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Neoadjuvant chemoradiotherapy in rectal cancer

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https://www.readbyqxmd.com/read/28338156/-pay-attention-to-the-selective-lateral-pelvic-lymph-node-dissection-in-mid-low-rectal-cancer
#1
Wenjian Meng, Ziqiang Wang
Lateral pelvic lymph node metastasis is an important metastatic mode and a major cause of locoregional recurrence of mid-low rectal cancer. Recently, there is an East-West discrepancy in regard to the diagnosis, clinical significance, treatment and prognosis of lateral pelvic lymph node metastasis. In the West, lateral nodal involvement may represent systemic disease and preoperative chemoradiotherapy can sterilize clinically suspected lateral nodes. Thus, in many Western countries, the standard therapy for lower rectal cancer is total mesorectal excision with chemoradiotherapy, and pelvic sidewall dissection is rarely performed...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28333014/single-nucleotide-polymorphism-tgf%C3%AE-1-r25p-correlates-with-acute-toxicity-during-neoadjuvant-chemoradiotherapy-in-rectal-cancer-patients
#2
J Joshua Smith, Isaac Wasserman, Sarah A Milgrom, Oliver S Chow, Chin-Tung Chen, Sujata Patil, Karyn A Goodman, Julio Garcia-Aguilar
PURPOSE: To validate the finding of an association between single nucleotide polymorphisms (SNPs) and toxicity during chemoradiotherapy (CRT) in rectal cancer patients, in an independent population. METHODS AND MATERIALS: The cohort consisted of 165 patients who received CRT for rectal cancer from 2006 to 2012. Prospectively recorded toxicity information, graded according to the Common Terminology Criteria for Adverse Events version 3.0, was retrieved from the medical record...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28326100/immunohistochemical-markers-as-predictors-of-histopathologic-response-and-prognosis-in-rectal-cancer-treated-with-preoperative-adjuvant-therapy-state-of-the-art
#3
REVIEW
Alessandro Del Gobbo, Stefano Ferrero
We explain the state of the art of the immunohistochemical markers of response in rectal cancers treated with neoadjuvant medical therapies and its implication with prognosis. Neoadjuvant chemoradiotherapy is widely used to improve the outcome of patients with locally advanced rectal cancer, and the evaluation of the effects of medical therapy is to date based on histomorphological examination by applying four grading systems of response to therapy (tumor regression grade (TRG)). The need to identify immunohistochemical markers that could ensure a better assessment of response and possibly provide additional prognostic information has emerged...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28324284/nonoperative-management-or-watch-and-wait-for-rectal-cancer-with-complete-clinical-response-after-neoadjuvant-chemoradiotherapy-a-critical-appraisal
#4
Tarik Sammour, Brandee A Price, Kate J Krause, George J Chang
BACKGROUND: There is increasing interest in nonoperative management (NOM) for rectal cancer with complete clinical response (cCR) after neoadjuvant chemoradiation (nCRT). OBJECTIVE: The aim of this systematic review was to summarize the available data on NOM, with the intention of formulating standardized protocols on which to base future investigations. METHODS: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted...
March 21, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28316153/-assessment-of-predictive-factors-for-survival-in-patients-with-locally-advanced-rectal-cancer-after-neoadjuvant-chemoradiotherapy
#5
G J Wu, T Yu, W W Jia, Q An, G Xiao, X Wang
Objective: To evaluate the clinical predictive factors for survival prognosis in patients with locally advanced rectal cancer after neoadjuvant chemoradiotheraphy. Methods: The study included 87 patients with middle and lower locally advanced rectal cancer, who underwent neoadjuvant chemoradiotheraphy followed by radical surgery between April 2007 and May 2015. The clinical factors associated with 3-year disease-free survival (DFS) and overall survival (OS) were analyzed.Kaplan-Meier analysis of disease-free survival and overall survival was performed for all patients...
