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Neoadjuvant chemoradiotherapy in rectal cancer

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https://www.readbyqxmd.com/read/29682714/-factors-associated-with-anastomotic-leakage-after-anterior-resection-in-rectal-cancer
#1
Kai Deng, Jianli Zhang, Xiuli Jiang, Shuai Feng
OBJECTIVE: To investigate the factors associated with the anastomotic leakage after anterior resection in rectal cancer. METHODS: From January 2014 to January 2017 471 patients underwent Dixon procedure for rectal cancer in The Affiliated Hospital of Qingdao University. The data of those patients was collected and reviewed retrospectively. Inclusion criteria included: 1) rectal cancer confirmed by preoperative electron colonoscopy; 2) the standard of total mesorectal excision followed by the surgeon during the surgery; and 3) elective surgery...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682712/-incidence-and-risk-factors-for-anastomotic-leakage-after-anterior-resection-for-rectal-cancer
#2
Jun Li, Yongbo An, Guocong Wu, Xiaomu Zhao, Yingchi Yang, Jin Wang, Lan Jin, Hongwei Wu, Na Zeng, Fuxiao Xie, Jie Dong, Anlong Yuan, Wuqing Sun, Ruiqing Zhou, Hongwei Yao, Zhongtao Zhang
OBJECTIVE: To assess the incidence and independent risk factors for clinical anastomotic leakage (AL) in patients undergoing anterior resection(AR) or low anterior resection, (LAR) for rectal cancer. METHODS: This was a retrospective case-control study of 550 patients with rectal cancer who underwent AR or LAR from April 2007 to March 2017 in Beijing Friendship Hospital, Capital Medical University. The relationship between the incidence of AL and clinicopathological manifestations was analyzed by Chi-squared test and Fisher exact test, and the independent risk factors of AL were analyzed using logistic regression analysis...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682709/-prevention-of-anastomotic-leakage-after-robotic-surgery-for-rectal-cancer
#3
Xiaohui Du, Xiaowei Xing
With popularity of robotic surgery system, robotic rectal cancer surgery is increasing. Precautionary measures of different perioperative periods should be taken to reduce the risk for anastomotic leakage. First, the general condition of patients should be acquainted and improved, and the risk for anastomotic leakage should be evaluated preoperatively. Preoperative neoadjuvant chemoradiotherapy may not increase the risk for anastomotic leakage after rectal surgery. The impact of routine bowel preparation to prevent anastomotic leakage needs to be verified further...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29681787/the-response-to-neoadjuvant-chemoradiotherapy-with-5-fluorouracil-in-locally-advanced-rectal-cancer-patients-a-predictive-proteomic-signature
#4
Anaïs Chauvin, Chang-Shu Wang, Sameh Geha, Perrine Garde-Granger, Alex-Ane Mathieu, Vincent Lacasse, François-Michel Boisvert
Background: Colorectal cancer is the third most common and the fourth most lethal cancer in the world. In the majority of cases, patients are diagnosed at an advanced stage or even metastatic, thus explaining the high mortality. The standard treatment for patients with locally advanced non-metastatic rectal cancer is neoadjuvant radio-chemotherapy (NRCT) with 5-fluorouracil (5-FU) followed by surgery, but the resistance rate to this treatment remains high with approximately 30% of non-responders...
2018: Clinical Proteomics
https://www.readbyqxmd.com/read/29663417/technical-note-a-deep-learning-based-auto-segmentation-of-rectal-tumors-in-mr-images
#5
Jiazhou Wang, Jiayu Lu, Gan Qin, Lijun Shen, Yiqun Sun, Hongmei Ying, Zhen Zhang, Weigang Hu
PURPOSE: Manual contouring of gross tumor volumes (GTV) is a crucial and time-consuming process in rectum cancer radiotherapy. This study aims to develop a simple deep learning based auto segmentation algorithm to segment rectal tumors on T2 weighted MR images. MATERIAL AND METHODS: MRI scans (3T, T2-weighted) of 93 patients with locally advanced (cT3-4 and/or cN1-2) rectal cancer treated with neoadjuvant chemoradiotherapy followed by surgery were enrolled in this study...
April 16, 2018: Medical Physics
https://www.readbyqxmd.com/read/29661620/tolerability-safety-and-outcomes-of-neoadjuvant-chemoradiotherapy-with-capecitabine-for-patients-aged-%C3%A2-70-years-with-locally-advanced-rectal-cancer
#6
Lotte Jacobs, Ellen van der Vlies, Daan Ten Bokkel Huinink, Haiko Bloemendal, Martijn Intven, Anke B Smits, Bas L A M Weusten, Peter D Siersema, Niels van Lelyveld, Maartje Los
INTRODUCTION: In studies of colorectal cancer, the elderly have been frequently underrepresented because comorbid conditions and functional status often lead to study exclusion. For elderly patients with an indication for neoadjuvant chemoradiotherapy (nCRT), physicians usually decide using clinical factors whether nCRT should be offered. The aim of the present retrospective study was to assess the tolerability of nCRT with capecitabine and the surgical outcomes in patients aged ≥ 70 years with locally advanced rectal cancer...
