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Neoadjuvant chemoradiotherapy in rectal cancer

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https://www.readbyqxmd.com/read/29449673/the-predictive-and-prognostic-potential-of-plasma-telomerase-reverse-transcriptase-tert-rna-in-rectal-cancer-patients
#1
Enrica Rampazzo, Paola Del Bianco, Roberta Bertorelle, Caterina Boso, Alessandro Perin, Giovanna Spiro, Francesca Bergamo, Claudio Belluco, Angela Buonadonna, Elisa Palazzari, Sara Leonardi, Antonino De Paoli, Salvatore Pucciarelli, Anita De Rossi
BACKGROUND: Preoperative chemoradiotherapy (CRT) followed by surgery is the standard care for locally advanced rectal cancer, but tumour response to CRT and disease outcome are variable. The current study aimed to investigate the effectiveness of plasma telomerase reverse transcriptase (TERT) levels in predicting tumour response and clinical outcome. METHODS: 176 rectal cancer patients were included. Plasma samples were collected at baseline (before CRT=T0), 2 weeks after CRT was initiated (T1), post-CRT and before surgery (T2), and 4-8 months after surgery (T3) time points...
February 15, 2018: British Journal of Cancer
https://www.readbyqxmd.com/read/29437271/novel-radiomic-signature-as-a-prognostic-biomarker-for-locally-advanced-rectal-cancer
#2
Yankai Meng, Yuchen Zhang, Di Dong, Chunming Li, Xiao Liang, Chongda Zhang, Lijuan Wan, Xinming Zhao, Kai Xu, Chunwu Zhou, Jie Tian, Hongmei Zhang
BACKGROUND: Locally advanced rectal cancer (LARC) patient stratification by clinicoradiologic factors may yield variable results. Therefore, more efficient prognostic biomarkers are needed for improved risk stratification of LARC patients, personalized treatment, and prognostication. PURPOSE/HYPOTHESIS: To compare the ability of a radiomic signature to predict disease-free survival (DFS) with that of a clinicoradiologic risk model in individual patients with LARC...
February 13, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29435147/morphologic-predictors-of-pathological-complete-response-to-neoadjuvant-chemoradiotherapy-in-locally-advanced-rectal-cancer
#3
Chongda Zhang, Feng Ye, Yuan Liu, Han Ouyang, Xinming Zhao, Hongmei Zhang
Purpose: To evaluate the value of morphological parameters that can be obtained conveniently by MRI for predicting pathologically complete response (pCR) in patients with rectal cancer. Materials and Methods: A cohort of 101 patients was examined using MRI before and after Neoadjuvant chemoradiotherapy (nCRT). Morphological parameters including maximum tumor area (MTA), maximum tumor length (MTL) and maximum tumor thickness (MTT), as well as cylindrical approximated tumor volume (CATV), distance to anal verge (DTA), and the reduction rates were evaluated by two experienced readers independently...
January 12, 2018: Oncotarget
https://www.readbyqxmd.com/read/29420226/serial-circulating-tumour-dna-analysis-during-multimodality-treatment-of-locally-advanced-rectal-cancer-a-prospective-biomarker-study
#4
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
#5
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/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/29394715/-results-of-neoadjuvant-chemoradiotherapy-for-rectal-cancer-with-invasion-to-the-adjacent-organs
#7
Harunobu Sato, Yoshikazu Koide, Miho Shiota, Masahiro Mizuno, Zenichi Morise, Ichiro Uyama
We reviewed the clinical records of 14 cases who received neoadjuvant chemoradiotherapy(CRT)to evaluate the clinical effectiveness of the CRT for T4b rectal cancer. The preoperative radiotherapy consisted of 40-50 Gy delivered in fractions of 1.8-2.0 Gy per day, 5 days per week. A treatment with intravenous 5-fluorouracil, or oral tegafur-uracil(UFT)with l-leucovorin, or oral S-1, or capecitabine or intravenous irinotecan with oral S-1, was administered during radiotherapy. One patient died due to pelvic abscess at 69 days after CRT...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29394672/-can-lateral-pelvic-node-dissection-omitted-in-rectal-cancer-with-suspected-lateral-node-metastasis-after-chemoradiotherapy
#8
Tadashi Onishi, Yujiro Fujie, Kei Adachi, Ryoji Nonaka, Jeong-Ho Moon, Shoichiro Fujita, Kazuhiko Hashimoto
