Efficacy and safety of consolidation chemotherapy during the resting period in patients with local advanced rectal cancer

Liang, Huan-Qing; Dong, Zhong‐Yi; Liu, Zhi‐Jie; Luo, Jiao; Zeng, Qin; Liao, Ping‑Yan; Wu, De‐Hua

doi:10.3892/ol.2018.9804

Cited by 13 publications

(32 citation statements)

References 28 publications

(38 reference statements)

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“…Garcia et al [ 26 ] reported that adding cycles of mFOLFOX6 during the radiation-surgery interval and prolonging the interval between radiation and surgery could increase pCR rates. Liang et al [ 34 ] observed that the addition of chemotherapy during the resting period, with a long interval between radiation and surgery, resulted in improved pCR and DFS rates compared with the nonaddition of consolidation chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of neoadjuvant chemoradiotherapy followed by radical resection for T4 colorectal cancer

Huang¹,

Huang²,

Ma³

et al. 2020

WJGO

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BACKGROUND Patients with clinical T4 colorectal cancer (CRC) have a poor prognosis because of compromised surgical margins. Neoadjuvant therapy may be effective in downstaging tumors, thereby rendering possible radical resection with clear margins. AIM To evaluate tumor downsizing and resection with clear margins in T4 CRC patients undergoing neoadjuvant concurrent chemoradiotherapy followed by surgery. METHODS This study retrospectively included 86 eligible patients with clinical T4 CRC who underwent neoadjuvant concurrent chemoradiotherapy followed by radical resection. Neoadjuvant therapy consisted of radiation therapy at a dose of 45-50.4 Gy and chemotherapy agents, either FOLFOX or capecitabine. A circumferential resection margin (CRM) of < 1 mm was considered to be a positive margin. We defined pathological complete response (pCR) as the absence of any malignant cells in a specimen, including the primary tumor and lymph nodes. A multivariate logistic regression model was used to identify independent predictive factors for pCR. RESULTS For 86 patients who underwent neoadjuvant chemoradiotherapy and surgery, the rate of pCR was 14%, and the R0 resection rate was 91.9%. Of the 61 patients with rectal cancer, 7 (11.5%) achieved pCR and 5 (8.2%) had positive CRMs. Of the 25 patients with colon cancer, 5 (20%) achieved pCR and 2 (8%) had positive CRMs. We observed that the FOLFOX regimen was an independent predictor of pCR ( P = 0.046). After a median follow-up of 47 mo, the estimated 5-year overall survival (OS) and disease-free survival (DFS) rates were 70.8% and 61.4%, respectively. Multivariate analysis revealed that a tumor with a negative resection margin was associated with improved DFS ( P = 0.014) and OS ( P = 0.001). Patients who achieved pCR exhibited longer DFS ( P = 0.042) and OS ( P = 0.003) than those who did not. CONCLUSION Neoadjuvant concurrent chemoradiotherapy engenders favorable pCR and R0 resection rates among patients with T4 CRC. The R0 resection rate and pCR are independent prognostic factors for patients with T4 CRC.

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Section: Discussionmentioning

confidence: 99%

Outcomes of neoadjuvant chemoradiotherapy followed by radical resection for T4 colorectal cancer

Huang¹,

Huang²,

Ma³

et al. 2020

WJGO

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“…However, most patients with rectal cancer in China are LARC at the first diagnosis. The current clinical data show that after nCRT and other neoadjuvant therapy, about 20% of rectal cancer patients can even achieve pathological complete response [ 5 , 6 ]. However, not all patients can benefit from nCRT, tumor downstaging in patients with LARC, tumor regression differs from patient to patient, ranging from pCR, intermediate regression, or even a complete lack of response.…”

