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Neoadjuvant chemoradiotherapy in rectal cancer

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https://www.readbyqxmd.com/read/28819296/intravoxel-incoherent-motion-diffusion-weighted-imaging-for-discriminating-the-pathological-response-to-neoadjuvant-chemoradiotherapy-in-locally-advanced-rectal-cancer
#1
Wen Lu, Hou Jing, Zhou Ju-Mei, Nie Shao-Lin, Cao Fang, Yu Xiao-Ping, Lu Qiang, Zeng Biao, Zhu Su-Yu, Hu Ying
To investigate the usefulness of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in discriminating the pathological complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC), 42 patients underwent preoperative IVIM-DWI before (pre-nCRT) and after nCRT (post-nCRT). The values of pre-nCRT and post-nCRT IVIM-DWI parameters (ADC, D, D* and f), together with the percentage changes (∆% parametric value) induced by nCRT, were compared between the pCR (tumour regression grade [TRG] 4) and non-pCR (TRG 0, 1, 2 or 3) groups and between the GR (TRG 3 or 4) and PR (TRG 0, 1 or 2) groups based on the Dworak TRG system...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28803718/total-neoadjuvant-therapy-a-shifting-paradigm-in-locally-advanced-rectal-cancer-management
#2
REVIEW
Aaron J Franke, Hiral Parekh, Jason S Starr, Sanda A Tan, Atif Iqbal, Thomas J George
Colorectal carcinoma is the second leading cause of cancer-related deaths in the United States, with rectal cancer accounting for approximately one-third of newly diagnosed cases, thus representing a major socioeconomic health burden. Although minimally invasive procedures (ie, transanal excision) may be appropriate for a subset of patients with small, superficially invasive tumors, a more comprehensive trimodality approach with neoadjuvant chemoradiotherapy, total mesorectal excision, and systemic chemotherapy is recommended for medically operable patients with nonmetastatic, locally advanced rectal cancer (LARC)...
June 27, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28797063/ct-texture-analysis-in-patients-with-locally-advanced-rectal-cancer-treated-with-neoadjuvant-chemoradiotherapy-a-potential-imaging-biomarker-for-treatment-response-and-prognosis
#3
Choong Guen Chee, Young Hoon Kim, Kyoung Ho Lee, Yoon Jin Lee, Ji Hoon Park, Hye Seung Lee, Soyeon Ahn, Bohyoung Kim
PURPOSE: To evaluate the association of computed tomography (CT) texture features of locally advanced rectal cancer with neoadjuvant chemoradiotherapy (CRT) response and disease-free survival (DFS). METHODS AND FINDINGS: The institutional review board approved this retrospective study. 95 patients who received neoadjuvant CRT, followed by surgery, for locally advanced rectal cancer were included. Texture features (entropy, uniformity, kurtosis, skewness, and standard deviation) were assessed in pretreatment CT images and obtained without filtration and with Laplacian of Gaussian spatial filter of various filter values (1...
2017: PloS One
https://www.readbyqxmd.com/read/28796730/squamous-cancers-of-the-rectum-demonstrate-poorer-survival-and-increased-need-for-salvage-surgery-compared-with-squamous-cancers-of-the-anus
#4
Audrey S Kulaylat, Christopher S Hollenbeak, David B Stewart
BACKGROUND: Squamous cell cancers of the anus are rare GI malignancies for which neoadjuvant chemoradiation is the first-line treatment for nonmetastatic disease. Squamous cancers of the rectum are far less common, and it is unclear to what degree chemoradiotherapy improves their outcomes. OBJECTIVE: The purpose of this study was to compare stage-specific survival for anal and rectal squamous cancers stratified by treatment approach. DESIGN: This was a retrospective cohort study...
September 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28778099/predictive-clinical-model-of-tumor-response-after-chemoradiation-in-rectal-cancer
#5
Marisa D Santos, Cristina Silva, Anabela Rocha, Carlos Nogueira, Fernando Castro-Poças, António Araujo, Eduarda Matos, Carina Pereira, Rui Medeiros, Carlos Lopes
Survival improvement in rectal cancer treated with neoadjuvant chemoradiotherapy (nCRT) is achieved only if pathological response occurs. Mandard tumor regression grade (TRG) proved to be a valid system to measure nCRT response. The ability to predict tumor response before treatment may significantly have impact the selection of patients for nCRT in rectal cancer. The aim is to identify potential predictive pretreatment factors for Mandard response and build a clinical predictive model design. 167 patients with locally advanced rectal cancer were treated with nCRT and curative surgery...