March 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28304150/additional-chemotherapy-and-salvage-surgery-for-poor-response-to-chemoradiotherapy-in-rectal-cancers
#6
Reena Engineer, Vikas Ostwal, Supreeta Arya, Priyamvada Gupta, Supriya Chopra, Prachi Patil, Sudhir Jatal, Avanish Saklani
AIM: A proportion of locally advanced rectal cancer patients who receive neoadjuvant chemoradiotherapy (NACRT) are still unresectable. This study was undertaken to assess the outcomes of giving additional chemotherapy to rectal cancer patients with unresectable disease after NACRT. METHODS: Patients with poor response to NACRT where mesorectal fascia was still involved on MRI and R0 resection was doubtful, received additional four cycles of chemotherapy with either CAPOX or FOLFIRINOX regimen, and the response was reevaluated with MRI and reassessed for surgical resection...
March 17, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28295220/total-neoadjuvant-therapy-for-rectal-cancer-an-emerging-option
#7
REVIEW
Ethan B Ludmir, Manisha Palta, Christopher G Willett, Brian G Czito
The treatment of locally advanced rectal cancer (LARC) has benefited from improved surgical techniques and from the implementation of neoadjuvant chemoradiotherapy (CRT), which have markedly decreased the rates of local recurrence. However, distant metastatic disease remains the most significant cause of death for these patients. Although adjuvant chemotherapy (ChT) after neoadjuvant CRT and definitive surgery is commonly recommended, the value of adjuvant systemic therapy remains less clear. Trials evaluating adjuvant ChT for rectal cancer have been handicapped by poor compliance rates and inconsistent survival results...
March 10, 2017: Cancer
https://www.readbyqxmd.com/read/28293088/do-pathological-variables-have-prognostic-significance-in-rectal-adenocarcinoma-treated-with-neoadjuvant-chemoradiotherapy-and-surgery
#8
Luca Reggiani Bonetti, Simona Lionti, Federica Domati, Valeria Barresi
AIM: To clarify which factors may influence pathological tumor response and affect clinical outcomes in patients with locally advanced rectal carcinoma treated with neo-adjuvant chemoradiotherapy and surgery. METHODS: Tumor regression grade (TRG) according to the Dworak system and yTNM stage were assessed and correlated with pre-treatment clinico-pathological variables in 215 clinically locally advanced (cTNM stage II and III) rectal carcinomas. Prognostic value of all pathological and clinical factors on disease free survival (DFS) and cancer specific survival (CSS) was analyzed by Kaplan Meier and Cox-regression analyses...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28291773/comprehensive-molecular-exploration-identified-promoter-dna-methylation-of-the-crbp1-gene-as-a-determinant-of-radiation-sensitivity-in-rectal-cancer
#9
K Yokoi, K Yamashita, S Ishii, T Tanaka, N Nishizawa, A Tsutsui, H Miura, H Katoh, T Yamanashi, M Naito, T Sato, T Nakamura, M Watanabe
BACKGROUND: Neoadjuvant chemoradiotherapy (NCRT) for advanced rectal cancer (RC) is a well-evidenced therapy; however, some RC patients have no therapeutic response. Patient selection for NCRT so that non-responsive patients are excluded has been subjective. To date, no molecular markers indicating radiation sensitivity have been reported. METHODS: We irradiated six colorectal cancer (CRC) cell lines and identified HCT116 cells as radiation-sensitive and HCT15 and DLD-1 cells as radiation resistant...
March 14, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28284574/comparison-of-5-fu-based-and-capecitabine-based-neoadjuvant-chemoradiotherapy-in-patients-with-rectal-cancer-a-meta-analysis
#10
Xiang-Cai Zou, Qiwen Wang, Jimin Zhang
INTRODUCTION: The inconvenience of using infusion therapies resulted in the development of capecitabine (CA), an oral fluoropyrimidine. In this meta-analysis, we evaluated 10 studies that compared the efficacy and safety of an oral CA-based regimen with those of a continuous infusion 5-fluorouracil (5-FU) regimen for neoadjuvant chemoradiotherapy in patients with rectal cancer. MATERIALS AND METHODS: The databases searched included Medline, Cochrane, EMBASE, and Google Scholar (until August 31, 2016)...
