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Neoadjuvant chemoradiotherapy in rectal cancer

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https://www.readbyqxmd.com/read/28440523/-outcome-of-watch-and-wait-strategy-or-organ-preservation-for-rectal-cancer-following-neoadjuvant-chemoradiotherapy-report-of-35-cases-from-a-single-cancer-center
#1
Aiwen Wu, Lin Wang, Changzheng Du, Yifan Peng, Yunfeng Yao, Jun Zhao, Tiancheng Zhan, Yong Cai, Yongheng Li, Yingshi Sun, Jiafu Ji
OBJECTIVE: To investigate the safety and efficacy of organ preservation surgery or "watch and wait" strategy for rectal cancer patients who are evaluated as clinical complete response(cCR) or near-cCR following neoadjuvant chemoradiotherapy (nCRT). METHOD: From March 2011 to June 2016, 35 patients with mid-low rectal cancers who were diagnosed as cCR or near-cCR following nCRT underwent organ preservation surgery with local excision or surveillance following "watch and wait" strategy in the Peking University Cancer Hospital...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28436629/-hypoxia-inducible-factor-1%C3%AE-and-cd133-predicts-pathological-complete-response-and-survival-for-locally-advanced-rectal-cancer-patients-after-neoadjuvant-chemoradiotherapy
#2
Cheng Cai, Jianping Wang, Zhifeng Zhong, Zhihui Dai, Qinghua Wang, Wuzhen Dong, Hongqi Shi, Qingwei Liu, Jinlin DU
Objective: To investigate the expression of hypoxia-inducible factor 1α (HIF-1α) and CD133 in predicting pathologic remission and survival of patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy. Methods: One hundred and fourteen patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy from January 2010 to December 2015 in Jinhua Municipal Central Hospital were enrolled in the study. RT-PCR and immunohistochemistry methods were used to detect the mRNA and protein expression of HIF-1α and CD133 before and after chemoradiotherapy...
January 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28436197/magnetic-resonance-imaging-following-neoadjuvant-chemoradiation-and-transanal-endoscopic-microsurgery-for-rectal-cancer
#3
Guilherme P São Julião, Cinthia Denise Ortega, Bruna Borba Vailati, Angelita Habr-Gama, Laura Melina Fernandez, Joaquim Gama-Rodrigues, Sergio Eduardo Araujo, Rodrigo O Perez
AIM: Full thickness local excision after neoadjuvant chemoradiotherapy (CRT) for patients with rectal cancer and incomplete clinical response has been a treatment strategy for organ preservation. Follow up of these patients is challenging since anatomic distortion and postoperative changes may be clinically indistinguishable from tumor recurrence. Magnetic resonance imaging (MRI) may have a role in detecting recurrence. The aim of this study is to describe the MRI findings during follow-up in patients having local excision following CRT with and without local recurrence...
April 24, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28435398/the-changes-of-tumour-vascular-endothelial-growth-factor-expression-after-neoadjuvant-chemoradiation-in-patients-with-rectal-adenocarcinoma
#4
David Buka, Josef Dvorak, Veronika Sitorova, Igor Sirak, Rene Voboril, Bohuslav Melichar, Igor Richter
AIM OF THE STUDY: The aim was to examine the effects of neoadjuvant chemoradiotherapy on VEGF expression in patients with locally advanced rectal cancer. MATERIALS AND METHODS: A total of 53 patients with locally advanced rectal cancer were retrospectively studied. Neoadjuvant treatment comprised external beam radiation (50.4 Gy/28 fractions) with continuous infusion of 5-fluorouracil. Four to 6 weeks after the chemoradiotherapy, the patients underwent surgical resection...
2017: Contemporary Oncology Współczesna Onkologia
https://www.readbyqxmd.com/read/28434582/effectiveness-between-early-and-late-temporary-ileostomy-closure-in-patients-with-rectal-cancer-a-prospective-study
#5
Li Zhen, Yanan Wang, Ze Zhang, Tongwei Wu, Ruoyan Liu, Tingting Li, Liying Zhao, Haijun Deng, Xiaolong Qi, Guoxin Li
A temporary stoma is often used in rectal cancer surgery to protect a distal anastomosis, which remains a major concern after rectal cancer surgery, particularly after low anterior resection. The temporary stoma is scheduled for closure. However, the optimal time of closure of the protecting stoma remains unclear because of sparse studies and data. We aimed to detect the efficacy between early and late temporary ileostomy closure in patients with rectal cancer during or after neoadjuvant chemoradiotherapy. We conducted a prospective, 2-group design between early and late ileostomy closure group in patients after rectal cancer surgery with temporary stoma...