July 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28770104/immunoscore-in-mismatch-repair-proficient-and-deficient-colon-cancer
#6
Erkki-Ville Wirta, Toni Seppälä, Marjukka Friman, Juha Väyrynen, Maarit Ahtiainen, Hannu Kautiainen, Teijo Kuopio, Ilmo Kellokumpu, Jukka-Pekka Mecklin, Jan Böhm
The aim of this study was to investigate immune response and its prognostic significance in colon carcinomas using the previously described Immunoscore (IS). A population-based series of 779 colorectal cancers, operated on between 2000 and 2010, were classified according to tumour, node, metastasis (TNM) status, mismatch repair (MMR), and BRAF mutation status. Rectal cancer cases (n = 203) were excluded as a high proportion of these patients received preoperative neoadjuvant chemoradiotherapy. Tissue microarray (TMA) samples collected from the tumour centre and invasive front were immunostained for CD3 and CD8...
July 2017: Journal of Pathology. Clinical Research
https://www.readbyqxmd.com/read/28768238/preoperative-chemoradiotherapy-for-rectal-cancer-the-sensitizer-role-of-the-association-between-mir-375-and-c-myc
#7
Raquel Conde-Muiño, Carlos Cano, Victoria Sánchez-Martín, Antonio Herrera, Ana Comino, Pedro P Medina, Pablo Palma, Marta Cuadros
Administration of chemoradiation before tumor resection has revolutionized the management of locally advanced rectal cancer, but many patients have proven resistant to this preoperative therapy. Our group recently reported a negative correlation between c-Myc gene expression and this resistance. In the present study, integrated analysis of miRNA and mRNA expression profiles was conducted in 45 pre-treatment rectal tumors in order to analyze the expressions of miRNAs and c-Myc and their relationship with clinicopathological factors and patient survival...
July 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28756039/muscle-wasting-and-survival-following-pre-operative-chemoradiotherapy-for-locally-advanced-rectal-carcinoma
#8
S Levolger, M G van Vledder, W J Alberda, C Verhoef, R W F de Bruin, J N M IJzermans, J W Burger
BACKGROUND & AIMS: Neoadjuvant chemoradiotherapy (NACRT) has increased local control in locally advanced rectal cancer. Reduced skeletal muscle mass (sarcopenia), or ongoing muscle wasting, is associated with decreased survival in cancer. This study aims to assess the change in body composition during NACRT and its impact on outcome using computed tomography (CT) imaging in locally advanced rectal cancer (LARC) patients. METHODS: LARC patients treated with NACRT were selected from a prospectively maintained database and retrospectively analyzed...
July 13, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28742699/understanding-and-resetting-radiation-sensitivity-in-rectal-cancer
#9
Katherine A Kelley, Rebecca A Ruhl, Shushan R Rana, Elizabeth Dewey, Cristina Espinosa, Charles R Thomas, Robert G Martindale, Sudarshan Anand, Vassiliki L Tsikitis
OBJECTIVE: The aim of the study was to explore specific microRNAs (miRs) in rectal cancer that would predict response to radiation and identify target pathways that may be exploited for neoadjuvant therapies. SUMMARY BACKGROUND DATA: Chemoradiotherapy (CRT) response is a predictor of survival in rectal cancer. Studies have demonstrated changes in RNA expression correlate with chemoradiation sensitivity across cancers. METHODS: Forty-five rectal cancer patients, partial responders (PR = 18), nonresponders (NR = 13), and complete responders (CR = 14) to CRT, as defined by a tumor regression score, were examined...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742692/oncologic-outcome-and-morbidity-in-the-elderly-rectal-cancer-patients-after-preoperative-chemoradiotherapy-and-total-mesorectal-excision-a-multi-institutional-and-case-matched-control-study
#10
Soo-Y Sung, Hong S Jang, Sung H Kim, Jae U Jeong, Songmi Jeong, Jin H Song, Mi J Chung, Hyeon M Cho, Hyung J Kim, Jun-Gi Kim, In K Lee, Jong H Lee
OBJECTIVE: To determine the toxicity and oncologic outcome of neoadjuvant chemoradiotherapy (CRT) followed by curative total mesorectal excision (TME) in the elderly (≥70 yrs) and younger (<70 yrs) rectal cancer patients. BACKGROUND: Sufficient data for elderly rectal cancer patients who received definitive trimodality have not been accumulated yet. PATIENTS AND METHODS: A total of 1232 rectal cancer patients who received neoadjuvant CRT and TME were enrolled in this study...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28728302/-clinical-efficacy-of-ladder-neoadjuvant-therapy-in-treatment-of-advanced-mid-low-rectal-cancer
#11
Y X Zhang, H B Wang, Y J Lu, H Y Liu
Objective: To explore the clinical efficacy of ladder neoadjuvant therapy in treatment of advanced mid-low rectal cancer. Methods: We performed a retrospective study of one hundred and eighty mid and low rectal cancer patients who underwent ladder neoadjuvant therapy(neoadjuvant chemotherapy followed by surgery if neoadjuvant chemotherapy was effective; neoadjuvant chemotherapy followed by neoadjuvant chemoradiotherapy if neoadjuvant chemotherapy was ineffective)(n=90) or neoadjuvant chemoradiotherapy (n=90)...