January 25, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28273303/association-between-incomplete-neoadjuvant-radiotherapy-and-survival-for-patients-with-locally-advanced-rectal-cancer
#11
Kyle Freischlag, Zhifei Sun, Mohamed A Adam, Jina Kim, Manisha Palta, Brian G Czito, John Migaly, Christopher R Mantyh
Importance: Failing to complete chemotherapy adversely affects survival in patients with colorectal cancer. However, the effect of incomplete delivery of neoadjuvant radiotherapy is unclear. Objective: To determine whether incomplete radiotherapy delivery is associated with worse clinical outcomes and survival. Design, Setting, and Participants: Data on 17 600 patients with stage II to III rectal adenocarcinoma from the 2006-2012 National Cancer Database who received neoadjuvant chemoradiotherapy followed by surgical resection were included...
March 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28270729/pre-and-post-surgery-treatments-in-rectal-cancer-a-long-term-single-centre-experience
#12
H Ozyurt, A S Ozden, Z Ozgen, C Gemici, G Yaprak
BACKGROUND: Our study evaluated long-term survival outcomes in rectal cancer patients treated with preoperative radiotherapy, and the impact on survival of concomitant and postoperative adjuvant chemotherapy (ctx), among other prognostic factors. METHODS: The study included 196 patients [median age: 58 years (range: 20-86 years); 63.0% men] with locally advanced rectal carcinoma and, in some cases, resectable liver metastasis. Rates of distant metastasis and local recurrence and of 5-year distant metastasis-free survival (dmfs) and overall survival (os) were determined...
February 2017: Current Oncology
https://www.readbyqxmd.com/read/28255388/the-evaluation-of-the-oxidative-stress-for-patients-receiving-neoadjuvant-chemoradiotherapy-for-locally-advanced-rectal-cancer
#13
G L Serbanescu, M I Gruia, M Bara, R M Anghel
Hypothesis: Nowadays, rectal cancer is an important healthcare challenge that affects many thousands of people each year worldwide, being diagnosed especially after the age of 50 years. Objective: This study attempted to evaluate the oxidative stress in patients with rectal cancer. Methods and results: 30 patients from the "Prof. Dr. Al. Trestioreanu" Institute of Oncology in Bucharest were treated with neoadjuvant radiochemotherapy during 2014 and 2016 and were included in the clinical study. Blood samples were obtained in dynamics during the treatment...
January 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28253875/the-interval-approach-an-adaptation-of-the-liver-first-approach-to-treat-synchronous-liver-metastases-from-rectal-cancer
#14
Mathieu D'Hondt, Valerio Lucidi, Koen Vermeiren, Bert Van Den Bossche, Vincent Donckier, Gregory Sergeant
BACKGROUND: The waiting interval after chemoradiotherapy (CRT) is an interesting therapeutic window to treat patients with synchronous liver metastases (SLM) from rectal cancer. METHODS: A retrospective analysis was performed of 18 consecutive patients (M/F 10/8, age (range) 60 (51-75) years) from five institutions who underwent liver resection of SLM during the waiting interval after CRT for rectal adenocarcinoma. RESULTS: All patients underwent interval liver surgery for a median (range) of 4 (2-14) liver metastases...
March 2, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28230017/comparison-of-perioperative-outcomes-between-laparoscopic-and-open-surgery-for-mid-low-rectal-cancer-with-total-mesorectal-excision-following-neoadjuvant-chemoradiotherapy
#15
COMPARATIVE STUDY
Weiping Chen, Qiken Li, Pengnian Qiu, Lai Jiang, Zhixuan Fu, Yongtian Fan, Dechuan Li, Peng Liu, Lilong Tang
OBJECTIVE: The objective of our study was to determine the feasibility and safety of laparoscopic total mesorectal excision (TME) for mid-low rectal cancer following neoadjuvant chemoradiotherapy (nCRT). METHODS: We retrospectively reviewed the records of 172 patients with locally advanced rectal cancer who underwent laparoscopic (n = 75) or conventional open (n = 97) surgery with TME following nCRT from June 2009 to October 2015. Perioperative outcomes and related clinical variables were collected and statistically analyzed...
