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Neoadjuvant chemotherapy in local advanced rectal cancer

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https://www.readbyqxmd.com/read/28900999/-study-on-the-relationship-between-tumor-regression-grade-and-lymph-node-regression-grade
#1
Quanquan Zhao, Chuangang Fu, Enda Yu, Wei Zhang, Ronggui Meng, Hantao Wang, Liqiang Hao, Hao Wang
OBJECTIVE: To investigate the relationship between tumor regression grade (TRG) and lymph node regression grade (LRG) after neoadjuvant chemoradiotherapy (CRT) for rectal cancer and its clinical implication. METHODS: Clinicopathological data of 176 rectal cancer patients undergoing radical excision after neoadjuvant CRT from January 2005 to December 2013 in our department were retrospectively analyzed. INCLUSION CRITERIA: (1) Radiology indicated locally advanced low rectal cancer and patients had strong desire to preserve the sphincter before neoadjuvant CRT; (2) there was no definite metastatic lesion before neoadjuvant CRT; (3) patients received whole course of neoadjuvant CRT (regular radiotherapy plus synchronous fluorouracil-like drugs chemotherapy); (4) patients underwent radical operation after neoadjuvant CRT...
September 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28891848/adjuvant-chemotherapy-after-preoperative-chemoradiation-improves-survival-in-patients-with-locally-advanced-rectal-cancer
#2
Zhifei Sun, Brian Gilmore, Mohamed A Adam, Jina Kim, Shiao-Wen D Hsu, John Migaly, Christopher R Mantyh
BACKGROUND: Practice guidelines differ in their support of adjuvant chemotherapy use in patients who received preoperative chemoradiation for rectal cancer. OBJECTIVE: The purpose of this study was to evaluate the impact of adjuvant chemotherapy among patients with locally advanced rectal cancer who received neoadjuvant chemoradiation and surgery. DESIGN: This was a retrospective study. Multivariable Cox proportional hazard modeling was used to evaluate the adjusted survival differences...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28890815/the-role-of-neoadjuvant-radiotherapy-for-locally-advanced-rectal-cancer-with-resectable-synchronous-metastasis
#3
Croix C Fossum, Jasim Y Alabbad, Lindsay B Romak, Christopher L Hallemeier, Michael G Haddock, Marianne Huebner, Eric J Dozois, David W Larson
BACKGROUND: Although neoadjuvant radiotherapy is typically administered for locally-advanced rectal cancer to reduce local recurrence (LR), its role for patients who present with synchronous resectable liver and/or lung metastasis is not well defined. The aim of this study was to evaluate the role of neoadjuvant radiotherapy for patients with stage IV rectal cancer undergoing curative-intent surgery. METHODS: This study is a retrospective review of a prospectively maintained surgical registry of all consecutive adult patients who underwent curative-intent resection at Mayo Clinic in Rochester, MN, from January 1990 until December 2014 with a median follow-up time of 43 (IQR 16-67) months...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28876659/abdominoperineal-resection-in-the-prone-position-early-outcomes-at-a-tertiary-institution-in-the-western-cape-south-africa
#4
N Stevenson, A V V Lambrechts
BACKGROUND: Abdominoperineal resection (APR) in the prone position is a new technique in the developing world, where colorectal cancer incidence is rising fast and the patient population is different from those in the developed world. Literature is lacking on the outcomes of this technique under these conditions. METHOD: All patients who underwent APR in the prone position for rectal adenocarcinoma from February 2011 to February 2017 were reviewed. Main endpoints were stage at presentation, neoadjuvant treatment, circumferential resection margin involvement, perineal wound complications, length of intensive care unit (ICU) stay and days discharged after surgery...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28871992/improved-metastasis-and-disease-free-survival-with-preoperative-sequential-short-course-radiation-therapy-and-folfox-chemotherapy-for-rectal-cancer-compared-with-neoadjuvant-long-course-chemoradiotherapy-results-of-a-matched-pair-analysis
#5
Stephanie Markovina, Fady Youssef, Amit Roy, Sonya Aggarwal, Shariq Khwaja, Todd DeWees, Benjamin Tan, Steven Hunt, Robert J Myerson, Daniel T Chang, Parag J Parikh, Jeffrey R Olsen
PURPOSE: To compare treatment and toxicity outcomes between a phase 2 institutional trial of near total neoadjuvant therapy (nTNT) for locally advanced rectal cancer and a similar historical control cohort treated at Washington University in St. Louis with the current US standard of care, defined as neoadjuvant chemoradiotherapy (NCRT), total mesorectal excision (TME), and adjuvant FOLFOX chemotherapy; to expand the comparison to an additional institution, patients treated with similar NCRT at Stanford University were included...
