoadjuvant-treatment
#9
L Bustamante-Lopez, C S Nahas, S C Nahas, U Ribeiro, C F Marques, G Cotti, A Rocco, I Cecconello
INTRODUCTION: Rectal cancer patients frequently present with locally advanced disease for which the standard of care includes neoadjuvant chemoradiotherapy followed by total mesorectal excision. Positive lymph nodes are one of the most powerful risk factors for recurrence and survival in colorectal cancer. In the absence of specific rectal guidelines, the literature recommends to the pathologist to optimize the number of rectal lymph nodes (LN) retrieved. We made a literature review in order to identify factors that could potentially affect the number of LN retrieved in specimens of patients with rectal cancer treated by chemoradiotherapy (CRT) followed by total mesorectal excision (TME)...
December 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28027520/lymph-node-yield-after-rectal-resection-in-patients-treated-with-neoadjuvant-radiation-for-rectal-cancer-a-systematic-review-and-meta-analysis
#10
REVIEW
Robert Mechera, Tibor Schuster, Robert Rosenberg, Benjamin Speich
BACKGROUND: The lymph node status represents a major prognostic factor in colorectal cancer. However, it was demonstrated that neoadjuvant chemoradiotherapy (CRT) decreases the numbers of lymph nodes in the specimen. Several studies describe less than 12 lymph nodes in the resected specimen of rectal cancer patients after neoadjuvant radiation. This meta-analysis quantifies the influence of neoadjuvant CRT or radiotherapy (RT) only on the lymph node yield in rectal cancer patients. METHODS: We performed a systematic review and searched PubMed, EMBASE and the Cochrane Library without any language restriction from 1st of January 1980 until 31st March 2015...
December 24, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/28025227/rectal-cancer-restaging-using-3d-cube-vs-2d-t2-weighted-technique-after-neoadjuvant-therapy-a-diagnostic-study
#11
Wuteng Cao, Yanbang Lian, Dechao Liu, Fangqian Li, Pan Zhu, Zhiyang Zhou
OBJECTIVE: This study aimed to compare the accuracy of rectal cancer restaging after neoadjuvant therapy with 3D CUBE sequence with 2D T2-weighted fast spin-echo (FSE) sequence. METHODS: This retrospective study comprised 72 patients with rectal cancer confirmed by colonoscopy and biopsy. After neoadjuvant therapy, all patients underwent pelvic magnetic resonance imaging (MRI) examination at 1.5T MRI sequences including a single coronal 3D CUBE T2-weighted FSE sequence with 1...
December 26, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/28011887/sweet-syndrome-a-painful-reality
#12
Uqba Khan, Humaira Rizvi, Farman Ali, Daniel Lebovic
Sweet syndrome is a rare disorder that is manifested by constellation of clinical features, including fever, neutrophilic leucocytosis, raised painful plaques on skin and dermal infiltration by neutrophils. Numerous aetiological associations have been reported in the literature, including various haematological malignancies and drugs. Our case was peculiar because of association of capecitabine and Sweet syndrome in rectal cancer. We describe a case of a woman aged 57 years, with recently diagnosed stage III rectal cancer, developed painful erythematous rash over her face along with fever and headache...
December 23, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/28011504/prognostic-and-therapeutic-potential-implications-of-genetic-variability-in-prostaglandin-e2-pathway-genes-in-rectal-cancer
#13
Marisa D Santos, Cristina Silva, Anabela Rocha, Carlos Nogueira, Fernando Castro-Poças, António Araujo, Eduarda Matos, Carina Pereira, Rui Medeiros, Carlos Lopes
AIM: To evaluate the prognostic significance and potential therapeutic implication of genetic variability in prostaglandin E2 pathway genes in patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (nCRT) followed by surgery. MATERIALS AND METHODS: This cohort study included 167 patients with LARC, treated with nCRT followed by surgery. A total of 61 single nucleotide polymorphisms (SNPs) were characterized using the Sequenom platform through multiplex amplification followed by mass-spectometric product separation...
January 2017: Anticancer Research
https://www.readbyqxmd.com/read/28011494/mmri-at-3-0-t-as-an-evaluation-tool-of-therapeutic-response-to-neoadjuvant-crt-in-patients-with-advanced-stage-rectal-cancer
#14
Ulrike I Attenberger, Melissa M Ong, Nils Rathmann, Fabian Doyon, Peter Kienle, Ralf-Dieter Hofheinz, Lothar R Pilz, Dietmar J Dinter, Stefan O Schoenberg, Daniel Hausmann
AIM: To assess whether multiparametric MRI (mMRI) can serve as a tool for evaluating response to chemoradiation therapy (CRT) in advanced-stage rectal cancer. PATIENTS AND METHODS: Twenty-one patients underwent a mMRI protocol at 3T before and after CRT. Two experienced radiologists evaluated the MRI measurements and inter-reader correlation was assessed. Changes in functional parameters in relation to regression, as well as pT stage were analyzed. The perfusion parameters plasma flow (PF) and mean transit time (MTT) were calculated offline using the established UMM Perfusion tool...
