Functional Imaging Predictors of Response to Chemoradiation

AbstractPurpose of ReviewEarly prediction of response to chemoradiotherapy in locally advanced rectal cancer has the potential to minimize surgical intervention in patients with complete response, while allowing non-responding patients to explore more aggressive treatments. Functional imaging detection of tumoral microstructural and metabolic changes presents a valuable tool for preoperative chemoradiation response assessment.Recent FindingsDiffusion-weighted MRI has increasingly been incorporated into study protocols, with the apparent diffusion coefficient largely found to be the most robust global predictor of neoadjuvant therapy response. However, no definitive predictive biomarkers have been identified, with inconsistent results across all imaging modalities.SummaryWe evaluated the pros and cons of PET/CT imaging; perfusion imaging; and diffusion-weighted, dynamic contrast-enhanced, multiparametric, and low-field functional MRI in the early prediction of response to chemoradiotherapy. Future directions of study include combinatorial imaging with both MRI and PET/CT modalities and further investigation of on-board low-field MRI imaging during radiotherapy treatment delivery.
Source: Current Colorectal Cancer Reports - Category: Cancer & Oncology Source Type: research

Related Links:

ConclusionCRT should be considered for cT3N0 patients, but its timing (neoadjuvant vs. adjuvant) seems not to affect the disease-free survival in the present cohort of patients.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
Authors: Son GM, Kye BH, Kim MK, Kim JG Abstract The oncological outcomes of laparoscopic rectal cancer surgery were evaluated in recent multicenter randomized clinical trials (RCTs). The MRC-CLASSIC, COLOR II, and COREAN trials found no differences in local recurrence or diseasefree survival rate between laparoscopic and open surgery. However, the noninferiority of laparoscopic surgery with respect to open surgery for rectal cancer was not established on statistical analysis in the ACOSOG Z6051 and the ALaCaRT trials. Quality of total mesorectal excision (TME) is one of the most important prognostic factors. Incom...
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
No abstract available
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Viewpoints Source Type: research
This study was conducted in a tertiary referral center. PATIENTS: All consecutive patients undergoing redo pelvic surgery after low anterior resection for rectal cancer between January 2005 and March 2018 were included. INTERVENTIONS: Redo surgery was divided into redo anastomosis and intersphincteric completion proctectomy. Transanal minimally invasive surgery procedures since November 2014 were compared with the conventional approach. MAIN OUTCOME MEASURES: Primary end points were procedural characteristics and 90-day major complications. RESULTS: In total, 104 patients underwent redo surgery; 47 received a r...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
BACKGROUND: Reconstruction of the pelvic floor defect caused by extralevator abdominoperineal excision poses a challenge for the surgeon. OBJECTIVE: The aim of this study was to analyze the long-term perineal wound complications in patients undergoing conventional primary closure versus biological mesh–assisted repair after extralevator abdominoperineal excision. DESIGN: This was a single-institution retrospective observational study. SETTINGS: The study was conducted at a tertiary academic medical center. PATIENTS: Patients with low advanced rectal cancer undergoing extralevator abdominoperineal excisi...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
No abstract available
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Video Vignette Source Type: research
This study aimed to compare the performance of two lymph node revealing solutions.MethodsThis randomized clinical trial (NTC02704988) investigated patients with colon or rectal cancer who underwent surgical resection with D2 lymphadenectomy. Specimens submitted for conventional pathological examination were randomly assigned for additional fixation with Carnoy or GEWF solution, and dissection was performed to examine the missed lymph nodes. The number of lymph nodes retrieved, additional identified metastatic lymph nodes, lymph node upstaging, and complementary indication of adjuvant therapy were investigated.ResultsThe nu...
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
ConclusionsOne-fifth of patients with locally advanced rectal cancer are manageable with a rectum-sparing approach after neoadjuvant therapy. With this strategy, about 80% patients will have their rectum preserved and 90% will be without stoma at long term.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
ConclusionsMale gender, diffuse peritonitis, positive lymph nodes, type of surgeon and postoperative anastomotic dehiscence significantly influence recurrence of  colorectal cancer in this series.
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
ConclusionsAn 11-point modified frailty index as measured in NSQIP correlates with readmissions after colorectal resection in patients with colon and rectal cancer.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
More News: Cancer | Cancer & Oncology | Colorectal Cancer | Neoadjuvant Chemotherapy Therapy | Neoadjuvant Therapy | Perfusion | Rectal Cancers | Study