Section: Introductionmentioning

confidence: 99%

3.0 T MRI IVIM-DWI for predicting the efficacy of neoadjuvant chemoradiation for locally advanced rectal cancer

Jiang

Wang

et al. 2020

Abdom Radiol

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Purpose The purpose of this study was to determine the diagnostic performance of intravoxel incoherent motion (IVIM) on assessing response to neoadjuvant chemoradiation (nCRT) in patients with Locally Advanced Rectal Cancer (LARC). Methods 50 patients with rectal cancer who underwent magnetic resonance (MR) imaging before and after nCRT, the values of pre-nCRT and post-nCRT IVIM-DWI parameters apparent diffusion coefficient (ADC), diffusion coefficient (D), false diffusion coefficient (D*), and perfusion fraction (f), together with the percentage changes (∆% parametric value) induced by nCRT were calculated. According to the patient's response to nCRT, the patients were divided into pathological complete response (pCR) and non-pCR groups, Good Response (GR) group and Poor Response (PR) group, and the above values were compared between different groups. Univariate and multiple logistic regression analysis were done to investigate the relation between different parameters and patient nCRT. Draw ROC curve according to sensitivity and specificity, and compare its diagnostic efficacy. Results There were no significant differences in the baseline data of 50 patients. After nCRT, the ADC and D values for LARC increased significantly (all p < 0.05). The pCR group (n = 9) had higher preD*, pref, postD*, ∆%ADC and ∆%D values than the non-pCR group (n = 41) (all p < 0.05). The GR group (n = 17) exhibited higher post D, ∆%ADC and ∆%D values than the PR group (n = 33) (all p < 0.05). From the results of Logistic regression analysis found that ∆%ADC and ∆%D were significantly correlated with patients' response to nCRT. Based on ROC analysis, ∆%D had a higher area under the curve value than ∆%ADC (p = 0.009) in discriminating the pCR from non-pCR groups. Conclusions IVIM-DWI technology may be helpful in identifying the pCR and GR patients to nCRT for LARC.

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“…The electronic search nally identi ed 15 articles met inclusion criteria, including eight RCTs [20][21][22][23][24][25][26][27][28] and seven non-RCTs 17,[29][30][31][32][33][34][35]. A total of 4091 patients with locally advanced rectal cancer was included, of these patients, 1906 in TNT and 2185 in NCRT group.…”

Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

“…The OS between TNT and NCRT A total of eight studies reported the long-term survival OS, including ve RCTs 20-22, 25, 28 and three non-RCTs 32,34,35 . The heterogeneity was low and xed-effects model was used for analysis.…”

Section: Post-operative Complicationsmentioning

confidence: 99%

The Oncologic Efficacy and Long-term Survival Outcomes of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: A Systemic Review and Meta-Analysis

Li¹,

Yu²,

Wang³

et al. 2021

Preprint

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Purpose To evaluate the pooled oncologic efficacy of total neoadjuvant therapy for locally advanced rectal cancer patients using meta-analysis method.Method To evaluate the pooled effects of total neoadjuvant therapy in terms of exact oncologic efficacy and long-term survival outcomes, a systemic literature search of PubMed, Embase, China Biology Medicine and WanFang Database was performed.Results A total of 15 studies including 4091 patients were finally identified. The pooled analysis revealed that total neoadjuvant therapy significantly increased the rates of T-downstaging (OR=2.16, 95% CI:1.63~2.87, P<0.00001), pathologic complete response (OR=1.90, 95% CI:1.60~2.27, P<0.00001) and R0 resection (OR=1.44, 95% CI: 1.07~1.93, P=0.01) with a comparable safety profile. Most importantly, patients received total neoadjuvant therapy had a superior overall survival rate compared to standard neoadjuvant chemoradiotherapy (HR=0.74, 95% CI: 0.62~0.89, P=0.001).Conclusion Patients with locally advanced rectal cancer can be managed with total neoadjuvant therapy with a superior short-term oncologic efficacy and long-term survival benefits.

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Efficacy and safety of consolidation chemotherapy during the resting period in patients with local advanced rectal cancer

Cited by 13 publications

References 28 publications

Outcomes of neoadjuvant chemoradiotherapy followed by radical resection for T4 colorectal cancer

Outcomes of neoadjuvant chemoradiotherapy followed by radical resection for T4 colorectal cancer

3.0 T MRI IVIM-DWI for predicting the efficacy of neoadjuvant chemoradiation for locally advanced rectal cancer

The Oncologic Efficacy and Long-term Survival Outcomes of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: A Systemic Review and Meta-Analysis

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