July 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28728151/a-modified-classification-of-prognostic-factors-based-on-pathological-stage-and-tumor-regression-grade-in-patients-with-rectal-cancer-who-receive-preoperative-chemoradiotherapy
#12
Toshiyuki Suzuki, Sotaro Sadahiro, Akira Tanaka, Kazutake Okada, Gota Saito, Hiroshi Miyakita, Takeshi Akiba, Hiroshi Yamamuro
OBJECTIVE: The histologic response to neoadjuvant chemoradiotherapy (CRT) has been intimately related to outcomes in locally advanced rectal cancer. However, reliable prognostic factors have yet to be established. SUBJECTS AND METHODS: The study group comprised 198 patients with locally advanced rectal cancer who received CRT. A modified classification based on the combination of ypStage and tumor regression grade (TRG) was developed. ypStage II with TRG 2 was classified as ypTRGstage IIA, and ypStage II with TRG 3 or 4 was classified as ypTRGstage IIB...
July 21, 2017: Oncology
https://www.readbyqxmd.com/read/28722084/-postoperative-complications-after-rectal-cancer-surgery-and-management
#13
Jin Gu, Qingkun Gao
Although neoadjuvant treatment such as radiotherapy, even chemoradiotherapy has already widely used in middle-low rectal cancer, surgery remains the mainstay of therapy for patients with rectal cancer. Because neoadjuvant chemoradiotherapy combined with surgery was adopted for the locally advanced rectal cancer as a standard treatment based on guidelines, postoperative complications of rectal cancer surgery caused surgeons attention and concern gradually. Some severe complications should seriously affect patient's quality of life, even patient's survival...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28711936/a-nomogram-predicting-pathological-complete-response-to-neoadjuvant-chemoradiotherapy-for-locally-advanced-rectal-cancer-implications-for-organ-preservation-strategies
#14
Yanwu Sun, Pan Chi, Huiming Lin, Xingrong Lu, Ying Huang, Zongbin Xu, Shenghui Huang, Xiaojie Wang
PURPOSE: To determine predictors of pathological complete response (pCR) in locally advanced rectal cancer patients treated with neoadjuvant chemoradiotherapy (nCRT), and develop a predictive nomogram. METHODS: A total of 522 locally advanced rectal cancer patients undergoing nCRT and curative resection between 2008 and 2014 were included. Uni- and multivariate analysis was performed to identify predictors of pCR. A nomogram was developed and validated by internal (n=425) and external validation (n=97)...
June 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28696522/assessment-of-the-imv-diameter-as-a-surrogate-marker-to-evaluate-response-to-neoadjuvant-chemoradiotherapy-for-locally-advanced-rectal-adenocarcinoma
#15
Catalin V Ivan, Joseph H Mullineux, Ratan Verma, Vikas Shah, Anirban De, Mosheir Elabassy, Arumugam Rajesh, James Andrew Stephenson
AIM: Neoadjuvant chemoradiotherapy for locally advanced rectal cancer aims to downstage prior to definitive management. Repeat imaging assessment of the tumour post-therapy has implications for treatment. Our aim is to assess if the Inferior Mesenteric Vein (IMV) diameter measured on CT can be used as a surrogate marker for evaluation of tumour response to neoadjuvant treatment. METHOD: IMV diameter was assessed in patients with and without locally advanced rectal cancer, pre- and post-radiotherapy to ascertain if IMV diameter is a surrogate marker of tumour response...
