Effect of radioimmunoscintigraphy in management of recurrent colorectal cancer

Lunniss, Peter J.; Skinner, S.J.M.; Britton, K. E.; Granowska, M.; Morris, Greg; Northover, John

doi:10.1046/j.1365-2168.1999.01008.x

Cited by 18 publications

(6 citation statements)

References 15 publications

(7 reference statements)

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“…L'imagerie par résonance magnétique (IRM) reste l'examen le plus performant pour le diagnostic des récidives locales, elle a une sensibilité de 85 % et une spécificité de 92 % [11,12]. La tomographie par émission de positon au FDG18 est une technique prometteuse, les données de la littérature soulignent son intérêt dans l'évaluation de la récidive des carcinomes rectaux du fait de son excellente valeur diagnostique et de son impact majeur sur la déci-sion thérapeutique ; sa sensibilité est de 97 % et sa spécificité de 90 % [13,14]. L'antigène carcinoembryonnaire (ACE), surtout élevé en cas de métastases, est normal une fois sur deux en cas de récidive [15] ; il était élevé chez les deux tiers de nos patients.…”

Section: Discussionunclassified

Prise en charge des récidives locales du cancer du rectum

et al. 2011

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But de l'étude : Le traitement des récidives locoré-gionales des cancers du rectum reste difficile et controversé. Le but de cette étude était d'évaluer rétrospectivement le résultat des différents moyens thérapeutiques et de définir la stratégie de prise en charge de ces récidives. Patients et méthodes : De janvier 2000 à décembre 2009, 113 patients ont été opérés pour cancer du rectum, dont 14 ont présenté une récidive locale de la maladie (huit hommes, six femmes). Cinq patients ont reçu une radiothérapie pré-opératoire. Résultats : Plus de 50 % des récidives sont survenues au cours de la première année, elles étaient symptomatiques dans 86 % des cas. L'opérabilité était de 71 % et la réséca-bilité de 60 %. Six patients ont bénéficié d'une résection à visée curative, et quatre n'ont pu bénéficier que d'un traitement palliatif : deux cas de laparotomie exploratrice avec simple biopsie, et deux cas de colostomie de décharge. La résection était R0 dans trois cas, soit 30 % des cas, elle a consisté en une résection antérieure élargie à une anse grê-lique avec anastomose colorectale, une exentération posté-rieure et une amputation abdominopérinéale (AAP). La résection était palliative dans trois cas : deux fois R1 et dans un cas R2. La mortalité opératoire était nulle et la morbidité était de 50 %. La survie globale est de 12 mois. Conclusion : Cette étude suggère qu'en l'absence d'autres traitements curatifs, l'exérèse, lorsqu'elle est réalisable, occupe une place essentielle dans le traitement de ces réci-dives au prix d'une intervention lourde. Une amélioration de la survie pourrait venir des associations thérapeutiques. Pour citer cette revue : J. Afr. Cancer 4 (2012). Mots clés Cancer du rectum · Récidives locorégionales · Chirurgie · RésectionAbstract Aim: Treatment of locally recurrent rectal cancer remains a difficult and controversial issue. The aim of this study was to retrospectively assess the efficiency of various treatment methods and to define the most accurate management of those recurrences. Patients and methods: From January 2000 to December 2009, 113 patients were treated for rectal cancer, out of which 14 (8 men and 6 women) presented local recurrences. Five patients received preoperative radiotherapy. Result: More than 50% of local recurrences occur in the first postoperative year, and symptoms were present in 86% of cases. Operability was 71%, and resectability was 60%. Six patients underwent a curative resection, and four patients underwent palliative treatment: laparotomy with biopsy in two cases and colostomy in other two cases. The resection was R0 in three cases (30%); it consisted of an anterior resection extended to small bowel with colorectal anastomosis, a posterior exenteration and an abdominoperineal resection. The resection was palliative in three cases: R1 in two cases and R2 in one case. Operative mortality was zero, and morbidity was 50%. The global survival was 12 months. Conclusion: The results of this study suggest that management of resection of local recurrences remains a c...