To elucidate ideal strategy of treatment for advanced lower rectal cancer, we investigated 11 patients with clinically suspected lateral pelvic node(LPN)metastasis among 36 patients who received neoadjuvant chemoradiation therapy(NCRT). Nodal metastasis was diagnosed as positive when the major axis of a lymph node was over 7mm in computed tomography(CT). Both tumor and nodal downstaging were observed in CT after NCRT; pathological complete response and ypN0 was obtained in 2(18.2%)and 6(54.5%)cases, respectively, and positive LPN was observed only in 2 cases...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29390548/short-course-neoadjuvant-chemoradiotherapy-and-surgery-are-beneficial-in-chinese-patients-a-retrospective-study
#9
Ming Jun Huang, Xiao Dong Wang, Yan Jie Hu, Jie Yang, Ka Li
Preoperative neoadjuvant chemoradiotherapy (NACR) is used to reduce tumor size for easier resection or improved resectability rates. Considering the difficulties regarding health insurance and health resources in China, an evidence-based short-course neoadjuvant chemoradiotherapy with surgery to cure patients was performed. This study compared the postoperative effects between short-course neoadjuvant chemoradiotherapy and surgery and surgery without neoadjuvant chemoradiotherapy.The current retrospective study was based on a rectal cancer database, including 274 patients diagnosed with rectal cancer between January 2014 and October 2016...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29388280/area-of-residual-tumor-is-a-robust-prognostic-marker-for-patients-with-rectal-cancer-undergoing-preoperative-therapy
#10
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/29362905/role-of-chemotherapy-in-the-neoadjuvant-adjuvant-setting-for-patients-with-rectal-adenocarcinoma-undergoing-chemoradiotherapy-and-surgery-or-radiotherapy-and-surgery
#11
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/29360680/value-of-fdg-pet-ct-volumetry-after-chemoradiotherapy-in-rectal-cancer
#12
Takayuki Okuno, Kazushige Kawai, Keitaro Koyama, Miwako Takahashi, Soichiro Ishihara, Toshimitsu Momose, Teppei Morikawa, Masashi Fukayama, Toshiaki Watanabe
BACKGROUND: Neoadjuvant chemoradiotherapy followed by an optimal surgery is the standard treatment for patients with locally advanced rectal cancer. FDG-PET/CT is commonly used as the modality for assessing the effect of chemoradiotherapy. OBJECTIVE: The purpose of this study was to investigate whether PET/CT-based volumetry could contribute to the prediction of pathological complete response or prognosis after neoadjuvant chemoradiotherapy. DESIGN: This was a retrospective cohort study...
March 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29360006/robotic-versus-laparoscopic-stapler-use-for-rectal-transection-in-robotic-surgery-for-cancer
#13
Deniz Atasoy, Erman Aytac, Volkan Ozben, Onur Bayraktar, Ilknur Erenler Bayraktar, Afag Aghayeva, Bilgi Baca, Ismail Hamzaoglu, Tayfun Karahasanoglu
BACKGROUND: This study was designed to compare the operative and short-term postoperative outcomes of the robotic and laparoscopic staplers in patients undergoing rectal surgery for cancer. MATERIALS AND METHODS: Between December 2014 and April 2017, patients consecutively undergoing robotic rectal surgery for cancer were included in this study. Patients were grouped into two according to the type of staplers for rectal transection [Robotic (45-mm) versus Laparoscopic (60-mm) linear staplers]...
January 23, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29357929/addition-of-platinum-derivatives-to-neoadjuvant-single-agent-fluoropyrimidine-chemoradiotherapy-in-patients-with-stage-ii-iii-rectal-cancer-protocol-for-a-systematic-review-and-meta-analysis-prospero-crd42017073064
#14
Felix J Hüttner, Pascal Probst, Eva Kalkum, Matthes Hackbusch, Katrin Jensen, Alexis Ulrich, Markus W Büchler, Markus K Diener
BACKGROUND: Neoadjuvant (chemo-)radiation has proven to improve local control compared to surgery alone, but this improvement did not translate into better overall or disease-specific survival. The addition of oxaliplatin to fluoropyrimidine-based neoadjuvant chemoradiotherapy holds the potential of positively affecting survival in this context since it has been proven effective in the palliative and adjuvant setting of colorectal cancer. Thus, the objective of this systematic review is to assess the efficacy, safety, and quality of life resulting from adding a platinum derivative to neoadjuvant single-agent fluoropyrimidine-based chemoradiotherapy in patients with Union for International Cancer Control stage II and III rectal cancer...
