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Neoadjuvant chemotherapy in rectal cancer

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https://www.readbyqxmd.com/read/29233486/cetuximab-combined-with-induction-oxaliplatin-and-capecitabine-followed-by-neoadjuvant-chemoradiation-for-locally-advanced-rectal-cancer-swog-0713
#1
Cynthia Gail Leichman, Shannon L McDonough, Stephen R Smalley, Kevin G Billingsley, Heinz-Josef Lenz, Matthew A Beldner, Aram F Hezel, Mario R Velasco, Katherine A Guthrie, Charles D Blanke, Howard S Hochster
BACKGROUND: Neoadjuvant chemoradiation (NCRT) is standard treatment for locally advanced rectal cancer. Pathologic complete response (pCR) has associated with improved survival. In modern phase III trials of NCRT, pCR ranges from 10% to 20%. Cetuximab improves response in KRAS (KRAS proto-oncogene) wild type (wt) metastatic colorectal cancer. S0713 was designed to assess improvement in pCR with additional use of cetuximab with induction chemotherapy and NCRT for locally advanced, KRAS-wt rectal cancer...
October 24, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29230964/preventive-effect-of-diverting-stoma-on-anastomotic-leakage-after-laparoscopic-low-anterior-resection-with-double-stapling-technique-reconstruction-applied-based-on-risk-stratification
#2
Atsushi Hamabe, Masaaki Ito, Hideaki Nishigori, Yuji Nishizawa, Takeshi Sasaki
INTRODUCTION: During laparoscopic low anterior resection with double stapling technique reconstruction, it is necessary to securely implement rectal transection and anastomosis to prevent anastomotic leakage (AL). However, risk factors and preventive measures for AL are not known sufficiently. Therefore, this study aimed to elucidate risk factors associated with AL and to clarify strategies to prevent it. METHODS: We analyzed a total of 296 cases with rectal cancer who had undergone laparoscopic low anterior resection with double stapling technique reconstruction at the National Cancer Center Hospital East...
December 12, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29225479/density-of-cd8-lymphocytes-in-biopsy-samples-combined-with-the-circulating-lymphocyte-ratio-predicts-pathologic-complete-response-to-chemoradiotherapy-for-rectal-cancer
#3
Binyi Xiao, Jianhong Peng, Rongxin Zhang, Jing Xu, Yongchun Wang, Yujing Fang, Junzhong Lin, Zhizhong Pan, Xiaojun Wu
Objectives: The systemic status and local immune status, as determined by the neutrophil-lymphocyte ratio (NLR) or the lymphocyte ratio (LYMR) and tumor-infiltrating lymphocyte (TIL) count, respectively, have been suggested as predictors of the tumor response to neoadjuvant chemoradiotherapy (nCRT) in rectal cancer, although the utility of these measures remains controversial. We aimed to investigate the values of the LYMR, NLR and TIL count and their combinations (TIL-LYMR/TIL-NLR) in predicting pathologic complete response (pCR) after nCRT...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/29223019/are-pathological-high-risk-features-in-locally-advanced-rectal-cancer-a-useful-selection-tool-for-adjuvant-chemotherapy
#4
Marloes Swets, Peter J K Kuppen, Erik J Blok, Hans Gelderblom, Cornelis J H van de Velde, Iris D Nagtegaal
BACKGROUND: Several histological high-risk factors are used as an indication for adjuvant therapy in stage II colon cancer. Those and other factors, including lymphatic invasion, perineural invasion (PNI), venous invasion and tumour budding are associated with decreased outcome. In this study, we evaluated the prognostic and predictive values of these biomarkers in a cohort of rectal cancer patients. MATERIALS AND METHODS: The trial-based cohort consisted of 221npTNM stage II-III rectal cancer patients, included in the PROCTOR/SCRIPT trial, a multicentre randomised phase III trial...
December 6, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29218690/neoadjuvant-volumetric-modulated-arc-therapy-in-rectal-cancer-and-the-correlation-of-pathological-response-with-diffusion-weighted-mri-and-apoptotic-markers
#5
Necla Gurdal, Merdan Fayda, Nijat Alishev, Baris Bakir, Didem Tastekin, Faruk Aykan, Ugur Gezer, Emre Balik, Esra Kaytan Saglam, Ethem Nezih Oral, Mine Gulluoglu, Ahmet Kizir
PURPOSE: In this prospective observational study, we aimed to report the applicability and tolerability of neoadjuvant volumetric modulated arc therapy with simultaneous integrated boost (SIB-VMAT) and concurrent chemotherapy in patients with locally advanced rectal cancer (LARC), and to evaluate the correlation of pathological response with apparent diffusion coefficient (ADC) measurements on diffusion-weighted magnetic resonance imaging (DW-MRI) and apoptotic markers. METHODS: The study enrolled 30 patients with T3 to T4 and/or N+ rectal cancer who preoperatively received SIB-VMAT and concurrent chemotherapy...
