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Neoadjuvant chemoradiotherapy in rectal cancer

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https://www.readbyqxmd.com/read/27903247/preoperative-conventional-chemoradiotherapy-versus-short-course-radiotherapy-with-delayed-surgery-for-rectal-cancer-results-of-a-randomized-controlled-trial
#1
Tadas Latkauskas, Henrikas Pauzas, Laura Kairevice, Aleksandras Petrauskas, Zilvinas Saladzinskas, Rasa Janciauskiene, Jurate Gudaityte, Paulius Lizdenis, Saulius Svagzdys, Algimantas Tamelis, Dainius Pavalkis
BACKGROUND: There still is no evidence which neoadjuvant therapy regimen for stage II-III rectal cancer is superior. The aim of this study was to compare results achieved after long-course chemoradiotherapy (CRT) with short-term radiotherapy (RT) followed by delayed surgery. METHODS: A randomized trial was carried out between 2007-2013. One hundred fifty patients diagnosed with stage II-III rectal cancer were randomized into one of two neoadjuvant treatment arms: conventional chemoradiotherapy (CRT) and short-term radiotherapy (RT) followed by surgery after 6-8 weeks...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27891147/effect-of-neoadjuvant-chemoradiotherapy-with-capecitabine-versus-fluorouracil-for-locally-advanced-rectal-cancer-a-meta-analysis
#2
REVIEW
Guo-Chen Liu, Jun-Ping Yan, Qing He, Xin An, Zhi-Zhong Pan, Pei-Rong Ding
A meta-analysis was carried out to compare the efficacy and safety of capecitabine plus radiation with 5-fluorouracil (5-FU) plus radiotherapy (RT) as neoadjuvant treatment in locally advanced rectal cancer (LARC). We searched the Cochrane database, Ovid, Medline, Embase, ISI databases, and Chinese Biomedical Literature Database between January 1998 and October 2014. Trials of capecitabine compared with 5-FU plus RT as neoadjuvant treatment for LARC were considered for inclusion. RevMan software was used to analyze these data...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27885479/wait-and-see-approach-for-rectal-cancer-with-a-clinically-complete-response-after-neoadjuvant-concurrent-chemoradiotherapy
#3
Hyun Jung Kim, Jin Ho Song, Hyeong Sik Ahn, Bong-Hoi Choi, Hojin Jeong, Hoon Sik Choi, Yun Hee Lee, Ki Mun Kang, Bae Kwon Jeong
PURPOSE: Rectal cancer patients with a pathological complete response (pCR) after neoadjuvant concurrent chemoradiotherapy (CCRT) have a better prognosis compared to those without a pCR. Therefore, the "Wait and See" (W&S) approach in those who achieved clinically complete response (cCR) after CCRT was introduced as an alternative modality to the total mesorectal excision (TME). The aim of this study was to compare the oncological outcomes between W&S and TME via meta-analysis. METHODS: We performed a comprehensive literature search on January 14, 2016, using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus...
November 24, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27873100/the-pretreatment-systemic-inflammatory-response-is-an-important-determinant-of-poor-pathologic-response-for-patients-undergoing-neoadjuvant-therapy-for-rectal-cancer
#4
Stephan B Dreyer, Arfon G M T Powell, Stephen T McSorley, Ashita Waterston, James J Going, Joanne Edwards, Donald C McMillan, Paul G Horgan
BACKGROUND: Not all patients respond equally to neoadjuvant chemoradiotherapy (nCRT), with subsequent effects on survival. The systemic inflammatory response has been shown to predict long-term outcomes in colorectal cancer. The current study examined the association between systemic inflammation and nCRT in patients with rectal cancer. METHODS: Between 1999 and 2010, patients who underwent nCRT were identified. Serum measurements of hemoglobin, C-reactive protein, albumin, modified Glasgow prognostic score (mGPS), and differential white cell counts were obtained before and after nCRT...
November 21, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27864695/adjuvant-chemotherapy-improves-overall-survival-of-rectal-cancer-patients-treated-with-neoadjuvant-chemoradiotherapy-regardless-of-pathologic-nodal-status
#5
Audrey S Kulaylat, Christopher S Hollenbeak, David B Stewart
BACKGROUND: After neoadjuvant chemoradiotherapy for rectal cancer, the interpretation of surgical pathology poses difficulties in deciding the need for adjuvant chemotherapy (AC). The aim of this study was to determine whether there is a survival benefit to providing AC in patients with node-negative disease on surgical pathology. METHODS: Patients with clinical stage II and III rectal adenocarcinoma who received neoadjuvant chemoradiation and definitive surgical resection from 2006 to 2012 were identified in the National Cancer Data Base...
