PURPOSE The optimal therapeutic sequence of the adjuvant chemotherapy component of preoperative chemoradiotherapy (CRT) for patients with locally advanced rectal cancer is controversial. Induction chemotherapy before preoperative CRT may be associated with better efficacy and compliance. PATIENTS AND METHODS A total of 108 patients with locally advanced rectal cancer were randomly assigned to arm A-preoperative CRT with capecitabine, oxaliplatin, and concurrent radiation followed by surgery and four cycles of postoperative adjuvant capecitabine and oxaliplatin (CAPOX)-or arm B-induction CAPOX followed by CRT and surgery. The primary end point was pathologic complete response rate (pCR). Results On an intention-to-treat basis, the pCR for arms A and B were 13.5% (95% CI, 5.6% to 25.8%) and 14.3% (95% CI, 6.4% to 26.2%), respectively. There were no statistically significant differences in other end points, including downstaging, tumor regression, and R0 resection. Overall, chemotherapy treatment exposure was higher in arm B than in arm A for both oxaliplatin (P < .0001) and capecitabine (P < .0001). During CRT, grades 3 to 4 adverse events were similar in both arms but were significantly higher in arm A during postoperative adjuvant CT than with induction CT in arm B. There were three deaths in each arm during the treatment period. CONCLUSION Compared with postoperative adjuvant CAPOX, induction CAPOX before CRT had similar pCR and complete resection rates. It did achieve more favorable compliance and toxicity profiles. On the basis of these findings, a phase III study to definitively test the induction strategy is warranted.
This preliminary study suggests that TS repetitive-sequence polymorphisms are predictive for tumor downstaging. TR sequences in TS promoter may be useful as a novel means of predicting response to preoperative 5-FU-based chemoradiation.
Tumour regression of grades I or II was a good indicator of DFS in locally advanced rectal cancer, treated by neoadjuvant chemotherapy and radiotherapy. Patients with a high regression grade were associated with a lower incidence of definitive stoma formation. The regression grade was shown to be a better prognostic factor than down-staging.
Introduction: We evaluate the impact of COVID-epidemic in colorectal cancer (CRC) diagnosis during Spain's state of emergency. Methods: We compared newly diagnosed patients with patients diagnosed in the same period of 2019. Results: A new diagnosis of CRC decreased 48% with a higher rate of patients diagnosed in the emergency setting (12.1% vs. 3.6%; p = .048) and a lower rate diagnosed in the screening program (5.2% vs. 33.3%; p = .000). Conclusions: Fewer patients have been diagnosed with CRC, with a higher rate of patients diagnosed in an emergency setting.
The EORTC Quality of Life Study Group has developed a questionnaire for evaluating Quality of Life in international clinical trials: QLQ-C30. The purpose of the present work is to validate the third version of this questionnaire (3.0) for use in Spain. Two hundred and one head and neck cancer patients completed the QLQ-C30 at one or two time points during the treatment and follow-up periods, and a subsample completed the questionnaire on three occasions. Psychometric evaluation of the structure, reliability and validity of the questionnaire was undertaken. The data support the structure and the reliability of the scales. Validity was confirmed in three ways: the interscale correlations are statistically significant and moderate, several scales and items discriminate among groups of patients with different scores on the clinical variables, and some scales reflect significant changes during treatment and the follow-up period. The EORTC QLQ-C30 (version 3.0) is a reliable and valid questionnaire when applied to a sample of Spanish head and neck cancer patients. These results are in line with previous studies.
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