Adjuvant treatment of colorectal cancer (current expert opinion derived from the Third International Conference: Perspectives in Colorectal Cancer, Dublin, 2001)

Cutsem, Éric Van; Dicato, M; Wils, J.; Cunningham, David; Díaz-Rubio, Eduardo; Glimelius, Bengt; Haller, Daniel G.; Johnston, Patrick G.; Kerr, David; Koehne, Claus-Henning; Labianca, Roberto; Minsky, Bruce D.; Nordlinger, Bernard; Roth, Arnaud; Rougier, P; Schmoll, Hans Joachim

doi:10.1016/s0959-8049(02)00122-3

Cited by 53 publications

(29 citation statements)

References 40 publications

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“…The 1990 NIH consensus recommends postoperative radiotherapy combined with chemotherapy for patients with UICC stage II and III rectal cancer (NIH consensus conference, 1990). A more recent expert opinion again recommends radiotherapy to be used as an adjunct to surgery preoperatively (short term or long term) or postoperatively (van Cutsem et al, 2002). Local failure was reduced in the postoperative radiotherapy arm of the NSABP protocol R-02 (8 vs 13% at 5 years), although survival was not affected by radiotherapy (Wolmark et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Preoperative short-term radiation therapy (25 Gy, 2.5 Gy twice daily) for primary resectable rectal cancer (phase II)

et al. 2005

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To evaluate the feasibility, effectiveness, and long-term bowel function of preoperative hyperfractionated accelerated radiotherapy in primary resectable rectal cancer. A total of 184 consecutive patients (median age 65 years, male : female ¼ 2 : 1) with clinical T3Nx rectal adenocarcinoma received preoperative pelvic radiation therapy with single fractions of 2.5 Gy twice daily (interval 6 h between fractions) to a total dose of 25 Gy within 1 week. Surgery was conducted the following week. Postoperative histology revealed UICC stage I in 33%, stage II in 26%, stage III in 34%, and stage IV in 7% of the patients. Median follow-up was 43 months (53 months for surviving patients). The actuarial 4-year-local-recurrence rate was 2.1%, overall recurrence 23%. Disease-specific and disease-free survivals at 4 years (excluding stage IV) were 82 and 69%, respectively. Overall survival for 4 years was 68%. Postoperative mortality was 0.5% (one patient), early anastomotic leakage occurred in 11.4%, and anastomotic stenosis requiring treatment in 6%, of 132 patients with primary anastomosis. Seven of 184 patients (3.8%) died of abdominal complications, all within the first year. Bowel function was satisfactory after more than 5 years. Local control in primarily resectable rectal cancer after 10 Â 2.5 Gy is excellent, warranting further evaluation of this treatment.

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Section: Discussionmentioning

confidence: 99%

Preoperative short-term radiation therapy (25 Gy, 2.5 Gy twice daily) for primary resectable rectal cancer (phase II)

et al. 2005

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“…In patients with locally advanced rectal cancer, curative treatment often includes multimodality treatment with radiotherapy and chemotherapy in addition to surgery. Preoperative radiotherapy of nonresectable primary tumours or recurrent tumours may reduce the tumour size and eradicate microscopic disease, thereby increasing the possibility of radical surgery and survival (Van Cutsem et al, 2002). If curative surgery is not possible, radiotherapy may offer good palliation.…”

Section: Introductionmentioning

confidence: 99%

Dietary intake and nutritional indicators are transiently compromised during radiotherapy for rectal cancer

et al. 2005

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Objective: Patients with rectal cancer receive curative radiotherapy towards the pelvis for 5 weeks. Little is known about the impact of radiotherapy on dietary intake and nutritional status. The objective was to examine whether curative radiotherapy for rectal cancer promoted altered intake of energy and nutrients, and change in nutritional indicators. Design: Prospective study. Setting: Department of Oncology in a tertiary care hospital. Subjects: A total of 31 consecutive patients receiving radiotherapy for rectal cancer (50 Gray). Interventions: A 7-day food intake registration, body weight, upper arm circumference, and analyses of blood samples were performed at the start and the end of radiotherapy, and at follow-up 4-6 weeks and 1 year after the end of radiotherapy. Results: At the end of 5 weeks of radiotherapy, the mean daily energy intake was reduced by 15% from 8.9 to 7.6 MJ as compared with baseline (P ¼ 0.002), and the intake of several nutrients was reduced (Po0.01). The percentages of energy derived from fat, protein, and carbohydrates did not change, nor did the nutrient density. A transient body weight reduction ofo1 kg was observed (P ¼ 0.009). Serum concentrations of vitamin A and 25-OH vitamin D did not change during radiotherapy. The daily intake of energy and nutrients, and body weight, had increased towards pretreatment values 4-6 weeks after radiotherapy. Conclusions: Radiotherapy for rectal cancer caused a transient reduction in energy intake and nutritional indicators. The nutritional quality of the diet was unchanged during radiotherapy.

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“…Curative surgery is feasible in threequarters of the patients, but despite this, about one half of the patients subsequently develop incurable recurrent cancer (Galandiuk et al, 1992). Adjuvant chemotherapy or chemoradiation reduces recurrences and mortality in colorectal cancer (Van Cutsem et al, 2002). Regimens containing 5-fluorouracil (5-FU) and leucovorin (LV) have been considered as standard adjuvant chemotherapy regimens in colorectal cancer (O'Connell et al, 1998;Wolmark et al, 1999;Kerr, 2001), and addition of oxaliplatin to 5-FU and LV appears to further improve efficacy (Andre et al, 2004).…”

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confidence: 99%

Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study

et al. 2007

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5-Fluorouracil (5-FU)-based chemotherapy is frequently associated with diarrhoea. We compared two 5-FU-based regimens and the effect of Lactobacillus and fibre supplementation on treatment tolerability. Patients diagnosed with colorectal cancer (n ¼ 150) were randomly allocated to receive monthly 5-FU and leucovorin bolus injections (the Mayo regimen) or a bimonthly 5-FU bolus plus continuous infusion (the simplified de Gramont regimen) for 24 weeks as postoperative adjuvant therapy. On the basis of random allocation, the study participants did or did not receive Lactobacillus rhamnosus GG supplementation (1 -2 Â 10 10 per day) and fibre (11 g guar gum per day) during chemotherapy. Patients who received Lactobacillus had less grade 3 or 4 diarrhoea (22 vs 37%, P ¼ 0.027), reported less abdominal discomfort, needed less hospital care and had fewer chemotherapy dose reductions due to bowel toxicity. No Lactobacillus-related toxicity was detected. Guar gum supplementation had no influence on chemotherapy tolerability. The simplified de Gramont regimen was associated with fewer grade 3 or 4 adverse effects than the Mayo regimen (45 vs 89%), and with less diarrhoea. We conclude that Lactobacillus GG supplementation is well tolerated and may reduce the frequency of severe diarrhoea and abdominal discomfort related to 5-FU-based chemotherapy.

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Adjuvant treatment of colorectal cancer (current expert opinion derived from the Third International Conference: Perspectives in Colorectal Cancer, Dublin, 2001)

Cited by 53 publications

References 40 publications

Preoperative short-term radiation therapy (25 Gy, 2.5 Gy twice daily) for primary resectable rectal cancer (phase II)

Preoperative short-term radiation therapy (25 Gy, 2.5 Gy twice daily) for primary resectable rectal cancer (phase II)

Dietary intake and nutritional indicators are transiently compromised during radiotherapy for rectal cancer

Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study

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