December 6, 2017: Tumori
https://www.readbyqxmd.com/read/29217398/is-neoadjuvant-chemoradiation-with-dose-escalation-and%C3%A2-consolidation-chemotherapy-sufficient-to-increase-surgery-free-and-distant-metastases-free-survival-in-baseline%C3%A2-ct3-rectal-cancer
#6
Guilherme Pagin São Julião, Angelita Habr-Gama, Bruna Borba Vailati, Patricia Bailão Aguilar, Jorge Sabbaga, Sérgio Eduardo Alonso Araújo, Adrian Mattacheo, Flavia Andrea Alexandre, Laura Melina Fernandez, Diogo Bugano Gomes, Joaquim Gama-Rodrigues, Rodrigo Oliva Perez
Patients with cT3 rectal cancer are less likely to develop complete response to neoadjuvant chemoradiation (nCRT) and still face significant risk for systemic relapse. In this setting, radiation (RT) dose-escalation and consolidation chemotherapy in "extended" nCRT regimens have been suggested to improve primary tumor response and decrease the risks of systemic recurrences. For these reasons we compared surgery-free and distant-metastases free survival among cT3 patients undergoing standard or extended nCRT...
November 26, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29203977/radical-treatment-of-rectal-cancer-in-elderly-is-feasible-than-feared-results-from-a-tertiary-care-centre
#7
Madhu Muralee, Rajesh Singh, Arun Peter Mathew, Kurian Cherian, K Chandramohan, Paul Augustine, S Roshni, Iqbal Ahamed
The thought of subjecting an elderly patient with rectal cancer to protocol-based neoadjuvant chemoradiation (NACTRT), surgery and adjuvant chemotherapy is sought with fear due to their multiple comorbidities and impaired functional status associated with the process of ageing. Hence, many a times the treatment is compromised and it is a fact that this subgroup of patients is underrepresented in most of the clinical trials. This study was aimed at analysing the perioperative and oncologic outcomes after protocol-based treatment of rectal cancer in the elderly patients, defined here as those with age ≥70 years...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29185241/quality-indicators-of-colorectal-cancer-care-in-southern-switzerland-results-from-a-population-based-study
#8
Alessandra Spitale, Laura Ortelli, Luca Mazzucchelli, Andrea Bordoni
AIM OF THE STUDY: Assessing the quality of cancer care (QoCC) has become increasingly relevant to providers, regulators and purchasers of healthcare worldwide. The aim of this study was to assess adherence to validated quality indicators (QIs) for colorectal cancer (CRC) in a population-based setting, and to compare results with the available literature. METHODS: All colorectal cancers diagnosed between 1 January 2011 and 31 December 2012 were identified from the files of the population-based Ticino Cancer Registry, southern Switzerland...
November 29, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29181181/adjuvant-chemotherapy-for-patients-with-ypt0-2n0-category-after-neoadjuvant-chemoradiotherapy-for-rectal-cancer
#9
Jue-Feng Wan, Li-Feng Yang, Ji Zhu, Gui-Chao Li, Zhen Zhang
Locally advanced rectal cancer patients with ypT0-2N0 have good prognosis and may not require as many cycles of adjuvant chemotherapy as patients with a poor (ypT3-4 or N+) response. The aim of the present study was to evaluate the three-year disease-free and overall survival between patients with ypT0-2N0 rectal adenocarcinoma who received 0-3 cycles of 5-fluorouracil-based adjuvant chemotherapy and those who received >3 cycles. A total of 106 patients with locally advanced rectal cancer, classified as ypT0-2N0 after surgery at the Fudan University Shanghai Cancer Center (Shanghai, China) between 2006 and 2012, were identified...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29178095/-efficacy-analysis-of-proximally-extended-resection-for-locally-advanced-rectal-cancer-after-neoadjuvant-chemoradiotherapy
#10
Qiyuan Qin, Yingyi Kuang, Tenghui Ma, Yali Wu, Huaiming Wang, Yanna Pi, Hui Wang, Lei Wang
OBJECTIVE: To evaluate the short-term outcomes and perioperative safety of proximally extended resection for locally advanced rectal cancer after neoadjuvant chemoradiotherapy. METHODS: From colorectal cancer database in The Sixth Affiliated Hospital of Sun Yat-sen University, a cohort of patients who underwent neoadjuvant chemoradiotherapy(1.8-2.0 Gy per day, 25-28 fractions, concurrent fluorouracil-based chemotherapy) followed by curative sphincter-preserving surgery for locally advanced rectal cancer between May 2016 and June 2017 were retrospectively identified...
