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Neoadjuvant chemotherapy in rectal cancer

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https://www.readbyqxmd.com/read/28503826/prospective-randomised-trial-of-neoadjuvant-chemotherapy-during-the-wait-period-following-pre-operative-chemoradiotherapy-for-rectal-cancer-results-of-the-wait-trial
#1
James Moore, Tim Price, Scott Carruthers, Sudarsha Selva-Nayagam, Andrew Luck, Michelle Thomas, Peter Hewett
AIMS: To determine whether the addition of additional cycles of chemotherapy during the "wait "period following neoadjuvant chemo-radiotherapy for rectal cancer improves the pathologic complete response rate (pCR). METHODS: Rectal cancer patients were randomly allocated to either a standard 10 week wait period before surgery (standard chemo-radiotherapy, SCRT) or to receive 3 cycles of 5FU based chemotherapy following chemo-radiotherapy during a similar 10 week wait (extended chemo-radiotherapy, XCRT)...
May 15, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28501970/cancer-center-volume-and-type-impact-stage-specific-utilization-of-neoadjuvant-therapy-in-rectal-cancer
#2
Emily F Midura, Andrew D Jung, Meghan C Daly, Dennis J Hanseman, Bradley R Davis, Shimul A Shah, Ian M Paquette
BACKGROUND: Neoadjuvant chemoradiation reduces local recurrence in locally advanced rectal cancer, and adherence to national and societal recommendations remains unknown. OBJECTIVE: To determine variability in guideline adherence in rectal cancer treatment and investigate whether hospital volume correlated with variability seen. DESIGN: We performed a retrospective analysis using the National Cancer Database rectal cancer participant user files from 2005 to 2010...
May 13, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28497757/safety-and-tolerability-of-veliparib-combined-with-capecitabine-plus-radiotherapy-in-patients-with-locally-advanced-rectal-cancer-a-phase-1b-study
#3
Brian G Czito, Dustin A Deming, Gayle S Jameson, Mary F Mulcahy, Houman Vaghefi, Matthew W Dudley, Kyle D Holen, Angela DeLuca, Rajendar K Mittapalli, Wijith Munasinghe, Lei He, John R Zalcberg, Samuel Y Ngan, Philip Komarnitsky, Michael Michael
BACKGROUND: Further optimisation of present standard chemoradiation is needed in patients with locally advanced rectal cancer. Veliparib, an oral poly(ADP-ribose) polymerase inhibitor, has been shown to enhance the antitumour activity of chemotherapy and radiotherapy in preclinical models. We aimed to establish the maximum tolerated dose and establish the recommended phase 2 dose of veliparib combined with neoadjuvant capecitabine and radiotherapy. METHODS: This phase 1b, open-label, multicentre, dose-escalation study was done at six hospitals (one in Australia and five in the USA)...
June 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28493401/the-role-of-adjuvant-chemotherapy-on-survival-and-recurrence-after-curative-rectal-cancer-surgery-on-patients-who-are-histologically-node-negative-after-neoadjuvant-chemoradiotherapy
#4
Dlh Baird, Q Denost, C Simillis, G Pellino, S Rasheed, C Kontovounisios, P P Tekkis, E Rullier
AIM: The aim of this study is to evaluate whether adjuvant chemotherapy will affect recurrence rates, disease free and overall survival in patients with rectal adenocarcinoma who were staged with MRI node positive disease (mrN+) preoperatively and underwent neoadjuvant chemoradiotherapy with curative rectal cancer surgery and their pathological staging was negative for nodal disease (ypN0). There is no consensus on the role of adjuvant chemotherapy in these patients. METHOD: Patients who received neoadjuvant chemoradiotherapy and underwent curative rectal cancer surgery for rectal adenocarcinoma staged as [mrTxN+M0] on MRI staging and on pathological staging were found to be [ypTxN0M0] were retrospectively identified from 01/2008-12/2012 from two tertiary referral centers (Royal Marsden Hospital and Saint-Andre Hospital)...
May 11, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28481852/baseline-t-classification-predicts-early-tumor-regrowth-after-nonoperative-management-in-distal-rectal-cancer-after-extended-neoadjuvant-chemoradiation-and-initial-complete-clinical-response
#5
Angelita Habr-Gama, Guilherme Pagin São Julião, Joaquim Gama-Rodrigues, Bruna Borba Vailati, Cinthia Ortega, Laura Melina Fernandez, Sérgio Eduardo Alonso Araújo, Rodrigo Oliva Perez
BACKGROUND: Selected patients with rectal cancer and complete clinical response after neoadjuvant chemoradiation have been managed nonoperatively with acceptable outcomes. However, ≈20% of these patients will develop early tumor regrowth. Identification of these patients could select candidates for more intensive follow-up. OBJECTIVE: The purpose of this study was to investigate the influence of baseline radiological T classification on recurrences after a complete clinical response managed nonoperatively after chemoradiation...
