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Neoadjuvant chemotherapy in rectal cancer

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https://www.readbyqxmd.com/read/29650419/comparison-of-pathological-complete-response-rates-after-neoadjuvant-short-course-radiotherapy-or-chemoradiation-followed-by-delayed-surgery-in-locally-advanced-rectal-cancer
#1
Sieske Hoendervangers, Alice M Couwenberg, Martijn P W Intven, Wilhelmina M U van Grevenstein, Helena M Verkooijen
INTRODUCTION: Patients with locally advanced rectal cancer (LARC) who are unfit for chemoradiation (CRT), are often offered short-course radiotherapy followed by delayed surgery (SCRT-delay). This entails a lower radiation dose, no chemotherapy and a shorter treatment period. This may lower their chances for complete tumor response and, as such, organ-sparing approaches. The purpose of this study was to compare the pathological complete response (pCR) rates between neoadjuvant CRT and SCRT-delay in patients with LARC in a nationwide database from the Netherlands...
March 23, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29650416/effect-of-comorbidities-in-stage-ii-iii-colorectal-cancer-patients-treated-with-surgery-and-neoadjuvant-adjuvant-chemotherapy-a-single-center-observational-study
#2
Marina Baretti, Lorenza Rimassa, Nicola Personeni, Laura Giordano, Maria Chiara Tronconi, Tiziana Pressiani, Silvia Bozzarelli, Armando Santoro
BACKGROUND: Comorbidity has a detrimental effect on cancer survival, however, it is difficult to disentangle its direct effect from its influence on treatment choice. In this study we assessed the effect of comorbidity on survival in patients who received standard treatment for resected stage II and III colorectal cancer (CRC). PATIENTS AND METHODS: In total, 230 CRC patients, 68 rectal (29.6%) and 162 colon cancer (70.4%) treated with surgical resection and neoadjuvant/adjuvant chemotherapy from December 2002 to December 2009 at Humanitas Cancer Center were retrospectively reviewed...
March 21, 2018: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29594202/time-to-surgery-and-pathologic-complete-response-after-neoadjuvant-chemoradiation-in-rectal-cancer-a-population-study-on-2094-patients
#3
Gabriella Macchia, Maria Antonietta Gambacorta, Carlotta Masciocchi, Giuditta Chiloiro, Giovanna Mantello, Maika di Benedetto, Marco Lupattelli, Elisa Palazzari, Liliana Belgioia, Almalina Bacigalupo, Aldo Sainato, Sabrina Montrone, Lucia Turri, Angela Caroli, Antonino De Paoli, Fabio Matrone, Carlo Capirci, Giampaolo Montesi, Rita Marina Niespolo, Mattia Falchetto Osti, Luciana Caravatta, Alessandra Galardi, Domenico Genovesi, Maria Elena Rosetto, Caterina Boso, Piera Sciacero, Lucia Giaccherini, Salvatore Parisi, Antonella Fontana, Francesco Romeo Filippone, Vincenzo Picardi, Alessio Giuseppe Morganti, Vincenzo Valentini
Background: To retrospectively evaluate the difference in terms of pathologic complete response (pCR) according to time elapsed between chemoradiation (CRT) and total mesorectal excision (TME) on a large unselected real-life dataset of locally advanced rectal cancer (LARC) patients. Methods: A multicentre retrospective cohort study of LARC patients from 21 Italian Radiotherapy Institutions was performed. Patients were stratified into 3 different time intervals from CRT...
June 2017: Clinical and Translational Radiation Oncology
https://www.readbyqxmd.com/read/29566109/adoption-of-total-neoadjuvant-therapy-for-locally-advanced-rectal-cancer
#4
Andrea Cercek, Campbell S D Roxburgh, Paul Strombom, J Joshua Smith, Larissa K F Temple, Garrett M Nash, Jose G Guillem, Philip B Paty, Rona Yaeger, Zsofia K Stadler, Kenneth Seier, Mithat Gonen, Neil H Segal, Diane L Reidy, Anna Varghese, Jinru Shia, Efsevia Vakiani, Abraham J Wu, Christopher H Crane, Marc J Gollub, Julio Garcia-Aguilar, Leonard B Saltz, Martin R Weiser
Importance: Treatment of locally advanced rectal (LARC) cancer involves chemoradiation, surgery, and chemotherapy. The concept of total neoadjuvant therapy (TNT), in which chemoradiation and chemotherapy are administered prior to surgery, has been developed to optimize delivery of effective systemic therapy aimed at micrometastases. Objective: To compare the traditional approach of preoperative chemoradiation (chemoRT) followed by postoperative adjuvant chemotherapy with the more recent TNT approach for LARC...
