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Neoadjuvant chemotherapy in rectal cancer

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https://www.readbyqxmd.com/read/29432076/neoadjuvant-chemotherapy-followed-by-radical-surgery-versus-concomitant-chemotherapy-and-radiotherapy-in-patients-with-stage-ib2-iia-or-iib-squamous-cervical-cancer-a-randomized-controlled-trial
#1
Sudeep Gupta, Amita Maheshwari, Pallavi Parab, Umesh Mahantshetty, Rohini Hawaldar, Supriya Sastri Chopra, Rajendra Kerkar, Reena Engineer, Hemant Tongaonkar, Jaya Ghosh, Seema Gulia, Neha Kumar, T Surappa Shylasree, Renuka Gawade, Yogesh Kembhavi, Madhuri Gaikar, Santosh Menon, Meenakshi Thakur, Shyam Shrivastava, Rajendra Badwe
Purpose We compared the efficacy and toxicity of neoadjuvant chemotherapy followed by radical surgery versus standard cisplatin-based chemoradiation in patients with locally advanced squamous cervical cancer. Patients and Methods This was a single-center, phase III, randomized controlled trial ( ClinicalTrials.gov identifier: NCT00193739). Eligible patients were between 18 and 65 years old and had stage IB2, IIA, or IIB squamous cervical cancer. They were randomly assigned, after stratification by stage, to receive either three cycles of neoadjuvant chemotherapy using paclitaxel and carboplatin once every 3 weeks followed by radical hysterectomy or standard radiotherapy with concomitant cisplatin once every week for 5 weeks...
February 12, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29420226/serial-circulating-tumour-dna-analysis-during-multimodality-treatment-of-locally-advanced-rectal-cancer-a-prospective-biomarker-study
#2
Jeanne Tie, Joshua D Cohen, Yuxuan Wang, Lu Li, Michael Christie, Koen Simons, Hany Elsaleh, Suzanne Kosmider, Rachel Wong, Desmond Yip, Margaret Lee, Ben Tran, David Rangiah, Matthew Burge, David Goldstein, Madhu Singh, Iain Skinner, Ian Faragher, Matthew Croxford, Carolyn Bampton, Andrew Haydon, Ian T Jones, Christos S Karapetis, Timothy Price, Mary J Schaefer, Jeanne Ptak, Lisa Dobbyn, Natallie Silliman, Isaac Kinde, Cristian Tomasetti, Nickolas Papadopoulos, Kenneth Kinzler, Bert Volgestein, Peter Gibbs
OBJECTIVE: For patients with locally advanced rectal cancer (LARC), adjuvant chemotherapy selection following surgery remains a major clinical dilemma. Here, we investigated the ability of circulating tumour DNA (ctDNA) to improve risk stratification in patients with LARC. DESIGN: We enrolled patients with LARC (T3/T4 and/or N+) planned for neoadjuvant chemoradiotherapy. Plasma samples were collected pretreatment, postchemoradiotherapy and 4-10 weeks after surgery...
February 2, 2018: Gut
https://www.readbyqxmd.com/read/29409457/the-potential-predictive-value-of-dek-expression-for-neoadjuvant-chemoradiotherapy-response-in-locally-advanced-rectal-cancer
#3
J Martinez-Useros, I Moreno, M J Fernandez-Aceñero, M Rodriguez-Remirez, A Borrero-Palacios, A Cebrian, T Gomez Del Pulgar, L Del Puerto-Nevado, W Li, A Puime-Otin, N Perez, M S Soengas, J Garcia-Foncillas
BACKGROUND: Limited data are available regarding the ability of biomarkers to predict complete pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Complete response translates to better patient survival. DEK is a transcription factor involved not only in development and progression of different types of cancer, but is also associated with treatment response. This study aims to analyze the role of DEK in complete pathological response following chemoradiotherapy for locally advanced rectal cancer...
February 6, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29407455/the-role-of-chemotherapy-in-localized-and-locally-advanced-rectal-cancer-a-systematic-revision
#4
REVIEW
Susana Roselló, Federica Papaccio, Desamparados Roda, Noelia Tarazona, Andrés Cervantes
Curative treatment of rectal cancer depends on an optimal surgical resection, with the addition of neoadjuvant radiotherapy (RT) with or without concomitant chemotherapy (ChT) in more advanced tumors. The role of adjuvant ChT is controversial and a more intensified neoadjuvant approach with the addition of ChT before or after RT, or even as single modality, is currently being explored in trials. A systematic review selecting randomised phase II and III trials on the role of ChT in localized rectal cancer was performed...
February 2018: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29402470/a-qualitative-signature-for-predicting-pathological-response-to-neoadjuvant-chemoradiation-in-locally-advanced-rectal-cancers
#5
You Guo, Weizhong Jiang, Lu Ao, Kai Song, Huxing Chen, Qingzhou Guan, Qiao Gao, Jun Cheng, Huaping Liu, Xianlong Wang, Guoxian Guan, Zheng Guo
BACKGROUND AND PURPOSE: The standard therapy for locally advanced rectal cancers (LARCs) is neoadjuvant chemoradiation (nCRT) followed by surgical resection. Pathological response to nCRT varies among patients, and it remains a challenge to predict pathological response to nCRT in LARCs. MATERIAL AND METHODS: Using 42 samples as the training cohort, we searched a signature by screening the gene pairs whose within-sample relative expression orderings are significantly correlated with the pathological response...
