Preoperative chemoradiation with or without induction oxaliplatin plus 5-fluorouracil in locally advanced rectal cancer

Abstract

Short-intense induction FOLFOX-4 significantly improves downstaging and sphincter preservation in low rectal tumors. Long-term outcomes were not improved in the FOLFOX-4 group of patients.

Sandwich-like neoadjuvant therapy with bevacizumab for locally advanced rectal cancer: a phase II trial

“…No surgery 2 8 chemotherapy before neoadjuvant CRT or consolidation chemotherapy after neoadjuvant CRT has been proved effective and safe [11,20,21]. In this study, we designed a sandwich-like neoadjuvant regimen combining induction chemotherapy with bevacizumab, concurrent CRT with bevacizumab and consolidation chemotherapy with FOLFOX.…”

Can Induction Chemotherapy before Concurrent Chemoradiation Impact Circumferential Resection Margin Positivity and Survival in Low Rectal Cancers?

“…After preoperative chemoradiation, positive CRM rate can vary between 3-14% Kellokumpu et al, 2012;Kenelley et al, 2013;Rullier et al, 2013;Calvo et al, 2014). CRM positivity as high as 26% has been reported in patients with low rectal cancers who undergo APR (Nagtegaal et al, 2002;Bernstein et al, 2009).…”

“…Preoperative chemoradiation reduces locoregional recurrence but does not alter systemic relapse which is the most common mode of failure in these patients (Gao et al, 2014). Various induction regimens have been developed and administered before chemoradiation in an attempt to reduce distant failure but equivocal outcomes have been reported (Chau et al, 2006;Calvo et al, 2014).…”

“…A recently concluded study showed improved pathological complete response (PCR) and R0 rates with induction but failed to show any long term improvement in outcomes (Calvo et al, 2014). The impact of induction chemotherapy before concurrent chemoradiation on CRM positivity rate in low rectal cancer has not been studied independently.…”

Clinical results and toxicity for short-course preoperative radiotherapy and total mesorectal excision in rectal cancer patients

“…The Stockholm II trial showed no increased toxicity rate in the radiotherapy group due to the introduction of three- or four-field box techniques [ 9 ]. Furthermore, the reported toxicity is lower than in classically fractionated chemoirradiation, and patient compliance could be increased [ 10 – 13 ]. The current guidelines allow both modalities, depending on the clinical goal.…”