March 22, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29558294/mr-imaging-with-apparent-diffusion-coefficient-histogram-analysis-evaluation-of-locally-advanced-rectal-cancer-after-chemotherapy-and-radiation-therapy
#5
Nandin-Erdene Enkhbaatar, Shigeaki Inoue, Hiroshi Yamamuro, Shuichi Kawada, Masashi Miyaoka, Naoya Nakamura, Sotaro Sadahiro, Yutaka Imai
Purpose To determine response to neoadjuvant chemotherapy and radiation therapy in patients with locally advanced rectal cancer (LARC) by using magnetic resonance (MR) apparent diffusion coefficient (ADC) histogram analysis. Materials and Methods Ninety-two patients with LARC underwent MR imaging with rectal barium before and after chemotherapy and radiation therapy (CRT). Rectal expansion with barium expanded the lumen, provided similar imaging geometry before and after CRT, and eliminated fecal matter, air, and residual fluid...
March 20, 2018: Radiology
https://www.readbyqxmd.com/read/29545727/contemporary-management-of-locally-advanced-rectal-cancer-resolving-issues-controversies-and-shifting-paradigms
#6
Aeris Jane D Nacion, Youn Young Park, Nam Kyu Kim
Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the efficacy of conventional chemoradiotherapy (CRT) followed by total mesorectal excision (TME) reaches a plateau, the need for alternative strategies in locally advanced rectal cancer (LARC) has grown in relevance. Several novel strategies have been conceptualized to address this issue, including: 1) neoadjuvant induction and consolidation chemotherapy before CRT; 2) neoadjuvant chemotherapy alone to avoid the sequelae of radiation; and 3) nonoperative management for patients who achieved pathological or clinical complete response after CRT...
February 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/29520203/prognostic-significance-of-tumor-regression-in-locally-advanced-rectal-cancer-after-preoperative-radiochemotherapy
#7
Mirko Omejc, Maja Potisek
Background: The majority of rectal cancers are discovered in locally advanced forms (UICC stage II, III). Treatment consists of preoperative radiochemotherapy, followed by surgery 6-8 weeks later and finally by postoperative chemotherapy. The aim of this study was to find out if tumor regression affected long-term survival in patients with localy advanced rectal cancer, treated with neoadjuvant radiochemotherapy. Patients and methods: Patients with rectal cancer stage II or III, treated between 2006 and 2010, were included in a retrospective study...
March 2018: Radiology and Oncology
https://www.readbyqxmd.com/read/29514017/mr-imaging-of-rectal-cancer-radiomics-analysis-to-assess-treatment-response-after-neoadjuvant-therapy
#8
Natally Horvat, Harini Veeraraghavan, Monika Khan, Ivana Blazic, Junting Zheng, Marinela Capanu, Evis Sala, Julio Garcia-Aguilar, Marc J Gollub, Iva Petkovska
Purpose To investigate the value of T2-weighted-based radiomics compared with qualitative assessment at T2-weighted imaging and diffusion-weighted (DW) imaging for diagnosis of clinical complete response in patients with rectal cancer after neoadjuvant chemotherapy-radiation therapy (CRT). Materials and Methods This retrospective study included 114 patients with rectal cancer who underwent magnetic resonance (MR) imaging after CRT between March 2012 and February 2016. Median age among women (47 of 114, 41%) was 55...