October 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28835750/adjuvant-second-dose-chemotherapy-before-surgery-for-patients-with-locally-advanced-rectal-malignancy-is-not-beneficial-a-systematic-review-and-meta-analysis
#6
REVIEW
Min Chen, Xue Song, Liang-Zhou Chen, Lin Xu, Yi-Pu Lu, Jin-Song Zhang
BACKGROUND: Preoperative chemoradiotherapy is the standard treatment for patients with locally advanced rectal cancer, although tumor responses vary widely; some patients may achieve a pathologic complete response rate (pCR) after chemoradiotherapy. Controversy exists with regard to the efficacy of different preoperative combination chemotherapy regimens and neoadjuvant chemoradiotherapy, compared with chemoradiotherapy alone. METHODS: PubMed, the Cochrane Library, and Embase databases were searched for comparative studies of patients with locally advanced rectal cancer that were published between January 1991 and January 2016...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28803718/total-neoadjuvant-therapy-a-shifting-paradigm-in-locally-advanced-rectal-cancer-management
#7
REVIEW
Aaron J Franke, Hiral Parekh, Jason S Starr, Sanda A Tan, Atif Iqbal, Thomas J George
Colorectal carcinoma is the second leading cause of cancer-related deaths in the United States, with rectal cancer accounting for approximately one-third of newly diagnosed cases, thus representing a major socioeconomic health burden. Although minimally invasive procedures (ie, transanal excision) may be appropriate for a subset of patients with small, superficially invasive tumors, a more comprehensive trimodality approach with neoadjuvant chemoradiotherapy, total mesorectal excision, and systemic chemotherapy is recommended for medically operable patients with nonmetastatic, locally advanced rectal cancer (LARC)...
June 27, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28756493/impact-of-adjuvant-chemotherapy-after-neoadjuvant-radio-or-radiochemotherapy-for-patients-with-locally-advanced-rectal-cancer
#8
Sven Lichthardt, Lisa Zenorini, Johanna Wagner, Johannes Baur, Alexander Kerscher, Niels Matthes, Caroline Kastner, Jörg Pelz, Volker Kunzmann, Christoph-Thomas Germer, Armin Wiegering
BACKGROUND: Due to its primarily extraperitoneal location, potential affection of the anorectal continence and different metastatic behavior the rectal carcinoma (RC) is classified and treated as an independent disease. Over the past few decades various trials have led to improved multimodal therapies (including radiation, chemotherapy and surgery) for locally advanced rectal cancer and significant changes in the management of this disease whereas the benefit of adjuvant chemotherapy remains unclear...
July 29, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28728302/-clinical-efficacy-of-ladder-neoadjuvant-therapy-in-treatment-of-advanced-mid-low-rectal-cancer
#9
Y X Zhang, H B Wang, Y J Lu, H Y Liu
Objective: To explore the clinical efficacy of ladder neoadjuvant therapy in treatment of advanced mid-low rectal cancer. Methods: We performed a retrospective study of one hundred and eighty mid and low rectal cancer patients who underwent ladder neoadjuvant therapy(neoadjuvant chemotherapy followed by surgery if neoadjuvant chemotherapy was effective; neoadjuvant chemotherapy followed by neoadjuvant chemoradiotherapy if neoadjuvant chemotherapy was ineffective)(n=90) or neoadjuvant chemoradiotherapy (n=90)...