January 2017: Anticancer Research
https://www.readbyqxmd.com/read/28008455/perfusion-ct-measurements-predict-tumor-response-in-rectal-carcinoma
#15
Aya Kino, Jenny Shaffer, Katherine E Maturen, Heiko Schmiedeskamp, Albert C Koong, Daniel T Chang, Dominik Fleischmann, Aya Kamaya
PURPOSE: To evaluate the capacity of perfusion CT imaging to distinguish between complete and incomplete responders after neoadjuvant chemoradiation therapy for rectal carcinoma, with particular attention to segmentation technique. MATERIALS AND METHODS: 17 patients were evaluated in this prospective IRB-approved study. For each patient, a perfusion CT acquisition was obtained prior to the initiation of chemoradiation, at 1-2 weeks after the start of chemoradiation, and at 12 weeks after the start of chemoradiation therapy...
December 23, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27998468/-clinicopathological-factors-affecting-the-lymph-node-yield-from-laparoscopically-resected-specimens-of-rectal-cancer
#16
X Liu, J Ma, Q Liu, Z X Zhou
Objective: To identify the clinicopathological factors affecting the number of lymph nodes yielded from specimens obtained by laparoscopic-assissted resection of rectal cancer, and discuss further the possible causes of insufficient lymph nodes retrieval (<12). Methods: The clinicopathological data of 422 consecutive rectal cancer cases, who underwent radical laparoscopic rectal resection (R0) at our department during January to October 2015, were analyzed retrospectively. The correlation between the clinicopathological factors and the number of lymph nodes yielded from the surgical specimens was assessed statistically...
December 23, 2016: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/27997526/organ-preservation-with-local-excision-or-active-surveillance-following-chemoradiotherapy-for-rectal-cancer
#17
B Creavin, E Ryan, S T Martin, A Hanly, P R O'Connell, K Sheahan, D C Winter
BACKGROUND: Organ preservation has been proposed as an alternative to radical surgery for rectal cancer to reduce morbidity and mortality, and to improve functional outcome. METHODS: Locally advanced non-metastatic rectal cancers were identified from a prospective database. Patients staged ⩾T3 or any stage N+ were referred for neoadjuvant chemoradiotherapy (CRT) (50-54 Gy and 5-fluorouracil), and were reassessed 6-8 weeks post treatment. An active surveillance programme ('watch and wait') was offered to patients who were found to have a complete endoluminal response...
December 20, 2016: British Journal of Cancer
https://www.readbyqxmd.com/read/27984651/neoadjuvant-long-course-chemoradiation-remains-strongly-favored-over-short-course-radiotherapy-by-radiation-oncologists-in-the-united-states
#18
Yvonne M Mowery, Joseph K Salama, S Yousuf Zafar, Harvey G Moore, Christopher G Willett, Brian G Czito, M Benjamin Hopkins, Manisha Palta
BACKGROUND: Short-course radiotherapy (SC-RT) and long-course chemoradiotherapy (LC-CRT) are accepted neoadjuvant treatments of rectal cancer. In the current study, the authors surveyed US radiation oncologists to assess practice patterns and attitudes regarding SC-RT and LC-CRT for patients with rectal cancer. METHODS: The authors distributed a survey to 1701 radiation oncologists regarding treatment of neoadjuvant rectal cancer. Respondents were asked questions regarding the number of patients with rectal cancer treated, preference for SC-RT versus LC-CRT, and factors influencing regimen choice...
December 16, 2016: Cancer
https://www.readbyqxmd.com/read/27981667/assessment-of-pathological-complete-response-to-preoperative-chemoradiotherapy-by-means-of-multiple-mathematical-models-of-diffusion-weighted-mri-in-locally-advanced-rectal-cancer-a-prospective-single-center-study
#19
Hai-Bin Zhu, Xiao-Yan Zhang, Xiao-Hong Zhou, Xiao-Ting Li, Yu-Liang Liu, Shuai Wang, Ying-Shi Sun
PURPOSE: To assess stretched-exponential, mono-exponential and intravoxel incoherent motion (IVIM) models of diffusion-weighted MRI(DWI) in predicting pathological complete response (pCR) to neoadjuvant chemoradiotherapy (CRT) in rectal cancer patients. MATERIALS AND METHODS: This prospective study recruited 98 consecutive patients with locally advanced rectal cancer who underwent 3 Tesla MR examination before, during and after CRT. The apparent diffusion coefficient (ADC), IVIM-derived parameters (D, f, and D*), and stretched-exponential model-derived parameters (DDC and α) were measured...
December 16, 2016: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/27978776/short-course-preoperative-radiotherapy-combined-with-chemotherapy-delayed-surgery-and-local-hyperthermia-for-rectal-cancer-a-phase-ii-study
#20
A O Rasulov, S S Gordeyev, Yu A Barsukov, S I Tkachev, A G Malikhov, S S Balyasnikova, M Yu Fedyanin
PURPOSE: The aim of this study was to investigate the feasibility of short-course radiotherapy with oral capecitabine, hyperthermia and delayed surgery for neoadjuvant treatment of rectal cancer. METHODS: Patients with clinically staged T2-3N0-2M0 primary rectal cancer were included. All patients received short-course 25 Gy in 5 Gy fractions radiotherapy with capecitabine, local hyperthermia and metronidazole. Capecitabine 1000 mg/m2 twice a day was given on days 1-14...
December 15, 2016: International Journal of Hyperthermia
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