March 7, 2018: Radiology
https://www.readbyqxmd.com/read/29506843/pathologic-response-following-treatment-for-locally-advanced-rectal-cancer-does-location-matter
#9
William H Ward, Elin R Sigurdson, Andrew C Esposito, Karen J Ruth, Samuel M Manstein, Eric C Sorenson, Brian D Wernick, Jeffrey M Farma
BACKGROUND: Despite advances in the treatment of rectal adenocarcinoma, the management of locally advanced disease remains a challenge. The standard of care for patients with stages II and III rectal cancer includes neoadjuvant chemoradiation followed by total mesorectal excision and postoperative chemotherapy. Much effort has been dedicated to the identification of predictive factors associated with pathologic complete response (pCR). The aim of our study was to examine our institutional experience and determine whether any association exists between anatomic tumor location and the rate of pCR...
April 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29483422/-multimodality-therapy-against-the-lateral-lymph-node-recurrence-of-rectal-cancer
#10
Tomohiro Tate, Yudai Fukui, Kenji Tomizawa, Yutaka Hanaoka, Shigeo Toda, Shuichiro Matoba, Hiroya Kuroyanagi
BACKGROUND: The local recurrence of rectal cancer classifies 4 types, anterior, posterior, lateral compartment and anastomotic site. This study evaluates outcome of laparoscopic lateral lymph node dissection(LLND)against the lateral lymph node recurrence. METHOD: Five patients were diagnosed as the lateral lymph node recurrence and underwent laparoscopic LLND. We diagnosed the lateral lymph node recurrence by CT, MRI and PET-CT. All cases revealed abnormal uptake on PET-CT...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29478127/impact-of-ras-braf-mutation-status-in-locally-advanced-rectal-cancer-treated-with-preoperative-chemotherapy
#11
Taihei Oshiro, Keisuke Uehara, Toshisada Aiba, Toshiki Mukai, Tomoki Ebata, Masato Nagino
PURPOSE: Our sincere hope is to establish the predictive factors of neoadjuvant chemotherapy (NAC) response and provide patients with greater certainty regarding treatment outcomes. The aim of this study was to assess the response to NAC and survival in patients with locally advanced rectal cancer (LARC) according to their RAS/BRAF mutation status. METHODS: Data on 57 patients with LARC who received NAC between 2009 and 2016 were analyzed retrospectively. The patients were classified into two groups based on their mutation status: wild-type in both RAS and BRAF (WT) or mutant-type in either RAS or BRAF (MT)...
February 24, 2018: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29465458/prognostic-implications-of-pathological-response-to-neoadjuvant-chemoradiation-in-pathologic-stage-iii-rectal-cancer
#12
Georgios Karagkounis, Leo Thai, Adam G Mace, Homer Wiland, Rish K Pai, Scott R Steele, James M Church, Matthew F Kalady
OBJECTIVE: To evaluate the independent prognostic ability of the American Joint Committee on Cancer (AJCC) tumor regression scores within pathologic stage II and III rectal cancers. BACKGROUND: Response to neoadjuvant chemoradiation (nCRT) has been debated as a biologic surrogate for tumor biology and prognosis in rectal cancer. AJCC regression scores have been shown to correlate with prognosis. METHODS: Patient demographics, tumor characteristics, and AJCC scores (0 = complete response; 1 = isolated tumor cells remaining; 2 = residual cancer outgrown by fibrosis; 3 = extensive residual cancer) were assessed from 545 rectal cancer patients treated by nCRT followed by surgery at a single institution...
February 20, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29464828/the-significance-of-tumor-infiltrating-lymphocytes-before-and-after-neoadjuvant-therapy-for-rectal-cancer
#13
Shinji Matsutani, Masatsune Shibutani, Kiyoshi Maeda, Hisashi Nagahara, Tatsunari Fukuoka, Shigetomi Nakao, Kosei Hirakawa, Masaichi Ohira
Recently, neoadjuvant therapy for locally advanced rectal cancer has been generally performed. However, biomarkers predicting the response to neoadjuvant therapy have not been established. Tumor-infiltrating lymphocytes (TILs) have a crucial effect on tumor progression and the survival outcome as the primary host immune response, and an antitumor immune effect has been reported to contribute to the response to radiotherapy and chemotherapy. We investigated the significance of TILs before and after neoadjuvant treatment and the change in the density of those TILs...
February 21, 2018: Cancer Science
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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