July 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28685354/a-multicenter-phase-2-study-on-the-feasibility-and-efficacy-of-neoadjuvant-chemotherapy-without-radiotherapy-for-locally-advanced-rectal-cancer
#10
Suguru Hasegawa, Saori Goto, Takuya Matsumoto, Koya Hida, Kenji Kawada, Ryo Matsusue, Takashi Yamaguchi, Ryuta Nishitai, Dai Manaka, Shigeru Kato, Yoshio Kadokawa, Satoshi Yamanokuchi, Junichiro Kawamura, Masazumi Zaima, Takahisa Kyogoku, Akiyoshi Kanazawa, Yukiko Mori, Masashi Kanai, Shigemi Matsumoto, Yoshiharu Sakai
BACKGROUND: This prospective multicenter phase 2 study aimed to evaluate the feasibility and efficacy of neoadjuvant chemotherapy (NAC) without radiotherapy for locally advanced rectal cancer (LARC). METHODS: Patients with LARC (cStage II and III) were included in the study. Those with cT4b tumor were excluded. Six cycles of modified FOLFOX6 (mFOLFOX6) plus either bevacizumab or cetuximab, depending on KRAS status, were administered before surgery. The primary end point of the study was the R0 resection rate...
July 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28655079/-pathological-insights-of-radiotherapy-related-damage-to-surgical-margin-after-preoperative-radiotherapy-in-patients-with-rectal-cancer
#11
RANDOMIZED CONTROLLED TRIAL
Q H Zhong, P H Wu, Q Y Qin, Y Y Kuang, T H Ma, H M Wang, Y X Zhu, D C Chen, J P Wang, L Wang
Objective: To investigate the effect of irradiation to anastomosis from preoperative radiotherapy for patients with rectal cancer by studying the pathological changes. Methods: In this retrospective study, patients enrolled in the FOWARC study from January 2011 to July 2014 in the Sixth Affiliated Hospital of Sun Yat-Sen University were included. In the FOWARC study, enrolled patients with local advanced rectal cancer were randomly assigned to receive either neoadjuvant chemo-radiotherapy or chemotherapy. Among these patients, 23 patients were selected as radiation proctitis (RP)group, who fulfilled these conditions: (1) received neoadjuvant chemo-radiotherapy followed by sphincter-preserving surgery; (2) developed radiation proctitis as confirmed by preoperative imaging diagnosis; (3) had intact clinical samples of surgical margins...
July 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28637039/different-impacts-of-preoperative-radiotherapy-and-chemoradiotherapy-on-oncological-outcomes-in-patients-with-stages-ii-and-iii-lower-rectal-cancer-a-propensity-score-analysis
#12
Hirotoshi Takiyama, Kazushige Kawai, Soichiro Ishihara, Koji Yasuda, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Teppei Morikawa, Toshiaki Watanabe
BACKGROUND/AIMS: The neoadjuvant therapy for locally advanced rectal cancer has been changed from radiotherapy (RT) to chemoradiotherapy (CRT). This study is aimed at evaluating the benefit of CRT in patients with stage II or III lower rectal cancer, with regard to the impact on recurrence. METHODS: A total of 474 patients with clinical stage II or III lower rectal cancer who received either preoperative RT (n = 221) or CRT (n = 253) followed by total mesorectal excision were identified from our institutional database...
June 21, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28594719/bowel-dysfunction-after-low-anterior-resection-with-neoadjuvant-chemoradiotherapy-or-chemotherapy-alone-for-rectal-cancer-a-cross-sectional-study-from-china
#13
Qiyuan Qin, Binjie Huang, Wuteng Cao, Jie Zhou, Tenghui Ma, Zhiyang Zhou, Jianping Wang, Lei Wang
BACKGROUND: Neoadjuvant therapy plays a vital role in the treatment of locally advanced rectal cancer but impairs bowel function after restorative surgery. Optimal decision making requires adequate information of functional outcomes. OBJECTIVE: This study aimed to assess postoperative bowel function and to identify predictors for severe dysfunction. DESIGN: The study included a cross-sectional cohort and retrospective assessments of pelvic anatomic features...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28586509/association-between-neoadjuvant-chemoradiation-and-survival-for-patients-with-locally-advanced-rectal-cancer
#14
Zhifei Sun, Mohamed A Adam, Jina Kim, Megan C Turner, Deborah A Fisher, Kingshuk Roy Choudhury, Brian G Czito, John Migaly, Christopher R Mantyh
AIM: To examine the overall survival differences of neoadjuvant therapy modalities: no therapy, chemotherapy alone, radiation alone, and chemoradiation in a large cohort of patients with locally advanced rectal cancer. METHOD: Adults with clinical stage II and III rectal adenocarcinoma were selected from the National Cancer Database and grouped by type of neoadjuvant therapies received: no therapy, chemotherapy only, radiotherapy only, or chemoradiation. Multivariable regression methods were used to compare adjusted differences in perioperative outcomes and overall survival...