November 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29168556/preliminary-results-of-a-cohort-study-of-induction-chemotherapy-based-treatment-for-locally-recurrent-rectal-cancer
#11
D M G I van Zoggel, S J Bosman, M Kusters, G A P Nieuwenhuijzen, J S Cnossen, G J Creemers, G van Lijnschoten, H J T Rutten
BACKGROUND: A significant number of patients treated for locally recurrent rectal cancer have local or systemic failure, especially after incomplete surgical resection. Neoadjuvant treatment regimens in patients who have already undergone preoperative (chemo)radiotherapy for the primary tumour are limited. The objective of the present study was to evaluate the influence of a neoadjuvant regimen incorporating induction chemotherapy (ICT) in patients with locally recurrent rectal cancer who had preoperative (chemo)radiotherapy for the primary cancer or an earlier local recurrence...
November 23, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29167909/outcomes-of-neoadjuvant-chemoradiotherapy-followed-by-total-mesorectal-excision-surgery-for-locally-advanced-rectal-cancer-a-single-institution-experience
#12
Michelle Shu Fen Tseng, Huili Zheng, Ivy Wei Shan Ng, Yiat Horng Leong, Cheng Nang Leong, Wei Peng Yong, Wai Kit Cheong, Jeremy Chee Seong Tey
INTRODUCTION: Neoadjuvant chemoradiotherapy (CRT) followed by total mesorectal excision (TME) surgery for locally advanced rectal cancer has been shown to improve local control and reduce toxicity, as compared to adjuvant CRT. We report the outcomes of our patients with locally advanced rectal cancer treated at National University Hospital, Singapore. METHODS: From April 2002 to December 2014, 117 patients with T3/4, N0/+, M0 rectal cancer received neoadjuvant CRT followed by TME surgery...
November 13, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/29167471/pim-3-as-a-potential-predictor-of-chemoradiotherapy-resistance-in-locally-advanced-rectal-cancer-patients
#13
Rong-Xin Zhang, Zhong-Guo Zhou, Shi-Xun Lu, Zhen-Hai Lu, De-Sen Wan, Zhi-Zhong Pan, Xiao-Jun Wu, Gong Chen
Approximately 30% of locally advanced rectal cancer patients might not benefit from chemoradiotherapy; however, the response to neoadjuvant chemoradiotherapy in these cases is difficult to predict. Pim-3 is a member of the provirus integration site for a moloney murine leukemia virus family of proteins that contributes to cell proliferation, survival, and chemotherapy resistance. Therefore, the relationship between Pim-3 expression and response to neoadjuvant chemoradiotherapy in rectal cancer patients is important to evaluate...
November 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29162332/integrating-downstaging-in-the-risk-assessment-of-patients-with-locally-advanced-rectal-cancer-treated-with-neoadjuvant-chemoradiotherapy-validation-of-valentini-s-nomograms-and-the-neoadjuvant-rectal-score
#14
Susana Roselló, Matteo Frasson, Eduardo García-Granero, Desamparados Roda, Esther Jordá, Samuel Navarro, Salvador Campos, Pedro Esclápez, Stephanie García-Botello, Blas Flor, Alejandro Espí, Carlotta Masciocchi, Vincenzo Valentini, Andrés Cervantes
BACKGROUND: Adjuvant chemotherapy is controversial in patients with locally advanced rectal cancer after preoperative chemoradiation. Valentini et al developed 3 nomograms (VN) to predict outcomes in these patients. The neoadjuvant rectal score (NAR) was developed after VN to predict survival. We aimed to validate these tools in a retrospective cohort at an academic institution. PATIENTS AND METHODS: VN and the NAR were applied to 158 consecutive patients with locally advanced rectal cancer treated with chemoradiation followed by surgery...
October 28, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29159744/treatment-and-outcome-of-synchronous-colorectal-carcinomas-a-nationwide-study
#15
A C R K Bos, R A Matthijsen, F N van Erning, M G H van Oijen, H J T Rutten, V E P P Lemmens
BACKGROUND: Synchronous colorectal carcinomas (CRC) occur in 1-8% of patients diagnosed with CRC. This study evaluated treatment patterns and patient outcomes in synchronous CRCs compared with solitary CRC patients. METHODS: All patients diagnosed with primary CRC between 2008 and 2013, who underwent elective surgery, were selected from the Netherlands Cancer Registry. Using multivariable regressions, the effects of synchronous CRC were assessed for both short-term outcomes (prolonged postoperative hospital admission, anastomotic leakage, postoperative 30-day mortality, administration of neoadjuvant or adjuvant treatment), and 5-year relative survival (RS)...