July 11, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28682967/applicability-of-american-joint-committee-on-cancer-and-college-of-american-pathologists-regression-grading-system-in-rectal-cancer
#16
Tarkan Jäger, Daniel Neureiter, Romana Urbas, Eckhard Klieser, Wolfgang Hitzl, Klaus Emmanuel, Adam Dinnewitzer
BACKGROUND: Different tumor grading systems have been proposed to predict the association between tumor response and clinical outcome after preoperative chemoradiotherapy in patients with rectal cancer. The American Joint Committee on Cancer and College of American Pathologists regression grading system was recommended as the standard tumor regression grading system for rectal adenocarcinoma. OBJECTIVE: This study evaluated the clinical applicability of the American Joint Committee on Cancer and College of American Pathologists regression grading system in neoadjuvant-treated patients with rectal cancer...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28676107/study-protocol-multi-parametric-magnetic-resonance-imaging-for-therapeutic-response-prediction-in-rectal-cancer
#17
Trang Thanh Pham, Gary Liney, Karen Wong, Robba Rai, Mark Lee, Daniel Moses, Christopher Henderson, Michael Lin, Joo-Shik Shin, Michael Bernard Barton
BACKGROUND: Response to neoadjuvant chemoradiotherapy (CRT) of rectal cancer is variable. Accurate imaging for prediction and early assessment of response would enable appropriate stratification of management to reduce treatment morbidity and improve therapeutic outcomes. Use of either diffusion weighted imaging (DWI) or dynamic contrast enhanced (DCE) imaging alone currently lacks sufficient sensitivity and specificity for clinical use to guide individualized treatment in rectal cancer...
July 4, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28675024/are-we-predicting-disease-progress-of-the-rectal-cancer-patients-without-surgery-after-neoadjuvant-chemoradiotherapy
#18
Bo Young Oh, Jung Wook Huh, Woo Yong Lee, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Ho-Kyung Chun
Purpose: There are patients who do not undergo surgery, regardless of tumor response for neoadjuvant chemoradiotherapy (nCRT) in rectal cancer. However, there have been few reports focused on how oncologic outcomes are worse in these patients. We sought to investigate oncologic outcomes for these non-operated patients with rectal cancer after nCRT. Materials and Methods: A total of 1,063 records of patients with rectal cancer who were treated with nCRT from January 2002 to December 2013 were retrospectively reviewed...
July 3, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28643307/-application-of-magnetic-resonance-in-non-operative-treatment-strategy-for-rectal-cancer
#19
Yi Wang, Gong Chen
The primary curative modality for localized rectal cancer is total mesorectal excision (TME). Local control rate of rectal cancer has been improved after neoadjuvant chemoradiotherapy and even pathological complete response (pCR) has been demonstrated in a significant minority. Patients who achieve pCR to neoadjuvant chemoradiotherapy have an excellent prognosis compared with those without pCR. If the patients with complete response to neoadjuvant chemoradiation can be demonstrated by clinical findings and medical imaging (cCR), a non-operative management (NOM) strategy may be pursued to preserve sphincter function and avoid complications induced by TME, which is a new tendency in the treatment of rectal cancer in recent years...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28638791/magnetic-resonance-imaging-for-diagnosis-and-neoadjuvant-treatment-evaluation-in-locally-advanced-rectal-cancer-a-pictorial-review
#20
REVIEW
Gulgun Engin, Rasul Sharifov
High-resolution pelvic magnetic resonance imaging (MRI) is the primary method for staging rectal cancer. MRI is highly accurate in the primary staging of rectal cancer; however, it has not proven to be effective in re-staging, especially in complete response evaluation after neoadjuvant therapy. Neoadjuvant chemoradiotherapy produces many changes in rectal tumors and on adjacent area, as a result, local tumor extent may not be accurately determined. However, adding diffusion-weighted sequences to the standard approach can improve diagnostic accuracy...
June 10, 2017: World Journal of Clinical Oncology
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