February 2, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29398323/delaying-surgery-after-neoadjuvant-chemoradiotherapy-in-rectal-cancer-has-no-influence-in-surgical-approach-or-short-term-clinical-outcomes
#6
Nuno Figueiredo, Sofoklis Panteleimonitis, Sotiris Popeskou, Jose F Cunha, Tahseen Qureshi, Geerard L Beets, Richard J Heald, Amjad Parvaiz
AIMS: In rectal cancer, increasing the interval between the end of neoadjuvant chemoradiotherapy (CRT) and surgery could improve the pathological complete response (pCR) rates, allow full-dose neoadjuvant chemotherapy, and select patients with a clinical complete response (cCR) for inclusion in a "watch & wait" program (W&W). However, controversy arises from waiting more than 8-12 weeks after CRT, as it might increase fibrosis around the total mesorectal excision (TME) plane potentially leading to technical difficulties and higher surgical morbidity...
February 1, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29388280/area-of-residual-tumor-is-a-robust-prognostic-marker-for-patients-with-rectal-cancer-undergoing-preoperative-therapy
#7
Naoki Sakuyama, Motohiro Kojima, Shingo Kawano, Yoko Matsuda, Mari Mino-Kenudson, Atsushi Ochiai, Masaaki Ito
The aim of this study was to elucidate differences in the histological features of rectal cancer between patients treated with preoperative chemoradiotherapy and those treated with preoperative chemotherapy. Area of residual tumor (ART) was also evaluated for its utility as a potential prognostic marker between them. Sixty-eight patients with rectal cancer who underwent sphincter-saving surgery were enrolled in this study. Of these, 39 patients received preoperative chemoradiotherapy (CRT group) and 29 patients received preoperative (neoadjuvant) chemotherapy (NAC group)...
February 1, 2018: Cancer Science
https://www.readbyqxmd.com/read/29375747/neoadjuvant-hyperfractionated-accelerated-radiotherapy-plus-concomitant-5-fluorouracil-infusion-in-locally-advanced-rectal-cancer-a-phase-ii-study
#8
Zeynep Gural, Sezer Saglam, Serap Yucel, Esra Kaytan-Saglam, Oktar Asoglu, Cetin Ordu, Hediye Acun, Rasul Sharifov, Semen Onder, Ahmet Kizir, Ethem N Oral
AIM: To evaluate the efficacy and tolerability of neoadjuvant hyperfractionated accelerated radiotherapy (HART) and concurrent chemotherapy in patients with locally advanced infraperitoneal rectal cancer. METHODS: A total of 30 patients with histopathologically confirmed T2-3/N0+ infraperitoneal adenocarcinoma of rectum cancer patients received preoperative 42 Gy/1.5 Gy/18 days/bid radiotherapy and continuous infusion of 5-fluorouracil (325 mg/m2). All patients were operated 4-8 wk after neoadjuvant concomitant therapy...
January 15, 2018: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29370182/correlation-of-pathological-complete-response-with-survival-after-neoadjuvant-chemotherapy-in-gastric-or-gastroesophageal-junction-cancer-treated-with-radical-surgery-a-meta-analysis
#9
Ziyu Li, Fei Shan, Yinkui Wang, Yan Zhang, Lianhai Zhang, Shuangxi Li, Yongning Jia, Kan Xue, Rulin Miao, Zhemin Li, Jiafu Ji
BACKGROUND: Neoadjuvant chemotherapy before radical gastrectomy is preferred for locally advanced gastric cancer. To avoid the problematic use of pTNM for patients after neoadjuvant chemotherapy, the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC) gastric cancer TNM staging system (8th edition) added ypTNM for the first time. But patients achieving pathological complete response were not covered by the new ypTNM staging system. To investigate whether pathological complete response is associated with better outcome in gastric cancer, as was reported in rectal, breast and bladder cancer...
2018: PloS One
https://www.readbyqxmd.com/read/29362905/role-of-chemotherapy-in-the-neoadjuvant-adjuvant-setting-for-patients-with-rectal-adenocarcinoma-undergoing-chemoradiotherapy-and-surgery-or-radiotherapy-and-surgery
#10
REVIEW
Shahab Ahmed, Cathy Eng
Rectal cancer has been successfully managed in the last couple of decades. In the USA, as the initial approach, neoadjuvant concurrent chemoradiation has been associated not only with decrease in tumor size and recurrence but also with higher resection rate with minimal side effects. Data support that addition of chemotherapy to radiotherapy is superior to radiotherapy alone in the neoadjuvant setting. Recent debates have addressed the question of administration of adjuvant chemotherapy following surgery. In this article, we discuss the role of chemotherapy in both the neoadjuvant and the adjuvant settings for locally advanced rectal cancer...