December 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28228938/physical-activity-levels-in-locally-advanced-rectal-cancer-patients-following-neoadjuvant-chemoradiotherapy-and-an-exercise-training-programme-before-surgery-a-pilot-study
#16
Lisa Loughney, Malcolm A West, Borislav D Dimitrov, Graham J Kemp, Michael Pw Grocott, Sandy Jack
BACKGROUND: The aim of this pilot study was to measure changes in physical activity level (PAL) variables, as well as sleep duration and efficiency in people with locally advanced rectal cancer (1) before and after neoadjuvant chemoradiotherapy (CRT) and (2) after participating in a pre-operative 6-week in-hospital exercise training programme, following neoadjuvant CRT prior to major surgery, compared to a usual care control group. METHODS: We prospectively studied 39 consecutive participants (27 males)...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28217301/risk-factors-for-perineal-wound-infection-after-abdominoperineal-resection-of-advanced-lower-rectal-cancer
#17
Takatoshi Nakamura, Takeo Sato, Kazushige Hayakawa, Yoko Takayama, Masanori Naito, Takahiro Yamanashi, Atsuko Tsutsui, Hirohisa Miura, Masahiko Watanabe
PURPOSE: Abdominoperineal resection (APR) of advanced lower rectal cancer carries a high incidence of perineal wound infection. The aim of this study was to retrospectively evaluate risk factors for perineal wound infection after APR. METHODS: The study group comprised 154 patients who underwent APR for advanced lower rectal cancer in our department from January 1990 through December 2012. The following 15 variables were studied as potential risk factors for perineal wound infection: sex, age, body-mass index, American Society of Anesthesiologists score, diabetes mellitus, preoperative albumin level, preoperative hemoglobin level, neoadjuvant chemoradiotherapy(NCRT), surgical procedure (open surgery vs...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28177997/outcome-and-salvage-surgery-following-watch-and-wait-for-rectal-cancer-after-neoadjuvant-therapy-a-systematic-review
#18
REVIEW
Joseph C Kong, Glen R Guerra, Satish K Warrier, Robert G Ramsay, Alexander G Heriot
BACKGROUND: Currently there is no reliable test to predict pathological complete response following neoadjuvant chemoradiotherapy for rectal cancer. However, there is increasing interest in using clinical complete response as a surrogate marker, allowing a subset of patients with locally advanced rectal cancer to be allocated into a "watch and wait" pathway. Little is known about the oncological safety of the "watch and wait" approach or the rate of salvage surgery in cases of tumor regrowth...
March 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28177891/tumour-infiltrating-regulatory-t-cell-density-before-neoadjuvant-chemoradiotherapy-for-rectal-cancer-does-not-predict-treatment-response
#19
Melanie J McCoy, Chris Hemmings, Chidozie C Anyaegbu, Stephanie J Austin, Tracey F Lee-Pullen, Timothy J Miller, Max K Bulsara, Nikolajs Zeps, Anna K Nowak, Richard A Lake, Cameron F Platell
Neoadjuvant (preoperative) chemoradiotherapy (CRT) decreases the risk of rectal cancer recurrence and reduces tumour volume prior to surgery. However, response to CRT varies considerably between individuals and factors associated with response are poorly understood. Foxp3+ regulatory T cells (Tregs) inhibit anti-tumour immunity and may limit any response to chemotherapy and radiotherapy. We have previously reported that a low density of Tregs in the tumour stroma following neoadjuvant CRT for rectal cancer is associated with improved tumour regression...
February 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/28159930/compared-planning-dosimetry-of-tomo-vmat-and-imrt-in-rectal-cancer-with-different-simulated-positions
#20
Jang-Chun Lin, Jo-Ting Tsai, Li-Jhen Chen, Ming-Hsien Li, Wei-Hsiu Liu
OBJECTIVES: To compare treatment plans for helical tomotherapy (TOMO), volumetric modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) for locally advanced rectal cancer (LARC). MATERIALS AND METHODS: This retrospective study from December 2010 to June 2013 included 20 patients with LARC who received neoadjuvant concurrent chemoradiotherapy (CCRT) with radiation doses of greater than 50.4 Gy. Dosimetric quality was evaluated based on doses to organs at risk (OARs), including small bowel, urinary bladder and bilateral femoral head, over the same coverage of the clinical target volume (CTV)...
January 31, 2017: Oncotarget
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