March 2, 2017: Current Problems in Cancer
https://www.readbyqxmd.com/read/28423720/meta-analysis-of-oxaliplatin-based-versus-fluorouracil-based-neoadjuvant-chemoradiotherapy-and-adjuvant-chemotherapy-for-locally-advanced-rectal-cancer
#6
Xing-Li Fu, Zheng Fang, Liang-Hui Shu, Guo-Qing Tao, Jian-Qiang Wang, Zhi-Lian Rui, Yong-Jie Zhang, Zhi-Qiang Tian
A meta-analysis was conducted to compare oxaliplatin-based with fluorouracil-based neoadjuvant chemoradiotherapy and adjuvant chemotherapy for locally advanced rectal cancer. MEDLINE, EMBASE and CENTRAL were systematically searched for relevant randomized controlled trials (RCTs) until January 31 2017. Review Manager (version 5.3) was used to analyze the data. Dichotomous data were calculated by odds ratio (OR) with 95% confidence intervals (CI). A total of 8 RCTs with 6103 stage II or III rectal cancer patients were analyzed, including 2887 patients with oxaliplatin+fluorouracil regimen and 3216 patients with fluorouracil alone regimen...
March 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28423701/identification-of-protein-clusters-predictive-of-tumor-response-in-rectal-cancer-patients-receiving-neoadjuvant-chemo-radiotherapy
#7
Ombretta Repetto, Valli De Re, Antonino De Paoli, Claudio Belluco, Lara Alessandrini, Vincenzo Canzonieri, Renato Cannizzaro
Preoperative neoadjuvant chemoradiotherapy (nCRT) is the gold standard in locally advanced rectal cancer, only 10-30% of patients achieving benefits. Currently, there is a need of a reliable selection of markers for the identification of poor or non-responders prior to therapy. In this work, we compared protein profiles before therapy of patients differing in their responses to nCRT to find novel predictive markers of response to therapy. Patients were grouped into 3 groups according to their tumor regression grading (TRG) after surgery: 'TRG 1-2', good responders, 'TRG 3' and 'TRG 4', poor responders...
March 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28422744/serum-mir-143-levels-predict-the-pathological-response-to-neoadjuvant-chemoradiotherapy-in-patients-with-locally-advanced-rectal-cancer
#8
Yukiharu Hiyoshi, Takashi Akiyoshi, Ramu Inoue, Keiko Murofushi, Noriko Yamamoto, Yosuke Fukunaga, Masashi Ueno, Hideo Baba, Seiichi Mori, Toshiharu Yamaguchi
Recently, several circulating miRNAs have been reported as promising, minimally invasive biomarkers for the diagnosis or prediction of the prognosis in various types of cancer. However, the utility of circulating miRNAs as predictive markers of the cancer response to neoadjuvant chemoradiotherapy (nCRT) for locally advanced rectal cancer is still unclear. To identify circulating serum miRNAs useful for predicting a pathological good response to nCRT, total 18 serum miRNAs of interest were analyzed by real-time polymerase chain reaction in 94 rectal cancer patients treated with nCRT and surgery...
March 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/28411888/neoadjuvant-therapy-and-transanal-endoscopic-surgery-in-t2-t3-superficial-n0-m0-rectal-tumors-local-recurrence-complete-clinical-and-pathological-response
#9
Xavier Serra-Aracil, Carlos Pericay, Laura Mora-Lopez, Juan Carlos Garcia Pacheco, José Isaac Latorraca, Julio Ocaña-Rojas, Alex Casalots, Eva Ballesteros, Salvador Navarro-Soto
INTRODUCTION: The association of preoperative chemoradiotherapy and transanal endoscopic surgery in T2 and superficial T3 rectal cancers presents promising results in selected patients. The main objective is to evaluate the long-term loco-regional and systemic recurrence and, as secondary objectives, to provide results of postoperative morbidity and the correlation between complete clinical and pathological response. METHODS: This is a retrospective observational study including a consecutive series of patients with T2-T3 superficial rectal cancer, N0, M0 who refused radical surgery (2008-2016)...
April 12, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28399874/early-closure-of-defunctioning-stoma-increases-complications-related-to-stoma-closure-after-concurrent-chemoradiotherapy-and-low-anterior-resection-in-patients-with-rectal-cancer
#10
Tzu-Chieh Yin, Hsiang-Lin Tsai, Ping-Fu Yang, Wei-Chih Su, Cheng-Jen Ma, Ching-Wen Huang, Ming-Yii Huang, Chun-Ming Huang, Jaw-Yuan Wang
BACKGROUND: After a low anterior resection, creating a defunctioning stoma is vital for securing the anastomosis in low-lying rectal cancer patients receiving concurrent chemoradiotherapy. Although it decreases the complication and reoperation rates associated with anastomotic leakage, the complications that arise before and after stoma closure should be carefully evaluated and managed. METHODS: This study enrolled 95 rectal cancer patients who received neoadjuvant concurrent chemoradiotherapy and low anterior resection with anastomosis of the bowel between July 2010 and November 2012...