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28481707/immune-checkpoint-blockade-in-metastatic-urothelial-cancer
#6
Arjun Vasant Balar
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
May 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28476941/systemic-chemotherapy-as-salvage-treatment-for-locally-advanced-rectal-cancer-patients-who-fail-to-respond-to-standard-neoadjuvant-chemoradiotherapy
#7
Francesco Sclafani, Gina Brown, David Cunningham, Sheela Rao, Paris Tekkis, Diana Tait, Federica Morano, Chiara Baratelli, Eleftheria Kalaitzaki, Shahnawaz Rasheed, David Watkins, Naureen Starling, Andrew Wotherspoon, Ian Chau
BACKGROUND: The potential of chemotherapy as salvage treatment after failure of neoadjuvant chemoradiotherapy for locally advanced rectal cancer (LARC) has never been explored. We conducted a single-center, retrospective analysis to address this question. PATIENTS AND METHODS: Patients with newly diagnosed LARC who were inoperable or candidates for extensive (i.e., beyond total mesorectal excision [TME]) surgery after long-course chemoradiotherapy and who received salvage chemotherapy were included...
May 5, 2017: Oncologist
https://www.readbyqxmd.com/read/28474202/neoadjuvant-capeox-therapy-followed-by-sphincter-preserving-surgery-for-lower-rectal-cancer
#8
Taishi Hata, Hidekazu Takahashi, Daisuke Sakai, Naotsugu Haraguchi, Junichi Nishimura, Toshihiro Kudo, Matsuda Chu, Ichiro Takemasa, Satoh Taroh, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
PURPOSE: This retrospective study investigates the safety of neoadjuvant chemotherapy with oxaliplatin capecitabine (CapeOx), followed by laparoscopic surgery, for lower rectal cancer, and its efficacy in preserving the sphincter. METHODS: Ten patients with diagnosed lower rectal cancer received three or four cycles of neoadjuvant CapeOx chemotherapy, prior to undergoing low anterior resection or intersphincteric resection, with total mesorectal excision. The primary outcomes were R0 resection and the rate of sphincter preservation...
May 4, 2017: Surgery Today
https://www.readbyqxmd.com/read/28465642/effects-of-omeprazole-in-improving-concurrent-chemoradiotherapy-efficacy-in-rectal-cancer
#9
Jin-Liang Zhang, Min Liu, Qing Yang, Shi-Yong Lin, Hong-Bo Shan, Hui-Yun Wang, Guo-Liang Xu
AIM: To explore the effects of omeprazole on chemoradiotherapy efficacy and tumor recurrence in rectal cancer. METHODS: The medical data of 125 rectal cancer patients who received the same neoadjuvant chemoradiotherapy (CRT) followed by surgery were retrospectively collected. Patients who received omeprazole (OME) orally at a dose of 20 mg at least once daily for six days and/or intravenously at 40 mg a day were recognized as eligible OME users (EOU). Otherwise, patients were regarded as non-eligible OME users (non-EOU)...
April 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28464745/diffusion-weighted-magnetic-resonance-imaging-of-rectal-cancer-tumour-volume-and-perfusion-fraction-predict-chemoradiotherapy-response-and-survival
#10
Kine Mari Bakke, Knut Håkon Hole, Svein Dueland, Krystyna Kotanska Grøholt, Kjersti Flatmark, Anne Hansen Ree, Therese Seierstad, Kathrine Røe Redalen
BACKGROUND: In locally advanced rectal cancer (LARC), responses to preoperative treatment are highly heterogeneous and more accurate diagnostics are likely to enable more individualised treatment approaches with improved responses. We investigated the potential of diffusion-weighted magnetic resonance imaging (DW MRI), with quantification of the apparent diffusion coefficient (ADC) and perfusion fraction (F), as well as volumetry from T2-weighted (T2W) MRI, for prediction of therapeutic outcome...