November 18, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27837319/functional-outcomes-after-tem-in-patients-with-complete-clinical-response-after-neoadjuvant-chemoradiotherapy
#6
Roberto Ghiselli, Monica Ortenzi, Luca Cardinali, Edlira Skrami, Rosaria Gesuita, Mario Guerrieri
BACKGROUND: In patients who exhibit a complete clinical response after radio-chemotherapy for rectal cancer, the standard surgical approach might constitute overtreatment. The aim of this study is to analyse the outcomes of anorectal function and quality of life after transanal endoscopic microsurgery (TEM) in irradiated patients with complete clinical response. PATIENTS AND METHODS: Between 2007 and 2014, 84 patients who were diagnosed with stage T2-T3-T4 N0 rectal cancer before chemoradiotherapy showed a complete clinical response to neoadjuvant therapy and underwent TEM...
November 11, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27830368/adjuvant-treatment-for-resected-rectal-cancer-impact-of-standard-and-intensified-postoperative-chemotherapy-on-disease-free-survival-in-patients-undergoing-preoperative-chemoradiation-a-propensity-score-matched-analysis-of-an-observational-database
#7
Benjamin Garlipp, Henry Ptok, Frank Benedix, Ronny Otto, Felix Popp, Karsten Ridwelski, Ingo Gastinger, Christoph Benckert, Hans Lippert, Christiane Bruns
AIMS: Adjuvant chemotherapy for resected rectal cancer is widely used. However, studies on adjuvant treatment following neoadjuvant chemoradiotherapy (CRT) and total mesorectal excision (TME) have yielded conflicting results. Recent studies have focused on adding oxaliplatin to both preoperative and postoperative therapy, making it difficult to assess the impact of adjuvant oxaliplatin alone. This study was aimed at determining the impact of (i) any adjuvant treatment and (ii) oxaliplatin-containing adjuvant treatment on disease-free survival in CRT-pretreated, R0-resected rectal cancer patients...
November 9, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27830030/vnn1-overexpression-is-associated-with-poor-response-to-preoperative-chemoradiotherapy-and-adverse-prognosis-in-patients-with-rectal-cancers
#8
Chi-Yung Chai, Yimin Zhang, Junlong Song, Shih-Chun Lin, Shengrong Sun, I-Wei Chang
BACKGROUND: Colorectal cancer is prevalent worldwide and it is also the fourth most common cause of cancer mortality. For rectal cancer, neoadjuvant concurrent chemoradiotherapy (CCRT) followed by radical proctectomy is gold standard treatment for patients with stage II/III rectal cancer. By data mining a public dataset of rectal cancer transcriptome (GSE35452) from Gene Expression Omnibus, National Center of Biotechnology Information (GEO, NCBI), we identified that VNN1 was the most significantly upregulated gene among those related to nitrogen compound metabolic process (GO:0006807)...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27824706/mucinous-rectal-adenocarcinoma-is-associated-with-a-poor-response-to-neoadjuvant-chemoradiotherapy-a-systematic-review-and-meta-analysis
#9
Niamh McCawley, Cillian Clancy, Brian D P O'Neill, Joseph Deasy, Deborah A McNamara, John P Burke
BACKGROUND: Mucinous adenocarcinoma represents a potentially poor prognostic subgroup of rectal cancer. A consensus on the effect of mucinous cancer on outcomes following neoadjuvant chemoradiotherapy and curative resection for rectal cancer has not been reached. OBJECTIVE: The aim of the current study is to use meta-analytical techniques to assess the association between mucinous histology and response to neoadjuvant chemoradiotherapy in rectal cancer. DATA SOURCES: A comprehensive literature search of PubMed, Embase, and The Cochrane Library was performed...
December 2016: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27819876/impact-of-postoperative-adjuvant-chemotherapy-following-long-course-chemoradiotherapy-in-stage-ii-rectal-cancer
#10
Jonathan M Loree, Hagen F Kennecke, Richard M Lee-Ying, Rachel A Goodwin, Erin D Powell, Patricia A Tang, Julie A Price Hiller, Michael M Vickers, Winson Y Cheung
OBJECTIVES: Use of adjuvant chemotherapy (AC) following neoadjuvant chemoradiation (nCRT) is controversial in rectal cancer (RC). We assessed a multi-institutional database to determine if there was benefit from AC for pathologic stage II RC patients and whether the addition of oxaliplatin to fluoropyrimidine (OXAC) therapy impacted outcomes. MATERIALS AND METHODS: We included patients who underwent nCRT and had pathologic stage II (ypT3/4 ypN0) tumors. Disease-free survival and overall survival were assessed...