April 11, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28386648/patterns-of-recurrence-in-patients-achieving-pathologic-complete-response-after-neoadjuvant-chemoradiotherapy-for-rectal-cancer
#11
Wen-Hua Fan, Jian Xiao, Xin An, Wu Jiang, Li-Ren Li, Yuan-Hong Gao, Gong Chen, Ling-Heng Kong, Jun-Zhong Lin, Jian-Ping Wang, Zhi-Zhong Pan, Pei-Rong Ding
PURPOSE: The aim of this study was to characterize the patterns of recurrence in patients achieving pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer. METHODS: Patients with locally advanced rectal cancer treated with neoadjuvant CRT and who achieved pCR from January 2004 to December 2012 were collected. The primary outcome measurement was the patterns of recurrence. RESULTS: Among 195 patients who achieved pCR, 18 developed recurrence...
April 6, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28378317/risk-factor-analysis-for-newly-developed-urogenital-dysfunction-after-total-mesorectal-excision-and-impact-of-pelvic-intraoperative-neuromonitoring-a-prospective-2-year-follow-up-study
#12
Daniel W Kauff, Hauke Lang, Werner Kneist
AIM: Urogenital dysfunction is a common sequela following total mesorectal excision for rectal cancer. This prospective study analyzed potential risk factors and investigated the impact of pelvic intraoperative neuromonitoring. METHOD: Included were 85 patients undergoing total mesorectal excision for rectal cancer, 43 under the control of pelvic intraoperative neuromonitoring. Urogenital function was assessed with validated questionnaires within a 2-year follow-up period...
April 4, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28370249/possible-role-of-nuclear-%C3%AE-catenin-in-resistance-to-preoperative-chemoradiotherapy-in-locally-advanced-rectal-cancer
#13
Hiroyuki Takahashi, Kie Nakamura, Akane Usami, Tomoko Tsuruta, Miki Hashimura, Toshihide Matsumoto, Makoto Saegusa
AIMS: β-catenin signaling participates in regulation of epithelial-mesenchymal transition (EMT)/cancer stem cell (CSC) properties. We focused on the role of β-catenin in resistance to neoadjuvant chemoradiotherapy in patients with rectal cancer especially pertaining to its association with EMT/CSC features. METHODS AND RESULTS: A total of 109 cases of locally advanced rectal cancer, along with a colon cancer cell line, were investigated. Nuclear β-catenin accumulation in pretreatment biopsied samples was inversely associated with therapeutic efficacy for chemoradiotherapy in resected rectal cancer...
March 28, 2017: Histopathology
https://www.readbyqxmd.com/read/28363512/diffusion-weighted-magnetic-resonance-imaging-in-locally-advanced-rectal-cancer-treated-with-neoadjuvant-chemoradiotherapy
#14
F De Felice, A L Magnante, D Musio, M Ciolina, C N De Cecco, M Rengo, A Laghi, V Tombolini
PURPOSE: To analyze diffusion-weighted magnetic resonance imaging (DW-MRI) for treatment response assessment in locally advanced rectal cancer (LARC). PATIENTS AND METHODS: Patients with histologically proven rectal adenocarcinoma, stage II-III disease, were enrolled and underwent surgery following neoadjuvant chemoradiotherapy (nCRT). All patients were referred for a DW-MRI protocol on a 3 Tesla MR-system, consisting of axial T2-weighted and DWI sequences prior (I), during (II) and after (III) nCRT...
March 23, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28351524/g9a-governs-colon-cancer-stem-cell-phenotype-and-chemoradioresistance-through-pp2a-rpa-axis-mediated-dna-damage-response
#15
Chi-Wen Luo, Jaw-Yuan Wang, Wen-Chun Hung, Guang Peng, Ya-Li Tsai, Tsung-Ming Chang, Chee-Yin Chai, Chih-Hung Lin, Mei-Ren Pan
BACKGROUND AND PURPOSE: Neoadjuvant concurrent chemoradiotherapy (CCRT) is a standard treatment of locally advanced colon cancer cell (CRC). In order to maximize efficacy and minimize toxicity, new drugs have been developed and used in combination with CCRT. Recently, it has been shown that G9a plays a role in mediating phenotypes of cancer stem cells (CSCs). This study aimed to characterize G9a as a biomarker in predicting therapy response to prevent overtreatment and adverse effects in CRC patients...
March 25, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28338156/-pay-attention-to-the-selective-lateral-pelvic-lymph-node-dissection-in-mid-low-rectal-cancer
#16
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
#17
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
#18
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
#19
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
#20
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]
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