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28439842/controversies-in-the-multimodality-management-of-locally-advanced-rectal-cancer
#11
REVIEW
Robert Díaz Beveridge, Dilara Akhoundova, Gema Bruixola, Jorge Aparicio
Neoadjuvant radiotherapy previous to radical surgery, both as short-course radiotherapy and as long-course radiotherapy combined with 5-FU-based chemotherapy (LCRCT), is routinely used in the management of locally advanced rectal cancer, with consistent benefits in the reduction in the local relapse risk. Unfortunately, survival benefits have been elusive to demonstrate with this approach, especially in the setting of radical surgery in the form of total mesorectal excision (TME). Concerns about over-treating early-stage patients and about the possible long-term side effects have also cast more doubts in a blanket approach of treating all patients with neoadjuvant radiotherapy, especially with LCRCT...
June 2017: Medical Oncology
https://www.readbyqxmd.com/read/28434582/effectiveness-between-early-and-late-temporary-ileostomy-closure-in-patients-with-rectal-cancer-a-prospective-study
#12
Li Zhen, Yanan Wang, Ze Zhang, Tongwei Wu, Ruoyan Liu, Tingting Li, Liying Zhao, Haijun Deng, Xiaolong Qi, Guoxin Li
A temporary stoma is often used in rectal cancer surgery to protect a distal anastomosis, which remains a major concern after rectal cancer surgery, particularly after low anterior resection. The temporary stoma is scheduled for closure. However, the optimal time of closure of the protecting stoma remains unclear because of sparse studies and data. We aimed to detect the efficacy between early and late temporary ileostomy closure in patients with rectal cancer during or after neoadjuvant chemoradiotherapy. We conducted a prospective, 2-group design between early and late ileostomy closure group in patients after rectal cancer surgery with temporary stoma...
March 2, 2017: Current Problems in Cancer
https://www.readbyqxmd.com/read/28426108/mri-assessment-and-outcomes-in-patients-receiving-neoadjuvant-chemotherapy-only-for-primary-rectal-cancer-long-term-results-from-the-gemcad-0801-trial
#13
U B Patel, G Brown, I Machado, J Santos-Cores, C Pericay, E Ballesteros, A Salud, M Isabel-Gil, C Montagut, J Maurel, J Ramón-Ayuso, N Martin, R Estevan, C Fernandez-Martos
Background: Primary chemotherapy has been tested as a possible approach for patients with high risk features but predicted clear mesorectal margins on preoperative MRI assessment. This study investigates the prognostic relevance of baseline and post-treatment MRI and pathology staging in rectal cancer patients undergoing primary chemotherapy. Patients and methods: Forty-six patients with T3 tumour > =2 mm from the mesorectal fascia were prospectively treated with Neoadjuvant Capecitabine, Oxaliplatin and Bevacizumab prior to surgery between 2009 and 2011...
February 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28423720/meta-analysis-of-oxaliplatin-based-versus-fluorouracil-based-neoadjuvant-chemoradiotherapy-and-adjuvant-chemotherapy-for-locally-advanced-rectal-cancer
#14
Xing-Li Fu, Zheng Fang, Liang-Hui Shu, Guo-Qing Tao, Jian-Qiang Wang, Zhi-Lian Rui, Yong-Jie Zhang, Zhi-Qiang Tian
A meta-analysis was conducted to compare oxaliplatin-based with fluorouracil-based neoadjuvant chemoradiotherapy and adjuvant chemotherapy for locally advanced rectal cancer. MEDLINE, EMBASE and CENTRAL were systematically searched for relevant randomized controlled trials (RCTs) until January 31 2017. Review Manager (version 5.3) was used to analyze the data. Dichotomous data were calculated by odds ratio (OR) with 95% confidence intervals (CI). A total of 8 RCTs with 6103 stage II or III rectal cancer patients were analyzed, including 2887 patients with oxaliplatin+fluorouracil regimen and 3216 patients with fluorouracil alone regimen...
March 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28420585/adjuvant-chemotherapy-is-associated-with-improved-overall-survival-in-locally-advanced-rectal-cancer-after-achievement-of-a-pathologic-complete-response-to-chemoradiation
#15
Danish Shahab, Emmanuel Gabriel, Kristopher Attwood, Wen Wee Ma, Valerie Francescutti, Steven Nurkin, Patrick M Boland
BACKGROUND: In locally advanced rectal adenocarcinoma, 15% to 20% of patients treated with neoadjuvant chemoradiation (nCRT) achieve a pathologic complete response (pCR). The benefit of adjuvant chemotherapy is controversial in rectal cancer. Our objective was to evaluate the effect of clinical risk factors and adjuvant chemotherapy usage on the outcomes of the pCR patient population. PATIENTS AND METHODS: We performed a retrospective study using the National Cancer Data Base from 2006 to 2013...
