Chemoradiotherapy alone or chemoradiotherapy followed by surgery in rectal cancer

SummaryIn locally advanced rectal cancer, neoadjuvant chemoradiotherapy provides a  significant benefit to local cancer control in addition to total mesorectal excision. However, in 10–40% of all patients, a complete clinical remission can be detected after completion of chemoradiotherapy. Recent studies have shown that those patients omitting radical surgery after successful neoadjuvant pretreatment can be safely managed within a close follow-up network without compromising short-term overall and disease-free survival. However, available data suggest that 20–30% of all patients assigned to a watch and wait regimen will eventually have to be transferred to surgical m anagement due to local recurrence. Careful patient selection is key for a successful watch and wait approach and the choice of non-operative management should not be made after completion of staging but rather after neoadjuvant chemoradiotherapy. Selected patients need to be thoroughly informed tha t there is still no standardized follow-up protocol and no predefined follow-up period.
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research

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This article will make a further study on this point. Methods: We collected perioperative clinical data from 382 patients with rectal cancer who underwent surgery from September 2015 to May 2017. After 1 month of follow-up, relevant risk factor data were collected and analyzed. Results: Data analysis showed that the incidence of AL was 14.65%. In single factor analysis, patients with high score of NRS-2002, high score of PG-SGA, diabetes, perioperative blood transfusion, postoperative diarrhea, later tumor stage, high score of ASA, low postoperative albumin, and rectal cancer patients with tumor close to the anus...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Discussion: This is the first prospective clinical controlled trial to assess postoperative QoL and efficacy for LRC patients after favorable long-course nCRT. The result is expected to provide new evidence for a more detailed individualized treatment guideline for LRC. Trial registration: This trial was registered at Chinese Clinical Trial Registry (ChiCTR1800017512; ChiCTR.org) on August 2, 2018.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
Conclusion: We suggest a new feasible treatment strategy for the management of synchronous colorectal and prostate cancers.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Authors: Huang Y, Gu X, Ge K, Fu G, Chu J, Wei W Abstract Neoadjuvant chemoradiotherapy has been established as the standard treatment for patients with locally advanced rectal cancer. However, the role of radiotherapy (RT) has not been fully confirmed in advanced colon cancer (LACC). We postulated that patients with pathological T4N2 locally advanced colon cancer would benefit more from RT. 6715 pT4N2M0 colon cancer patients were included in the Surveillance, Epidemiology, and End Results (SEER) database. The primary endpoints were 5-year overall survival (OS) and cancer-specific survival (CSS). Propensity score m...
Source: Artificial Cells, Nanomedicine and Biotechnology - Category: Biotechnology Tags: Artif Cells Nanomed Biotechnol Source Type: research
ew D. Beggs Radiotherapy is routinely used as a neoadjuvant, adjuvant or palliative treatment in various cancers. There is significant variation in clinical response to radiotherapy with or without traditional chemotherapy. Patients with a good response to radiotherapy demonstrate better clinical outcomes universally across different cancers. The PI3K/AKT/mTOR pathway upregulation has been linked to radiotherapy resistance. We reviewed the current literature exploring the role of inhibiting targets along this pathway, in enhancing radiotherapy response. We identified several studies using in vitro cancer cell lines, in...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
Authors: Huang CM, Huang CW, Ma CJ, Yeh YS, Su WC, Chang TK, Tsai HL, Juo SH, Huang MY, Wang JY Abstract We aimed to identify predictors of a pathological complete response (pCR) in patients with locally advanced rectal cancer (LARC) following a multimodality therapy. We retrospectively reviewed 236 patients with LARC treated with neoadjuvant chemoradiotherapy (CRT) followed by radical resection from January 2011 to December 2017. Patients were administered CRT, which comprised radiotherapy and chemotherapy with an oxaliplatin plus 5-fluorouracil- or fluoropyrimidine-based regimen. Clinical factors were correlated ...
Source: Journal of Oncology - Category: Cancer & Oncology Tags: J Oncol Source Type: research
ConclusionThe addition of EGFR inhibitors in the nCRT for KRAS-wild type LARC patients provides comparable efficacy and acceptable safety. However, the results should be interpreted cautiously due to the small amount of relevant data and need further confirmation by more future studies.
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Publication date: Available online 29 April 2020Source: European Journal of Surgical OncologyAuthor(s): Laura Lorenzon, Karol Polom
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
ConclusionsMRI T2-weighted sequences-based TA was not effective in predicting pathological complete response to nCRT in patients with LARC. Further studies are needed to thoroughly investigate the potential of MRI TA in this setting.
Source: La Radiologia Medica - Category: Radiology Source Type: research
Abstract BACKGROUND/AIM: A great proportion of patients with rectal cancer initially present with locally advanced disease and can potentially benefit from neoadjuvant concurrent chemoradiotherapy (CCRT) for downstaging before surgery. However, risk and clinical outcome stratification remain a great challenge. We aimed to find the potential biomarker to predict the effect of neoadjuvant CCRT on rectal cancer. METHODS: We identified epiregulin (EREG) as the most significant predictive marker for neoadjuvant CCRT response from the published rectal cancer transcriptome data set GSE35452. We collected 172 biopsy ...
Source: Oncology - Category: Cancer & Oncology Authors: Tags: Oncology Source Type: research
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