Preoperative chemoradiation versus radiation alone for stage II and III resectable rectal cancer

Ceelen, Wim; Nieuwenhove, Yves Van; Fierens, Kaat

doi:10.1002/14651858.cd006041.pub2

Cited by 80 publications

(60 citation statements)

References 32 publications

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“…Dies wurde in Metaanalysen bestätigt [968,969] [997]. Die Resultate der amerikanischen NSABP R04-Studie, die in einem 2 × 2-faktoriellen Design neben der Frage der neoadjuvanten Radiochemotherapie mit infusionalem 5-Fluorouracil (225 mg/m²/Tag während der RT) vs. Capecitabin (1650 mg/m²/Tag während der RT) auch den Einsatz von Oxaliplatin untersuchte (siehe unten), bestätigten die Deutsche Studie, soweit es chirurgische Resultate, pCR-Raten und die Verträglichkeit der Therapie betrifft [998].…”

Section: Hintergrundunclassified

S3-Leitlinie – Kolorektales Karzinom

Schmiegel

Buchberger

Follmann³

et al. 2017

Z Gastroenterol

136

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Section: Hintergrundunclassified

S3-Leitlinie – Kolorektales Karzinom

Schmiegel

Buchberger

Follmann³

et al. 2017

Z Gastroenterol

136

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“…Longterm results by meta-analyses [25,26] and a recent Cochrane review [27] confirmed the benefits of radiation therapy, but also documented bowel toxicities (obstruction, fistulae, sphincter and sexual dysfunction). In randomized clinical trials, severe acute radiation enteritis ranged from 12 to 18% when concomitant chemotherapy is used [18,28].…”

Section: Intensity-modulated Radiation Therapymentioning

confidence: 86%

Intensity-modulated radiation therapy for patients with rectal cancer

2014

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“…Radiotherapy is often combined with chemotherapy, chemoradiotherapy (CRT). CRT induces downsizing and downstaging of the tumour and regional lymph nodes thereby enabling surgery of an otherwise inoperable tumour (1,3,4). There are well-known short-term and long-term side-effects of pelvic radiation and chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Response to neoadjuvant treatment in rectal cancer surgery

Loftås

2016

Linköping University Medical Dissertations

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Rectal cancer is one of the three most common malignancies in Sweden with an annual incidence of about 2000 cases. Current treatment consists of surgical resection of the rectum including the loco-regional lymph nodes in the mesorectum. In advanced cases, neoadjuvant chemo-radiotherapy (CRT) prior to the operative treatment reduces local recurrences and enables surgery. The neoadjuvant treatment can also eradicate the tumour completely, i.e. complete response. This research project was designed to investigate the effects of preoperative radiotherapy/ CRT and analyze methods to predict response to CRT. Study I investigated the expression of the FXYD-3 protein with immunohistochemistry in rectal cancer, with or without preoperative radiotherapy. The results from the total cohort showed that, strong FXYD-3 expression was correlated to infiltrative tumour growth (p = 0.02). In the radiotherapy group, strong FXYD-3 expression was related to an unfavourable prognosis (p = 0.02). Tumours with strong FXYD-3 expression had less tumour necrosis (p = 0.02) after radiotherapy. FXYD-3 expression in the primary tumour was increased compared to normal mucosa (p=0.008). We concluded that FXYD-3 expression was a prognostic factor in patients receiving preoperative radiotherapy for rectal cancer. Study II investigated FXYD-3 expression in tumours that developed local recurrences following surgery and compared this with expression in tumours that did not develop local recurrences. There was no difference in the expression of FXYD-3 between the group that developed local recurrences and the group that did not develop local recurrences. There was no difference in survival between those with strong or weak FXYD-3 expression. We concluded that this study could not confirm the findings from study 1 i.e. that FXYD-3 expression has prognostic significance in rectal cancer. Study III was a register-based study on the incidence and effects of complete response to neoadjuvant treatment. Eight per cent of the patients with adequate CRT to achieve complete response also had a complete histological response of the luminal tumor in the resected bowel. Sixteen per cent of that group had remaining lymph node metastases in the operative specimen. Chemotherapy together with radiotherapy doubled the chance of complete response in the luminal tumour. Patients with remaining lymph node metastases had a lower survival rate compared to those without. We concluded that residual nodal involvement after neoadjuvant treatment was an important factor for reduced survival after complete response in the luminal tumour. Study IV followed up the results from the previous study by re-evaluating magnetic resonance imaging (MRI)- images in patients with complete tumour response. Two experienced MRI radiologists performed blinded re-staging of post CRT MR- images from patients with complete response in the luminal tumour. One group with lymph node metastases and another one without were studied and the results compared with the pathology reports. The sensitivity, spe...

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Preoperative chemoradiation versus radiation alone for stage II and III resectable rectal cancer

Abstract: * Neoplasm Recurrence, Local [prevention & control]; Randomized Controlled Trials as Topic; Rectal Neoplasms [ * drug therapy; pathology; * radiotherapy; surgery] 20 Preoperative chemoradiation versus radiation alone for stage II and III resectable rectal cancer (Review)

Cited by 80 publications

References 32 publications

S3-Leitlinie – Kolorektales Karzinom

S3-Leitlinie – Kolorektales Karzinom

Intensity-modulated radiation therapy for patients with rectal cancer

Response to neoadjuvant treatment in rectal cancer surgery

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