June 6, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28583790/transanal-endoscopic-microsurgery-after-neoadjuvant-radiochemotherapy-for-locally-advanced-extraperitoneal-rectal-cancer
#15
G Rizzo, G Zaccone, M Magnocavallo, C Mattana, D P Pafundi, M A Gambacorta, V Valentini, C Coco
PURPOSE: The aim of this study is to provide a prospective analysis of post-operative and oncological outcomes in patients affected by locally advanced rectal cancer (LARC), who obtained a major/complete clinical response after pre-operative radio-chemotherapy (RCT) and were treated with local excision (LE) by trans-anal endoscopic microsurgery (TEM) to confirm a pathological complete response (pCR) after to neo-adjuvant RCT. METHODS: All patients with LARC treated by pre-operative RCT and full-thickness LE by TEM (2000-2014) were included in the study...
August 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28576182/evolving-role-of-radiotherapy-in-the-management-of-rectal-carcinoma
#16
REVIEW
Clayton A Smith, Lisa A Kachnic
Management of locally advanced rectal cancer has evolved over time from surgical resection alone to multimodality therapy with preoperative radiation, chemotherapy, and total mesorectal excision resulting in excellent local control rates. Refinements in neoadjuvant therapies and their sequencing have improved pathologic complete response rates such that consideration of selective radiation and nonoperative management are now active clinical trial questions. Advances in radiation treatment planning and delivery techniques may allow for further reduction in acute treatment-related toxicity in select patient populations...
July 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28551665/the-role-of-concomitant-radiation-boost-in-neoadjuvant-chemoradiotherapy-for-locally-advanced-rectal-cancer
#17
Harun Badakhshi, Mahmoud Ismail, Christos Boskos, Kuaile Zhao, David Kaul
BACKGROUND/AIM: This study analyzed the impact of concomitant boost on long-term clinical outcomes in locally advanced rectal cancer. PATIENTS AND METHODS: A total of 141 patients (median age=61 years) were treated with neoadjuvant chemoradiotherapy. Median total dose was 50.4 Gy. Forty-three patients received a concomitant boost. Concurrent chemotherapy consisted of 5-fluorouracil (5-FU), given as a 24-h continuous infusion. Mean follow-up was 83.7 months. RESULTS: The 3, 5-, and 10-year overall survival (OS) rates were 91...
June 2017: Anticancer Research
https://www.readbyqxmd.com/read/28537875/n-myc-downstream-regulated-gene-1-promotes-oxaliplatin-triggered-apoptosis-in-colorectal-cancer-cells-via-enhancing-the-ubiquitination-of-bcl-2
#18
Xiao Yang, Fan Zhu, Chaoran Yu, Jiaoyang Lu, Luyang Zhang, Yanfeng Lv, Jing Sun, Minhua Zheng
N-myc downstream-regulated gene1 (NDRG1) has been identified as a potent tumor suppressor gene. The molecular mechanisms of anti-tumor activity of NDRG1 involve its suppressive effects on a variety of tumorigenic signaling pathways. The purpose of this study was to investigate the role of NDRG1 in the apoptosis of colorectal cancer (CRC) cells. We first collected the clinical data of locally advanced rectal cancer (LARC) patients receiving oxaliplatin-based neoadjuvant chemotherapy in our medical center. Correlation analysis revealed that NDRG1 positively associated with the downstaging rates and prognosis of patients...
July 18, 2017: Oncotarget
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
#19
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
#20
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...
August 2017: Digestive Diseases and Sciences
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