January 23, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29354903/-the-value-of-mri-with-cube-sequence-in-early-evaluation-of-the-efficacy-of-neoadjuvant-therapy-for-locally-advanced-rectal-cancer
#11
Xinhua Wang, Wuteng Cao, Dechao Liu, Fangqian Li, Wenli Li, Liang Kang, Yanhong Deng, Zhiyang Zhou
OBJECTIVE: To investigate the value of MRI with CUBE sequence in early evaluation of the efficacy of neoadjuvant therapy (NAT) for locally advanced rectal cancer. METHODS: Inclusion criteria: (1) rectal cancer proven by biopsy; (2) locally advanced rectal cancer (T3-4 or positive lymph nodes) with distance from lower edge of tumor to anal verge within 12 cm diagnosed by MRI before NAT; (3) acceptance of NAT treatment regulations and completion of NAT; (4) completion of routine MRI scan and CUBE scan before and after 2-course NAT chemotherapy (including new neoadjuvant chemotherapy and chemoradiotherapy); (5) completion of surgery 6-8 weeks after NAT; (6) exclusion of any previous NAT due to rectal malignant tumor or other tumors; (7) exclusion of poor image quality of preoperative routine MRI insufficient for rectal cancer staging or of CUBE image insufficient for tumor volume measurement...
January 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29340767/analysis-of-prognostic-factors-after-resection-of-solitary-liver-metastasis-in-colorectal-cancer-a-22-year-bicentre-study
#12
Sara Acciuffi, Frank Meyer, Astrid Bauschke, Utz Settmacher, Hans Lippert, Roland Croner, Annelore Altendorf-Hofmann
PURPOSE: The investigation of the predictors of outcome after hepatic resection for solitary colorectal liver metastasis. METHODS: We recruited 350 patients with solitary colorectal liver metastasis at the University Hospitals of Jena and Magdeburg, who underwent curative liver resection between 1993 and 2014. All patients had follow-up until death or till summer 2016. RESULTS: The follow-up data concern 96.6% of observed patients. The 5- and 10-year overall survival rates were 47 and 28%, respectively...
January 16, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29290999/impact-of-neoadjuvant-and-adjuvant-radiotherapy-on-disease-specific-survival-in-patients-with-stages-ii-iv-rectal-cancer
#13
Yinying Wu, Haiyang Liu, Xianglin L Du, Fan Wang, Jing Zhang, Xiaohai Cui, Enxiao Li, Jin Yang, Min Yi, Yunfeng Zhang
Objectives: The purposes of this study were to determine whether neoadjuvant or adjuvant radiotherapy affected disease-specific survival (DSS) in patients with rectal cancer and whether stratification by tumor stage affected the results. Results: 55.5% patients had neoadjuvant-radiotherapy (NRT), and 18.3% patients had adjuvant- radiotherapy (ART). Multivariable models showed that treatment type was independently associated with DSS. Patients with stages III/IV tumors who received ART plus chemotherapy had significantly worse DSS than did those who received NRT plus chemotherapy (NCRT) (P = 0...
December 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/29281151/quantitative-intravoxel-incoherent-motion-parameters-derived-from-whole-tumor-volume-for-assessing-pathological-complete-response-to-neoadjuvant-chemotherapy-in-locally-advanced-rectal-cancer
#14
Qiaoyu Xu, Yanyan Xu, Hongliang Sun, Queenie Chan, Kaining Shi, Aiping Song, Wu Wang
BACKGROUND: Many locally advanced rectal cancer (LARC) patients can benefit from neoadjuvant chemotherapy (NACT), with some achieving a pathological complete response (pCR). However, there is limited research reporting on the value of intravoxel incoherent motion (IVIM) in monitoring pCR in patients with LARC. PURPOSE: To identify whether IVIM parameters derived from whole-tumor volume (WTV) before and after NACT could accurately assess pCR in patients with LARC...
December 27, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29260978/dna-hypermethylation-as-a-predictor-of-extramural-vascular-invasion-emvi-in-rectal-cancer
#15
Rory F Kokelaar, Huw G Jones, Jeremy Williamson, Namor Williams, A Paul Griffiths, John Beynon, Gareth J Jenkins, Dean A Harris
Structured Abstract Purpose: DNA hypermethylation in gene promoter regions (CpG islands) is emerging as an important pathway in colorectal cancer tumourigenesis. Whilst genetic mutations have been associated with extramural vascular invasion (EMVI) in rectal cancer, no such association has yet been made with epigenetic factors. METHODS: 100 consecutive neoadjuvant-naïve patients undergoing curative surgery for rectal were classified according to the presence or absence of EMVI on histopathological examination...
December 20, 2017: Cancer Biology & Therapy
https://www.readbyqxmd.com/read/29233486/cetuximab-combined-with-induction-oxaliplatin-and-capecitabine-followed-by-neoadjuvant-chemoradiation-for-locally-advanced-rectal-cancer-swog-0713
#16
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
#17
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
#18
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
#19
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...
January 2018: 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
#20
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
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