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Neoadjuvant chemoradiotherapy in rectal cancer

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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
#1
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/28635312/predictors-of-adherence-to-aerobic-exercise-in-rectal-cancer-patients-during-and-after-neoadjuvant-chemoradiotherapy
#2
Andria R Morielli, Normand G Boulé, Nawaid Usmani, Kurian Joseph, Keith Tankel, Diane Severin, Kerry S Courneya
This pilot study explored predictors of adherence to exercise during and after neoadjuvant chemoradiotherapy (NACRT) in rectal cancer patients. Eighteen rectal cancer patients were prescribed three supervised aerobic exercise sessions/week during NACRT followed by ≥150 min/week of unsupervised aerobic exercise after NACRT. Although not statistically significant, adherence to supervised exercise during NACRT was meaningfully better for patients who were women (d = .82; P = .12), younger (d = -.62; P = ...
June 21, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28633587/sarcomatoid-carcinoma-manifesting-as-recurrent-rectal-cancer-and-mimicking-radiation-induced-extraskeletal-osteosarcoma-a-case-report
#3
MiJo Lee, Hyun-Jin Son, Je-Ho Jang, Hyun-Young Han, Moon Hyang Park
Here, we report an unusual case of sarcomatoid carcinoma mimicking extraskeletal osteosarcoma that manifested as recurrent rectal cancer. Five years earlier, a 76-year-old male patient had undergone neoadjuvant chemoradiotherapy followed by a laparoscopic low anterior resection due to adenocarcinoma of the rectum. He was admitted because of pain in the anus and left hip. He underwent abdominal computed tomography that revealed a newly developed left perirectal mass with gluteus maximus invasion measuring up to 8 cm, and therefore, an abdominoperineal resection was performed...
June 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28620444/clinical-utility-of-pretreatment-prediction-of-chemoradiotherapy-response-in-rectal-cancer-a-review
#4
REVIEW
Byong Chul Yoo, Seung-Gu Yeo
Approximately 20% of all patients with locally advanced rectal cancer experience pathologically complete responses following neoadjuvant chemoradiotherapy (CRT) and standard surgery. The utility of radical surgery for patients exhibiting good CRT responses has been challenged. Organ-sparing strategies for selected patients exhibiting complete clinical responses include local excision or no immediate surgery. The subjects of this tailored management are patients whose presenting disease corresponds to current indications of neoadjuvant CRT, and their post-CRT tumor response is assessed by clinical and radiological examinations...
March 2017: EPMA Journal
https://www.readbyqxmd.com/read/28607594/high-expression-of-aldolase-b-confers-a-poor-prognosis-for-rectal-cancer-patients-receiving-neoadjuvant-chemoradiotherapy
#5
Yu-Feng Tian, Pei-Ling Hsieh, Ching-Yih Lin, Ding-Ping Sun, Ming-Jen Sheu, Ching-Chieh Yang, Li-Ching Lin, Hong-Lin He, Julia Solórzano, Chien-Feng Li, I-Wei Chang
Background : Colorectal cancer is the third most common cancer in both sex 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 documented database of rectal cancer transcriptome (GSE35452) from Gene Expression Omnibus, National Center of Biotechnology Information, we recognized that ALDOB was the most significantly up-regulated transcript among those related to glycolysis (GO: 0006096)...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28603932/prognostic-significance-of-tumour-regression-grade-after-neoadjuvant-chemoradiotherapy-for-a-cohort-of-locally-advanced-rectal-cancer-patients-an-8-year-retrospective-single-institutional-study
#6
Lai Xu, Songhua Cai, Tixian Xiao, Yanyu Chen, Huizhong Qiu, Bin Wu, Guole Lin, Xiyu Sun, Junyang Lu, Weixun Zhou, Yi Xiao
AIM: Locally advanced rectal cancer (LARC) is frequently treated with neoadjuvant chemoradiotherapy (NACRT) to reduce the risk of local recurrence and improve survival. Tumour response to NACRT is variable and may influence the prognosis after subsequent surgery. This study compared the prognostic values of tumour regression grade (TRG) and neoadjuvant pathologic (ypTNM) downstaging in stage II and III rectal cancer patients treated with NACRT followed by curative surgery. METHOD: This study included 185 LARC patients treated with long-course radiotherapy (45 Gy in 25 fractions) plus 5-fluorouracil over 5 weeks between 2005 and 2013...