November 4, 2016: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27796635/clinically-node-negative-pathologically-node-positive-rectal-cancer-patients-who-did-not-receive-neoadjuvant-therapy
#11
Nouf Akeel, Nan Lan, Luca Stocchi, Meagan M Costedio, David W Dietz, Emre Gorgun, Matthew F Kalady, Georgios Karagkounis, Hermann Kessler, Feza H Remzi
PURPOSE: Neoadjuvant chemoradiotherapy is the preferred standard of care for clinical stages II-III rectal cancer. It is uncertain whether clinically node negative (cN-) tumors found to be pathologically stage III could be optimally treated with surgery alone and avoid adjuvant treatments. The aim of our study was to define the outcomes of such patients. METHODS: Patients undergoing radical surgery using total mesorectal excision (TME) techniques for rectal cancer (≤12 cm from the anal verge) with curative intent during 2000-2012 and found to have stage III disease on final pathology were identified from a prospectively maintained database...
October 27, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27793945/a-comparative-effectiveness-study-of-two-oral-chemotherapy-drugs-uft-vs-capecitabine-in-neoadjuvant-concurrent-chemoradiotherapy-for-patients-with-locally-advanced-rectal-cancer
#12
Chun-Ru Chien, William Tzu-Liang Chen, Hwei-Min Wang, Tao-Wei Ke, Hua-Che Chiang, Sheng-Chi Chang, Yu-Chun Huang, Che-Hung Lin, Chun-Lin Huang, Ying-Chun Lin, Tsung-Wei Chen, Chia-Chin Li, K S Clifford Chao
BACKGROUND/AIM: Capecitabine is the current standard oral chemotherapy used in neoadjuvant concurrent chemoradiotherapy (NCCRT) for locally advanced rectal cancer (LARC) in North America. We compared the effectiveness of another oral chemotherapy agent, UFT (an oral combination of uracil and tegafur), to that of capecitabine. MATERIALS AND METHODS: We identified LARC patients diagnosed from 2007 to 2011 using a population-based registry in Taiwan (Health and Welfare Data Science Center, HWDC) and constructed a propensity score matched cohort to balance observable potential confounders...
November 2016: Anticancer Research
https://www.readbyqxmd.com/read/27784746/crlx101-a-nanoparticle-drug-conjugate-containing-camptothecin-improves-rectal-cancer-chemoradiotherapy-by-inhibiting-dna-repair-and-hif-1%C3%AE
#13
Xi Tian, Minh Nguyen, Henry Putnam Foote, Joseph M Caster, Kyle C Roche, Christian G Peters, Pauline Wu, Lata Jayaraman, Edward G Garmey, Joel E Tepper, Scott Eliasof, Andrew Z Wang
Novel agents are needed to improve chemoradiotherapy for locally advanced rectal cancer. In this study, we assessed the ability of CRLX101, an investigational nanoparticle-drug conjugate containing the payload camptothecin (CPT), to improve therapeutic responses as compared to standard chemotherapy. CRLX101 was evaluated as a radiosensitizer in colorectal cancer cell lines and murine xenograft models. CRLX101 was as potent as CPT in vitro in its ability to radiosensitize cancer cells. Evaluations in vivo demonstrated that the addition of CRLX101 to standard chemoradiotherapy significantly increased therapeutic efficacy by inhibiting DNA repair and HIF-1α pathway activation in tumor cells...
October 26, 2016: Cancer Research
https://www.readbyqxmd.com/read/27780316/can-we-eliminate-neoadjuvant-chemoradiotherapy-in-favor-of-neoadjuvant-multiagent-chemotherapy-for-select-stage-ii-iii-rectal-adenocarcinomas-analysis-of-the-national-cancer-database
#14
Richard J Cassidy, Yuan Liu, Kirtesh Patel, Jim Zhong, Conor E Steuer, David A Kooby, Maria C Russell, Theresa W Gillespie, Jerome C Landry
BACKGROUND: Stage II and III rectal cancers have been effectively treated with neoadjuvant chemoradiotherapy (NCRT) followed by definitive resection. Advancements in surgical technique and systemic therapy have prompted investigation of neoadjuvant multiagent chemotherapy (NMAC) regimens with the elimination of radiation (RT). The objective of the current study was to investigate factors that predict for the use of NCRT versus NMAC and compare outcomes using the National Cancer Data Base (NCDB) for select stage II and III rectal cancers...
October 25, 2016: Cancer
https://www.readbyqxmd.com/read/27761895/patient-centered-outcomes-to-decide-treatment-strategy-for-patients-with-low-rectal-cancer
#15
Michitaka Honda, Takashi Akiyoshi, Hisashi Noma, Atsushi Ogura, Toshiya Nagasaki, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Yosuke Fukunaga, Masashi Ueno
BACKGROUND: For patients with low-lying rectal cancer, the feasibility of anus-preserving surgery in combination with neoadjuvant chemoradiotherapy (NACRT) has been not well established from the perspective of patient-centered outcomes. METHODS: We investigated 278 patients with low-lying rectal adenocarcinoma from 2005 to 2012. We compared their symptoms and QOL scores of patients who underwent anus-preserving surgery with (n = 88) and without (n = 143) NACRT according to the Wexner scale, EORTC QLQ C-30, CR29, and the modified fecal incontinence quality life scale (mFIQL)...