March 18, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28411888/neoadjuvant-therapy-and-transanal-endoscopic-surgery-in-t2-t3-superficial-n0-m0-rectal-tumors-local-recurrence-complete-clinical-and-pathological-response
#16
Xavier Serra-Aracil, Carlos Pericay, Laura Mora-Lopez, Juan Carlos Garcia Pacheco, José Isaac Latorraca, Julio Ocaña-Rojas, Alex Casalots, Eva Ballesteros, Salvador Navarro-Soto
INTRODUCTION: The association of preoperative chemoradiotherapy and transanal endoscopic surgery in T2 and superficial T3 rectal cancers presents promising results in selected patients. The main objective is to evaluate the long-term loco-regional and systemic recurrence and, as secondary objectives, to provide results of postoperative morbidity and the correlation between complete clinical and pathological response. METHODS: This is a retrospective observational study including a consecutive series of patients with T2-T3 superficial rectal cancer, N0, M0 who refused radical surgery (2008-2016)...
April 12, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28391777/remarkable-response-to-fluorouracil-leucovorin-oxaliplatin-and-irinotecan-therapy-in-urothelial-cancer-of-the-renal-pelvis-a-case-report
#17
Takuya Tsujino, Kiyoshi Takahara, Tomohisa Matsunaga, Yuki Yoshikawa, Tomoaki Takai, Taizo Uchimoto, Kenkichi Saito, Naoki Tanda, Hajime Hirano, Hayahito Nomi, Naokazu Ibuki, Teruo Inamoto, Haruhito Azuma
BACKGROUND: No standard chemotherapy regimen for advanced urothelial cancer has been established, except for cisplatin-based regimens. We report the case of a patient with double primary cancer, urothelial carcinoma of the upper urinary tract and colorectal cancer, who underwent oxaliplatin-based chemotherapies. CASE PRESENTATION: A 56-year-old Japanese man presented to our hospital with the diagnosis of a left renal pelvic tumor and rectal cancer. Several examinations including ureteroscopic biopsy and computed tomography-guided biopsy were performed; however, the diagnosis of renal pelvic cancer could not be made...
April 10, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28386670/the-impact-of-pathologic-complete-response-in-patients-with-neoadjuvantly-treated-locally-advanced-rectal-cancer-a-large-single-center-experience
#18
A M Dinaux, R Amri, L G Bordeianou, T S Hong, J Y Wo, L S Blaszkowsky, J N Allen, J E Murphy, H Kunitake, D L Berger
Small cohort studies demonstrated better oncologic outcomes for patients with pathologic complete response (PathCR) after neoadjuvant treatment for locally advanced rectal cancer. This study reviews long-term outcomes of a large cohort of clinically stage II/III rectal cancer patients who received neoadjuvant chemoradiation and surgery. This is a retrospective analysis of a single-center cohort, including all clinical stage II/III rectal cancer patients who received neoadjuvant chemoradiation and surgery between 2004 and 2014 (n = 271)...
April 6, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28333014/single-nucleotide-polymorphism-tgf%C3%AE-1-r25p-correlates-with-acute-toxicity-during-neoadjuvant-chemoradiotherapy-in-rectal-cancer-patients
#19
J Joshua Smith, Isaac Wasserman, Sarah A Milgrom, Oliver S Chow, Chin-Tung Chen, Sujata Patil, Karyn A Goodman, Julio Garcia-Aguilar
PURPOSE: To validate the finding of an association between single nucleotide polymorphisms (SNPs) and toxicity during chemoradiotherapy (CRT) in rectal cancer patients, in an independent population. METHODS AND MATERIALS: The cohort consisted of 165 patients who received CRT for rectal cancer from 2006 to 2012. Prospectively recorded toxicity information, graded according to the Common Terminology Criteria for Adverse Events version 3.0, was retrieved from the medical record...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28304150/additional-chemotherapy-and-salvage-surgery-for-poor-response-to-chemoradiotherapy-in-rectal-cancers
#20
Reena Engineer, Vikas Ostwal, Supreeta Arya, Priyamvada Gupta, Supriya Chopra, Prachi Patil, Sudhir Jatal, Avanish Saklani
AIM: A proportion of locally advanced rectal cancer patients who receive neoadjuvant chemoradiotherapy (NACRT) are still unresectable. This study was undertaken to assess the outcomes of giving additional chemotherapy to rectal cancer patients with unresectable disease after NACRT. METHODS: Patients with poor response to NACRT where mesorectal fascia was still involved on MRI and R0 resection was doubtful, received additional four cycles of chemotherapy with either CAPOX or FOLFIRINOX regimen, and the response was reevaluated with MRI and reassessed for surgical resection...
March 17, 2017: Asia-Pacific Journal of Clinical Oncology
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