June 11, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28601342/organ-preservation-for-rectal-cancer-greccar-2-a-prospective-randomised-open-label-multicentre-phase-3-trial
#7
Eric Rullier, Philippe Rouanet, Jean-Jacques Tuech, Alain Valverde, Bernard Lelong, Michel Rivoire, Jean-Luc Faucheron, Mehrdad Jafari, Guillaume Portier, Bernard Meunier, Igor Sileznieff, Michel Prudhomme, Frédéric Marchal, Marc Pocard, Denis Pezet, Anne Rullier, Véronique Vendrely, Quentin Denost, Julien Asselineau, Adélaïde Doussau
BACKGROUND: Organ preservation is a concept proposed for patients with rectal cancer after a good clinical response to neoadjuvant chemotherapy, to potentially avoid morbidity and side-effects of rectal excision. The objective of this study was to compare local excision and total mesorectal excision in patients with a good response after chemoradiotherapy for lower rectal cancer. METHODS: We did a prospective, randomised, open-label, multicentre, phase 3 trial at 15 tertiary centres in France that were experts in the treatment of rectal cancer...
June 7, 2017: Lancet
https://www.readbyqxmd.com/read/28595169/the-addition-of-target-therapy-to-neoadjuvant-chemoradiotherapy-in-locally-advanced-rectal-cancer-a-review
#8
Ilaria Benevento, Francesca De Felice, Daniela Musio, Vincenzo Tombolini
Currently, neoadjuvant fluoropyrimidine-based chemoradiotherapy (CRT) is standard practice in the management of locally advanced rectal cancer (LARC). In the last decade there has been a lively interest in the improvement of clinical outcomes by modifying this standard regimen by the addition of further agents. We review combinations of targeted therapies and conventional CRT currently under investigation in LARC patients.
June 9, 2017: Chemotherapy
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
#9
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/28583894/local-recurrence-after-five-years-is-associated-with-preoperative-chemoradiotherapy-treatment-in-patients-diagnosed-with-stage-ii-and-iii-rectal-cancer
#10
Gabriel Marin, Javier Suárez, Ruth Vera, Enrique Balén, Antonio Viudez, Elena Mata
AIM: To asses the moment of local recurrence and its influence on the appraisal of the results of neoadjuvant chemoradiotherapy (CRT). METHODS: We evaluated 317 patients with a preoperative diagnosis of stage II or III rectal cancer who underwent rectal resection. Gender, age, neoadjuvant treatment, circumferencial resection margin, adjuvant treatment, pretreatment carcinoembryonic antigen level, tumor location, TNM stage, lymph node retrieval, abdominoperineal resection, and lymphatic or vascular infiltration were registered prospectively...
June 3, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28581407/continuous-effect-of-radial-resection-margin-on-recurrence-and-survival-in-rectal-cancer-patients-who-receive-preoperative-chemoradiation-and-curative-surgery-a-multicenter-retrospective-analysis
#11
SooYoon Sung, Sung Hwan Kim, Joo Hwan Lee, Taek Keun Nam, Songmi Jeong, Hong Seok Jang, Jin Ho Song, Jeong Won Lee, Jung Min Bae, Jong Hoon Lee
PURPOSE: To elucidate the proper length and prognostic value of resection margins in rectal cancer patients who received preoperative chemoradiotherapy (CRT) followed by curative total mesorectal excision (TME). METHODS AND MATERIALS: A total of 1476 rectal cancer patients staging cT3-4N0-2M0 were analyzed. All patients received radiation dose of 50.4 Gy in 28 fractions with concurrent 5-fluorouracil or capecitabine. Total mesorectal excision was performed 4 to 8 weeks after radiation therapy...
July 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28567186/critical-evaluation-of-contemporary-management-in-a-new-pelvic-exenteration-unit-the-first-25-consecutive-cases
#12
Min Hoe Chew, Yu-Ting Yeh, Ee-Lin Toh, Stephen Aditya Sumarli, Ghee Kheng Chew, Lui Shiong Lee, Mann Hong Tan, Tiffany Priyanthi Hennedige, Shin Yi Ng, Say Kiat Lee, Tze Tec Chong, Hairil Rizal Abdullah, Terence Lin Hon Goh, Mohamed Zulfikar Rasheed, Kok Chai Tan, Choong Leong Tang
AIM: To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODS: This retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome...