October 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27757395/long-term-oncologic-outcomes-of-neoadjuvant-concurrent-chemoradiotherapy-with-capecitabine-and-radical-surgery-in-locally-advanced-rectal-cancer-10-year-experiences-at-a-single-institution
#16
Kyung Ha Lee, Jin Soo Kim, Ji Yeon Kim
PURPOSE: Oral capecitabine has demonstrated to be safe and efficient as neoadjuvant concurrent chemoradiotherapy (NCRT) for locally advanced rectal cancers. The aim of this study was to evaluate the long-term oncologic outcomes of NCRT with capecitabine and radical surgery. METHODS: From January 2000 to June 2010, 238 patients were treated at our center for locally advanced rectal cancers using conventional NCRT with capecitabine and radical surgery. Univariate and multivariate analyses were used to evaluate the factors associated with oncologic outcomes with log rank and Cox regression tests...
October 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27741381/reduced-dose-to-small-bowel-with-the-prone-position-and-a-belly-board-versus-the-supine-position-in-neoadjuvant-3d-conformal-radiotherapy-for-rectal-adenocarcinoma
#17
Rohen White, Farshad Foroudi, Joseph Sia, Mary Ann Marr, Daryl Lim Joon
INTRODUCTION: No consensus exists regarding the optimal treatment setup for neoadjuvant radiotherapy of rectal cancer using a 3D conformal (3D CRT) technique. Positioning the patient prone with a belly board aims to reduce the amount of small bowel irradiated. METHODS: Twenty-five patients with locally advanced rectal cancer underwent computed tomography (CT) planning for neoadjuvant chemoradiotherapy. Patients were simulated prone with a belly board and then in the supine position...
July 28, 2016: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/27740975/molecular-predictors-of-response-to-neoadjuvant-chemoradiation-for-rectal-cancer
#18
Yulia Kundel, Nicola J Nasser, Lea Rath-Wolfson, Ofer Purim, Natalia Yanichkin, Ronen Brenner, Tanya Zehavi, Yuval Nardi, Eyal Fenig, Aaron Sulkes, Baruch Brenner
OBJECTIVES: To determine whether the expression of specific molecular markers in the rectal cancer biopsies prior to treatment, can correlate with complete tumor response to chemoradiotherapy (CRT) as determined by the pathology of the surgical specimen. METHODS: We retrospectively examined pretreatment rectal biopsies of patients aged 18 years or older with locally advanced rectal cancer who had been treated with neoadjuvant CRT and surgical resection in our tertiary-care, university-affiliated medical center, between January 2001 and December 2011...
October 12, 2016: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27721486/pathological-assessment-of-rectal-cancer-after-neoadjuvant-chemoradiotherapy-distribution-of-residual-cancer-cells-and-accuracy-of-biopsy
#19
Lin Xiao, Xin Yu, Wenjing Deng, Huixia Feng, Hui Chang, Weiwei Xiao, Huizhong Zhang, Shaoyan Xi, Mengzhong Liu, Yujia Zhu, Yuanhong Gao
We investigated the distribution of residual cancer cells (RCCs) within different layers of the bowel wall in surgical specimens and the value of biopsies of primary rectal lesion after preoperative volumetric modulated arc therapy (VMAT) with concurrent chemotherapy in patients with rectal cancer. Between April 2011 and April 2013, 178 patients with rectal cancer who received preoperative VMAT, concurrent chemotherapy, and surgery were evaluated; 79 of the patients received a biopsy of the primary lesion after chemoradiotherapy and prior to surgery...
October 10, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27720700/manometric-evaluation-of-anorectal-function-in-patients-treated-with-neoadjuvant-chemoradiotherapy-and-total-mesorectal-excision-for-rectal-cancer
#20
Paola De Nardi, Sabrina Gloria Giulia Testoni, Maura Corsetti, Hulda Andreoletti, Patrizia Giollo, Sandro Passaretti, Pier Alberto Testoni
BACKGROUND: An altered anorectal function is reported after chemoradiotherapy (CRT) and surgery for rectal cancer. AIM: The aim of this study was to clarify the relative contribution of neoadjuvant chemoradiation and surgical resection on the impairment of anorectal function as evaluated by anorectal manometry. METHODS: Thirty-nine patients with rectal cancer, who underwent neoadjuvant CRT and laparoscopic rectal resection, were evaluated with the Pescatori Faecal Incontinence score, and with anorectal manometry: before neoadjuvant therapy (T0), after neoadjuvant therapy and before surgery (T1), 12 months after stoma closure (T2)...
September 22, 2016: Digestive and Liver Disease
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