March 8, 2018: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29594111/waiting-time-following-neoadjuvant-chemoradiotherapy-for-rectal-cancer-does-it-really-matter
#7
Aris Plastiras, Michail Sideris, Andy Gaya, Amyn Haji, Joseph Nunoo-Mensah, Asif Haq, Savvas Papagrigoriadis
Background: Neoadjuvant chemoradiotherapy (CRT) is considered the standard approach before any surgical intervention for locally advanced rectal tumors and has been proven to significantly improve the local recurrence rates of rectal cancer. However, the optimal timing of surgical resection after neoadjuvant CRT remains debatable. Objective and Methods: We conducted a retrospective review of 65 consecutive patients with locally advanced rectal cancer who underwent preoperative CRT followed by surgical resection in order to evaluate the optimal time for surgical treatment...
February 2018: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/29593430/prospective-study-of-neoadjuvant-chemoradiotherapy-using-intensity-modulated-radiotherapy-and-5-fluorouracil-for-locally-advanced-rectal-cancer-toxicities-and-response-assessment
#8
David K Simson, Swarupa Mitra, Parveen Ahlawat, Upasna Saxena, Manoj Kumar Sharma, Sheh Rawat, Harpreet Singh, Babita Bansal, Lalitha Kameshwari Sripathi, Aditi Tanwar
Aims and objectives: The past 2 decades witnessed the strengthening of evidence favoring the role of neoadjuvant chemoradiation (CHRT) in the treatment of locally advanced rectal cancer. The study aims to evaluate the response and acute toxicities to neoadjuvant CHRT using intensity-modulated radiotherapy (IMRT) in the treatment of rectal cancer. Predictive factors to achieve pathological complete response (pCR) were analyzed, as a secondary endpoint. Materials and methods: All consecutive patients who underwent IMRT as part of neoadjuvant CHRT in the treatment of rectal cancer between August 2014 and December 2016 at a tertiary cancer care center were accrued for the study...
2018: Cancer Management and Research
https://www.readbyqxmd.com/read/29587797/comparison-of-efficacy-and-safety-of-preoperative-chemoradiotherapy-in-locally-advanced-upper-and-middle-lower-rectal-cancer
#9
Ming-Yii Huang, Hsin-Hua Lee, Hsiang-Lin Tsai, Ching-Wen Huang, Yung-Sung Yeh, Cheng-Jen Ma, Chun-Ming Huang, Chiao-Yun Chen, Joh-Jong Huang, Jaw-Yuan Wang
BACKGROUND: We aimed to explore the efficacy and safety profile of preoperative neoadjuvant chemoradiation (NACRT) in locally advanced rectal cancer (LARC) in upper rectum versus middle/lower rectum. METHODS: The study included 173 patients with stage II or III (T2-4b, N0-2b) LARC who underwent NACRT followed by total mesorectal excision (TME) between January 2011 and October 2016. Cox regression, log-rank test, and Kaplan-Meier curves were calculated. RESULTS: Among the 173 patients, 58 had lesions in the upper rectum and 115 patients had lesions in middle/lower rectum...
March 27, 2018: Radiation Oncology
https://www.readbyqxmd.com/read/29578178/comparison-of-short-course-with-long-course-preoperative-neoadjuvant-therapy-for-rectal-cancer-a-meta-analysis
#10
Ke Chen, Guoming Xie, Qi Zhang, Yanping Shen, Taoqi Zhou
Aim: This study attempted to compare the prognostic performance of short- and long-course preoperative treatments for neoadjuvant therapy of rectal cancer by meta-analysis. Methods: Electronic databases of PubMed and Embase were searched for eligible studies updated to February 29, 2016. Studies were included based on several predefined inclusion criteria. Quality assessment was carried out according to the Cochrane Collaboration recommendations in Cochrane handbook...
2018: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/29552288/mri-texture-analysis-in-predicting-treatment-response-to-neoadjuvant-chemoradiotherapy-in-rectal-cancer
#11
Yankai Meng, Chongda Zhang, Shuangmei Zou, Xinming Zhao, Kai Xu, Hongmei Zhang, Chunwu Zhou
To evaluate the importance of MRI texture analysis in prediction and early assessment of treatment response before and early neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC). This retrospective study comprised of 59 patients. The tumoral texture parameters were compared between pre- and early nCRT. Area Under receiver operating characteristic (ROC) Curves [AUCs] were used to compare the diagnostic performance of statistically significant difference parameters and logistic regression analysis predicted probabilities for discriminating responders and nonresponders...