May 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28567185/extramural-vascular-invasion-and-response-to-neoadjuvant-chemoradiotherapy-in-rectal-cancer-influence-of-the-cpg-island-methylator-phenotype
#13
Jeremy Stuart Williamson, Huw Geraint Jones, Namor Williams, Anthony Paul Griffiths, Gareth Jenkins, John Beynon, Dean Anthony Harris
AIM: To identify whether CpG island methylator phenotype (CIMP) is predictive of response to neoadjuvant chemoradiotherapy (NACRT) and outcomes in rectal cancer. METHODS: Patients undergoing NACRT and surgical resection for rectal cancer in a tertiary referral centre between 2002-2011 were identified. Pre-treatment tumour biopsies were analysed for CIMP status (high, intermediate or low) using methylation specific PCR. KRAS and BRAF status were also determined using pyrosequencing analysis...
May 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28551665/the-role-of-concomitant-radiation-boost-in-neoadjuvant-chemoradiotherapy-for-locally-advanced-rectal-cancer
#14
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/28534322/-value-of-functional-magnetic-resonance-imaging-in-predicting-outcomes-of-neoadjuvant-chemoradiotherapy-in-rectal-cancer
#15
Yishan Yu, Jinbo Yue, Jinming Yu
Rectal cancer is one of the common cancers which poses a threat to the health of mankind. In recent years. Multi-modality treatment strategies for locally advanced rectal cancer improve the treatment efficiency. Accurate prediction of the treatment response after the neoadjuvant chemoradiotherapy (CRT) can guide more suitable treatment strategy. MERCURY study proved the prognostic value of post-CRT standard morphologic MRI(T2-weighted) assessment of tumor regression grade(TRG), and MRI assessment of circumferential resection margin can guide the definitive surgery...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28529623/high-expression-of-epha4-predicted-lesser-degree-of-tumor-regression-after-neoadjuvant-chemoradiotherapy-in-rectal-cancer
#16
Ching-Yih Lin, Ying-En Lee, Yu-Feng Tian, Ding-Ping Sun, Ming-Jen Sheu, Chen-Yi Lin, Chien-Feng Li, Sung-Wei Lee, Li-Ching Lin, I-Wei Chang, Chieh-Tien Wang, Hong-Lin He
Background: Numerous transmembrane receptor tyrosine kinase pathways have been found to play an important role in tumor progression in some cancers. This study was aimed to evaluate the clinical impact of Eph receptor A4 (EphA4) in patients with rectal cancer treated with neoadjuvant concurrent chemoradiotherapy (CCRT) combined with mesorectal excision, with special emphasis on tumor regression. Methods: Analysis of the publicly available expression profiling dataset of rectal cancer disclosed that EphA4 was the top-ranking, significantly upregulated, transmembrane receptor tyrosine kinase pathway-associated gene in the non-responders to CCRT, compared with the responders...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28524777/can-a-longer-waiting-period-after-neoadjuvant-chemoradiotherapy-improve-the-pathologic-complete-response-rate-in-patients-with-rectal-cancer
#17
Jun Li, Jian Li
No abstract text is available yet for this article.
May 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28507455/neoadjuvant-chemoradiotherapy-of-the-rectal-carcinoma-the-correlation-between-the-findings-on-the-restaging-multiparametric-3t-mri-scanning-and-the-surgical-findings
#18
Radovan Vojtíšek, Eva Korčáková, Jan Mařan, Ondřej Šorejs, Jindřich Fínek
AIM: To figure out how to correlate the findings on functional MRI and carried out after neoadjuvant CRT of rectal carcinoma with final histology after surgery. BACKGROUND: Neoadjuvant CRT is the standard treatment of locally advanced rectal carcinoma. Its use leads to the downstaging of the disease and in 15-42% of patients even to the detection of pCR after TME. The use of functional MRI improves the sensitivity and specificity of pCR detection up to 52-64% and 89-98%, respectively...
July 2017: Reports of Practical Oncology and Radiotherapy
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/28502421/is-neoadjuvant-chemoradiotherapy-always-necessary-for-mid-high-local-advanced-rectal-cancer-a-comparative-analysis-after-propensity-score-matching
#20
Y Zhang, Y Sun, Z Xu, P Chi, X Lu
AIM: This study was aimed to compare perioperative and oncological outcomes of mid/high locally advanced midrectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (NCRT) vs. surgery alone, and to identify risk factors for local recurrence in mid/high LARC. METHOD: A total of 471 mid/high LARC patients treated with surgery alone or NCRT (50.4 Gy in 28 fractions) with concurrent FOLFOX/XELOX followed by TME in 6-8 weeks from 2008 to 2014 were matched 1:1 by using propensity score analysis...
May 4, 2017: European Journal of Surgical Oncology
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