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Neoadjuvant chemotherapy in local advanced rectal cancer

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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
#1
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/29233486/cetuximab-combined-with-induction-oxaliplatin-and-capecitabine-followed-by-neoadjuvant-chemoradiation-for-locally-advanced-rectal-cancer-swog-0713
#2
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/29223019/are-pathological-high-risk-features-in-locally-advanced-rectal-cancer-a-useful-selection-tool-for-adjuvant-chemotherapy
#3
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
#4
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/29203977/radical-treatment-of-rectal-cancer-in-elderly-is-feasible-than-feared-results-from-a-tertiary-care-centre
#5
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
#6
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
#7
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
#8
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/29167909/outcomes-of-neoadjuvant-chemoradiotherapy-followed-by-total-mesorectal-excision-surgery-for-locally-advanced-rectal-cancer-a-single-institution-experience
#9
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
#10
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
#11
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/29124955/current-issues-of-preoperative-radio-chemo-therapy-and-its-future-evolution-in-locally-advanced-rectal-cancer
#12
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
#13
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/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
#14
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
https://www.readbyqxmd.com/read/28982208/comparing-pathological-complete-response-rate-using-oral-capecitabine-versus-infusional-5-fluorouracil-with-preoperative-radiotherapy-in-rectal-cancer-treatment
#15
Narotam Jootun, Tess Evans, Jackie Mak, Greg Makin, Cameron Platell
BACKGROUND: Infusional 5-fluorouracil (5-FU) has been the standard radiation sensitizer in patients undergoing preoperative long-course chemoradiotherapy (CRT) for locally advanced rectal cancer in Australia. Capecitabine (Xeloda) is an oral 5-FU prodrug of comparable pharmacodynamic activity, currently preferred in place of 5-FU infusion, its established counterpart in neoadjuvant CRT for rectal cancer. The few studies quantifying pathological complete response (pCR) of Xeloda versus 5-FU have produced inconsistent results...
October 5, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28900999/-study-on-the-relationship-between-tumor-regression-grade-and-lymph-node-regression-grade
#16
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
#17
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
#18
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
#19
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
#20
MULTICENTER STUDY
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
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