January 22, 2018: Systematic Reviews
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
#15
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/29354896/-10-year-series-studies-of-chronic-radiation-proctopathy-from-the-sixth-affiliated-hospital-of-sun-yat-sen-university
#16
Lei Wang, Tenghui Ma, Jianping Wang
Chronic radiation proctopathy (CRP) is the delayed adverse effect after radiotherapy for pelvic malignancies. It is characterized as progressive fibrosis in pathology. The symptoms are usually unspecific which include rectal bleeding, perianal pain, tenesmus, stool frequencies and so on. The course of CRP can present from months to years after radiation. Severe complications can occur in the late stage and will greatly affect the quality of life. Currently, there is no standard guides for diagnosis and treatment of CRP...
January 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29354895/-therapeutic-evaluation-and-surgical-strategy-after-neoadjuvant-chemoradiotherapy-for-rectal-cancer
#17
Liangang Ma, Zhenjun Wang
Neoadjuvant chemoradiotherapy for rectal cancer could significantly reduce the tumor stage, improve the radical resection and increase the overall survival rate of the patients. Recently researches reported that patients who acquired complete response after neoadjuvant chemoradiotherapy might accept "wait and see" strategy or local excision and could earn promising long-term outcomes as those accepted radical surgery. The diagnostic criteria and efficacy of tumor response for chemoradiotherapy are insufficient and controversial...
January 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29354604/difference-in-tumor-area-as-a-predictor-of-a-pathological-complete-response-for-patients-with-locally-advanced-rectal-cancer
#18
Ji Hyeong Song, Yo-Han Park, Sang Hyuk Seo, Anbok Lee, Kwang Hee Kim, Min Sung An, Ki Beom Bae, Kwan Hee Hong, Jin Won Hwang, Ji Hyun Kim, Hyun Seok Jung, Ki Jung Ahn
Purpose: This study was conducted to discover the clinical factors that can predict pathologically complete remission (pCR) after neoadjuvant chemoradiotherapy (CRT), so that those factors may help in deciding on a treatment program for patients with locally advanced rectal cancer. Methods: A total of 137 patients with locally advanced rectal cancer were retrospectively enrolled in this study, and data were collected retrospectively. The patients had undergone a total mesorectal excision after neoadjuvant CRT...
December 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/29341150/effect-of-akt-activation-and-experimental-pharmacological-inhibition-on-responses-to-neoadjuvant-chemoradiotherapy-in-rectal-cancer
#19
F C Koyama, C M Lopes Ramos, F Ledesma, V A F Alves, J M Fernandes, B B Vailati, G P São Julião, A Habr-Gama, J Gama-Rodrigues, R O Perez, A A Camargo
BACKGROUND: Neoadjuvant chemoradiotherapy (CRT) is one of the preferred initial treatment strategies for locally advanced rectal cancer. Responses are variable, and most patients still require surgery. The aim of this study was to identify molecular mechanisms determining poor response to CRT. METHODS: Global gene expression and pathway enrichment were assessed in pretreatment biopsies from patients with non-metastatic cT2-4 N0-2 rectal cancer within 7 cm of the anal verge...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29329555/exercise-during-and-after-neoadjuvant-rectal-cancer-treatment-the-exert-trial-study-protocol-for-a-randomized-controlled-trial
#20
Andria R Morielli, Nawaid Usmani, Normand G Boulé, Diane Severin, Keith Tankel, Tirath Nijjar, Kurian Joseph, Alysa Fairchild, Kerry S Courneya
BACKGROUND: Standard treatment for locally advanced rectal cancer includes 5-6 weeks of neoadjuvant chemoradiotherapy (NACRT) followed by total mesorectal excision 6-8 weeks later. NACRT improves local disease control and surgical outcomes but also causes side effects including fatigue, diarrhea, hand-foot syndrome, and physical deconditioning that may impede quality of life (QoL), treatment completion, treatment response, and long-term prognosis. Interventions to improve treatment outcomes and manage side effects that are safe, tolerable and low-cost are highly desirable...
January 12, 2018: Trials
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