November 20, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29158365/phase-ii-trial-using-a-combination-of-oxaliplatin-capecitabine-and-celecoxib-with-concurrent-radiation-for-newly-diagnosed-resectable-rectal-cancer
#16
Emilio P Araujo-Mino, Yehuda Z Patt, Cristina Murray-Krezan, Joshua A Hanson, Pranshu Bansal, Ben J Liem, Ashwani Rajput, M Houman Fekrazad, Glenory Heywood, Fa Chyi Lee
LESSONS LEARNED: Colorectal cancers exhibit a high level of cyclooxygenase-2 (COX-2) expression with strong preclinical rationale for improved clinical outcomes with COX-2 inhibition. Celecoxib is a COX-2 inhibitor and we have shown that it can be safely combined with capecitabine and oxaliplatin as part of neoadjuvant treatment with radiation therapy (RT) in rectal cancer.There was a significant improvement in skin toxicity with this combination as compared with historical data. Considering the field has moved on to single-agent capecitabine, we believe future trials with capecitabine and celecoxib hold potential...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29124955/current-issues-of-preoperative-radio-chemo-therapy-and-its-future-evolution-in-locally-advanced-rectal-cancer
#17
Bin Ma, Qingzhou Xu, Yongxi Song, Peng Gao, Zhenning Wang
Neoadjuvant therapies are effective for local control and tumor downstaging. Up to date, preoperative long-course chemoradiotherapy and short-course radiotherapy are the two primary guideline-recommended neoadjuvant therapies for locally advanced rectal cancer patients. However, clinicians throughout the world are trying their best to further optimize the regimens and concepts of neoadjuvants. Hence, there is an urgent need to summarize evidence regarding indications of neaoadjuvant therapies and relative merits of current standard regimens...
November 2017: Future Oncology
https://www.readbyqxmd.com/read/29113729/intensified-neoadjuvant-chemoradiotherapy-for-locally-advanced-rectal-cancer-in-elderly-patients-toxicity-disease-control-and-survival-outcomes
#18
Francesca De Felice, Karen Llange, Filippo Rubini, Nadia Bulzonetti, Rossella Caiazzo, Daniela Musio, Vincenzo Tombolini
INTRODUCTION: We report the treatment compliance, toxicity rates, and long-term clinical outcomes of elderly patients who received intensified neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC). PATIENTS AND METHODS: We identified a retrospective cohort of patients aged ≥ 70 years with LARC who received intensified neoadjuvant CRT, followed by surgery and adjuvant chemotherapy, from 2007 to 2014. Intensified neoadjuvant CRT consisted of radiotherapy (total dose, 50...
October 16, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29112560/is-the-distance-worth-it-patients-with-rectal-cancer-traveling-to-high-volume-centers-experience-improved-outcomes
#19
Zhaomin Xu, Adan Z Becerra, Carla F Justiniano, Courtney I Boodry, Christopher T Aquina, Alex A Swanger, Larissa K Temple, Fergal J Fleming
BACKGROUND: It is unclear whether traveling long distances to high-volume centers would compensate for travel burden among patients undergoing rectal cancer resection. OBJECTIVE: The purpose of this study was to determine whether operative volume outweighs the advantages of being treated locally by comparing the outcomes of patients with rectal cancer treated at local, low-volume centers versus far, high-volume centers. DESIGN: This was a population-based study...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29104590/impact-of-body-mass-index-on-surgical-and-oncological-outcomes-in-laparoscopic-total-mesorectal-excision-for-locally-advanced-rectal-cancer-after-neoadjuvant-5-fluorouracil-based-chemoradiotherapy
#20
Yanwu Sun, Pan Chi
Aims: To evaluate the impact of body mass index (BMI) on the surgical outcome of laparoscopic total mesorectal excision (laTME) for locally advanced rectal cancer (LARC, clinically staged as UICC stage II/III) after neoadjuvant chemoradiotherapy (nCRT). Methods: 312 LARC patients undergoing laTME after nCRT were divided into nonobese (BMI < 25.0 kg/m(2), n = 249) and obese (BMI ≥ 25.0 kg/m(2), n = 63) groups. Preoperative radiotherapy was delivered in 45-50...
2017: Gastroenterology Research and Practice
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