February 23, 2018: Oncotarget
https://www.readbyqxmd.com/read/29545727/contemporary-management-of-locally-advanced-rectal-cancer-resolving-issues-controversies-and-shifting-paradigms
#12
Aeris Jane D Nacion, Youn Young Park, Nam Kyu Kim
Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the efficacy of conventional chemoradiotherapy (CRT) followed by total mesorectal excision (TME) reaches a plateau, the need for alternative strategies in locally advanced rectal cancer (LARC) has grown in relevance. Several novel strategies have been conceptualized to address this issue, including: 1) neoadjuvant induction and consolidation chemotherapy before CRT; 2) neoadjuvant chemotherapy alone to avoid the sequelae of radiation; and 3) nonoperative management for patients who achieved pathological or clinical complete response after CRT...
February 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/29545442/unusual-case-of-a-rectal-tumour
#13
Maryam Alfa-Wali, Samantha Muktar, Dimitrios Pissas, Ceri Slater
A 48-year-old man presented as an emergency with a 3-week history of rectal bleeding. Examination of his rectum revealed a circumferential tumour, 2 cm from the anal verge. An MRI scan reported a locally infiltrative mid-lower rectal tumour staged as T3d/T4 N2 MX. A colonoscopy revealed appearances of severe proctitis and biopsies did not show any evidence of dysplasia or malignancy. The patient was discussed at the regional colorectal cancer multidisciplinary team meeting with a management plan for neoadjuvant chemoradiotherapy following repeat biopsies, which were again negative for malignancy...
March 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29518574/proteomic-profiling-of-rectal-cancer-reveals-acid-ceramidase-is-implicated-in-radiation-response
#14
D L Bowden, P A Sutton, M A Wall, P V Jithesh, R E Jenkins, D H Palmer, C E Goldring, J L Parsons, B K Park, N R Kitteringham, D Vimalachandran
BACKGROUND: Neoadjuvant chemoradiotherapy (CRT) is used in locally advanced rectal cancer when tumours threaten the circumferential resection margin, with varying response to treatment. This experimental study aimed to identify significantly differentially expressed proteins between patients responding and not responding to CRT, and to validate any proteins of interest. METHODS: Mass spectrometry (with isobaric tagging for relative quantification) analysis of rectal cancers pre- and post-CRT, and at resection...
March 5, 2018: Journal of Proteomics
https://www.readbyqxmd.com/read/29502372/-evaluation-of-progression-free-survival-for-locally-advanced-rectal-cancer-by-mri-after-neoadjuvant-chemoradiotherapy-and-total-mesorectal-excision
#15
J X Zhang, Z Yang, P Fan, J J Zhang, L Xin, L N Hou, X S Du, X T Yang
Objective: To evaluate the predictive value of MRI features and pathological parameters on local recurrence, metastasis and progression free survival (PFS) for locally advanced rectal cancer after neoadjuvant chemoradiotherapy and subsequent total mesorectal excision surgery. Methods: A retrospective analysis of 95 patients with locally advanced rectal adenocarcinoma who underwent total mesorectal excision after neoadjuvant chemoradiotherapy was performed. Univariate and multivariate analyses were performed to evaluate the predictive value of MRI features before chemoradiation and postoperative pathological parameters on progression free survival...
February 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/29471616/non-operative-management-of-rectal-cancer-future-perspectives-turning-into-reality
#16
Nicolò DE Manzini, Gabriele Bellio, Pio Corleone, Marina Troian
The management of rectal cancer has considerably changed over the last decades and complete response to neoadjuvant chemoradiotherapy is becoming a common clinical entity. There is still no consensus on the definition of complete response to neoadjuvant treatment prior to surgery. Treatment programs are mostly heterogeneous and non-randomized. In addition, techniques to diagnose complete response are still unclear and there is no uniformity in surveillance modality of those patients managed without operative intervention...
February 21, 2018: Minerva Chirurgica
https://www.readbyqxmd.com/read/29464828/the-significance-of-tumor-infiltrating-lymphocytes-before-and-after-neoadjuvant-therapy-for-rectal-cancer
#17
Shinji Matsutani, Masatsune Shibutani, Kiyoshi Maeda, Hisashi Nagahara, Tatsunari Fukuoka, Shigetomi Nakao, Kosei Hirakawa, Masaichi Ohira
Recently, neoadjuvant therapy for locally advanced rectal cancer has been generally performed. However, biomarkers predicting the response to neoadjuvant therapy have not been established. Tumor-infiltrating lymphocytes (TILs) have a crucial effect on tumor progression and the survival outcome as the primary host immune response, and an antitumor immune effect has been reported to contribute to the response to radiotherapy and chemotherapy. We investigated the significance of TILs before and after neoadjuvant treatment and the change in the density of those TILs...
February 21, 2018: Cancer Science
https://www.readbyqxmd.com/read/29449673/the-predictive-and-prognostic-potential-of-plasma-telomerase-reverse-transcriptase-tert-rna-in-rectal-cancer-patients
#18
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
#19
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
#20
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
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