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Section: Discussionunclassified

Prise en charge des récidives locales du cancer du rectum

et al. 2011

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“…The antibody binds strongly to both well and poorly-differentiated colorectal adenocarcinomas. Radioimmunoscintigraphy using 99m Tc PR1A3 was beneficial in the management of a sub-group of colorectal cancer patients [17, 18]. PR1A3 was used in radioimmunoguided surgery (RIGS) to detect and remove occult metastatic deposits in patients with colorectal cancer [19].…”

Section: Nuclear Imagingmentioning

confidence: 99%

“…Although rapid clearance from kidney was observed, high liver accumulation was the biggest drawback [50]. Recently, Kramer-Marek et al used anti-HER2 affibodies [18]F-FBEM-Z HER2:342 prepared using site-specific labeling techniques for in vivo imaging of HER2-positive SKOV3 tumors [51]. Biodistribution and microPET imaging studies revealed rapid, high and specific accumulation in HER2 over-expressing SKOV3 tumor.…”

Section: Nuclear Imagingmentioning

confidence: 99%

Recent trends in antibody-based oncologic imaging

et al. 2012

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Antibodies, with their unmatched ability for selective binding to any target, are considered as potentially the most specific probes for imaging. Their clinical utility, however, has been limited chiefly due to their slow clearance from the circulation, longer retention in non-targeted tissues and the extensive optimization required for each antibody-tracer. The development of newer contrast agents, combined with improved conjugation strategies and novel engineered forms of antibodies (diabodies, minibodies, single chain variable fragments, and nanobodies), have triggered a new wave of antibody-based imaging approaches. Apart from their conventional use with nuclear imaging probes, antibodies and their modified forms are increasingly being employed with non-radioisotopic contrast agents (MRI and ultrasound) as well as newer imaging modalities, such as quantum dots, near infra red (NIR) probes, nanoshells and surface enhanced Raman spectroscopy (SERS). The review article provides new developments in the usage of antibodies and their modified forms in conjunction with probes of various imaging modalities such as nuclear imaging, optical imaging, ultrasound, MRI, SERS and nanoshells in preclinical and clinical studies on the diagnosis, prognosis and therapeutic responses of cancer.

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“…Technetium labelled PR1A3 has been shown to detect 100% of primary CRC's. At present however, colonoscopy remains the investigation of choice for detecting primary lesions, although 99m-Tc PR1A3 is being used clinically to detect recurrent CRC, with a sensitivity and specificity of 96% and 50% respectively [42] . Despite the realization that it is difficult to detect recurrence early enough to be curable, in this study 25% had a beneficial alteration in their management plan.…”

Section: Radioimmunoscintigraphymentioning

confidence: 99%

The impact of new technology on surgery for colorectal cancer

Makin¹,

Breen²,

Monson³

2001

WJG

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Advances in technology continue at a rapid pace and affect all aspects of life, including surgery. We have reviewed some of these advances and the impact they are having on the investigation and management of c o l o r e c t a l c a n c e r . M o d e r n e n d o s c o p e s , w i t h magnifying, variable stiffness and localisation capabilities are making the primary investigation of colonic cancer easier and more acceptable for patients. Imaging investigations looking at primary, metastatic and recurrent disease are shifting to digital data sets, which can be stored, reviewed remotely, potentially fused with other modalities and reconstructed as 3 dimensional (3D) images for the purposes of advanced diagnostic interpretation and computer assisted surgery. They include virtual colonoscopy, trans-rectal ultrasound, magnetic resonance imaging, positron emission tomography and radioimmunoscintigraphy. Once a colorectal carcinoma is diagnosed, the treatment options available are expanding. Colonic stents are being used to relieve large bowel obstruction, either as a palliative measure or to improve the patient's overall condition before definitive surgery. Transanal endoscopic microsurgery and minimally invasive techniques are being used with similar outcomes and a lower mortality, morbidity and hospital stay than open trans-abdominal surgery. Transanal endoscopic microsurgery allows precise excision of both benign and early malignant lesions in the mid and upper rectum. Survival of patients with i n o p e r a b l e h e p a t i c m e t a s t a s e s f o l l o w i n g radiofrequency ablation is encouraging. Robotics and telemedicine are taking surgery well into the 21 st century. Artificial neural networks are being developed to enable us to predict the outcome for individual patients. New technology has a major impact on the way we practice surgery for colorectal cancer.Subject headings colorectal neoplasms; technology; surgery; radiology

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Effect of radioimmunoscintigraphy in management of recurrent colorectal cancer

Cited by 18 publications

References 15 publications

Prise en charge des récidives locales du cancer du rectum

Prise en charge des récidives locales du cancer du rectum

Recent trends in antibody-based oncologic imaging

The impact of new technology on surgery for colorectal cancer

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