Short-course preoperative radiotherapy combined with chemotherapy, delayed surgery and local hyperthermia for rectal cancer: a phase II study

Abstract

Short-course radiotherapy with chemotherapy, radiosensitizers and delayed surgery is a feasible treatment for rectal cancer and may lead to tumour regression rate comparable with long-course chemoradiation.

Antiproliferative and pro‑apoptotic effects of Cyclocarya�paliurus polysaccharide and X‑ray irradiation combination on SW480 colorectal cancer cells

“…It is one of the most important treatment methods for treating advanced rectal cancer, including preoperative neo-adjuvant radiotherapy, intra-operative radiotherapy and postoperative adjuvant radiotherapy, which can effectively improve the local control rate and anal protection rate, and reduce the risk of tumor recurrence and metastasis (24–30). In the treatment of rectal cancer, radiotherapy and chemotherapy are often used in combination, as chemotherapy often induces systemic toxicity (31). As technology advances, modern radiation therapy technology enables a high degree of conformity, including the use of computed tomography images to provide high precision and precise treatment, optimizing treatment planning (32,33); however, the limitation of radiation exposure remains an issue with radiotherapy.…”

Antiproliferative and pro‑apoptotic effects of Cyclocarya�paliurus polysaccharide and X‑ray irradiation combination on SW480 colorectal cancer cells

“…It is one of the most important treatment methods for treating advanced rectal cancer, including preoperative neo-adjuvant radiotherapy, intra-operative radiotherapy and postoperative adjuvant radiotherapy, which can effectively improve the local control rate and anal protection rate, and reduce the risk of tumor recurrence and metastasis (24–30). In the treatment of rectal cancer, radiotherapy and chemotherapy are often used in combination, as chemotherapy often induces systemic toxicity (31). As technology advances, modern radiation therapy technology enables a high degree of conformity, including the use of computed tomography images to provide high precision and precise treatment, optimizing treatment planning (32,33); however, the limitation of radiation exposure remains an issue with radiotherapy.…”

Preoperative short course radiotherapy with concurrent and consolidation chemotherapies followed by delayed surgery in locally advanced rectal cancer: preliminary results

“…Currently, this hypothesis is being tested in adjunct to SRT in RAPIDO trial [ 29 ]. However, the above studies used chemotherapy in a sequential fashion with SRT but in trials implementing concurrent chemotherapy protocols, the rate of cPR ranged from 1.4% to 21.1% [ 9 , 10 , 20 , 21 ]. It is noteworthy that regimens that contain oral capecitabine are associated with absolutely better and higher responses than bolus and infusional 5FU.…”

“…Other investigators tested the addition of preoperative chemotherapy following SRT [ 8 ] and delayed surgery with results comparable to conventional chemoradiation. Due to the concerns of increased toxicity, only a few studies are available regarding the addition of concurrent chemotherapy to SRT but with appropriate results and acceptable complications rate [ 9 , 10 ].…”

External validation of a rectal cancer outcome prediction model with a cohort of patients treated with preoperative radiochemotherapy and deep regional hyperthermia

“…While local failures after preoperative radiochemotherapy followed by 'perfect' total mesorectal excision have become a rare event, there is still a great interest in establishing therapeutic regimens that can increase tumour downstaging and therefore qualify a relevant number of patients for organ-preservation strategies. Besides dose-escalated radiotherapy, intensified chemotherapy regimens and total neoadjuvant therapy, hyperthermia is a treatment modality that is currently under investigation in prospective phase II trials [32][33][34][35][36][37][38].…”

Antiproliferative and pro‑apoptotic effects of Cyclocarya�paliurus polysaccharide and X‑ray irradiation combination on SW480 colorectal cancer cells

“…It is one of the most important treatment methods for treating advanced rectal cancer, including preoperative neo-adjuvant radiotherapy, intra-operative radiotherapy and postoperative adjuvant radiotherapy, which can effectively improve the local control rate and anal protection rate, and reduce the risk of tumor recurrence and metastasis (24–30). In the treatment of rectal cancer, radiotherapy and chemotherapy are often used in combination, as chemotherapy often induces systemic toxicity (31). As technology advances, modern radiation therapy technology enables a high degree of conformity, including the use of computed tomography images to provide high precision and precise treatment, optimizing treatment planning (32,33); however, the limitation of radiation exposure remains an issue with radiotherapy.…”

Preoperative short course radiotherapy with concurrent and consolidation chemotherapies followed by delayed surgery in locally advanced rectal cancer: preliminary results

“…Currently, this hypothesis is being tested in adjunct to SRT in RAPIDO trial [ 29 ]. However, the above studies used chemotherapy in a sequential fashion with SRT but in trials implementing concurrent chemotherapy protocols, the rate of cPR ranged from 1.4% to 21.1% [ 9 , 10 , 20 , 21 ]. It is noteworthy that regimens that contain oral capecitabine are associated with absolutely better and higher responses than bolus and infusional 5FU.…”

“…Other investigators tested the addition of preoperative chemotherapy following SRT [ 8 ] and delayed surgery with results comparable to conventional chemoradiation. Due to the concerns of increased toxicity, only a few studies are available regarding the addition of concurrent chemotherapy to SRT but with appropriate results and acceptable complications rate [ 9 , 10 ].…”

External validation of a rectal cancer outcome prediction model with a cohort of patients treated with preoperative radiochemotherapy and deep regional hyperthermia

“…While local failures after preoperative radiochemotherapy followed by 'perfect' total mesorectal excision have become a rare event, there is still a great interest in establishing therapeutic regimens that can increase tumour downstaging and therefore qualify a relevant number of patients for organ-preservation strategies. Besides dose-escalated radiotherapy, intensified chemotherapy regimens and total neoadjuvant therapy, hyperthermia is a treatment modality that is currently under investigation in prospective phase II trials [32][33][34][35][36][37][38].…”

Antiproliferative and pro‑apoptotic effects of Cyclocarya�paliurus polysaccharide and X‑ray irradiation combination on SW480 colorectal cancer cells

“…It is one of the most important treatment methods for treating advanced rectal cancer, including preoperative neo-adjuvant radiotherapy, intra-operative radiotherapy and postoperative adjuvant radiotherapy, which can effectively improve the local control rate and anal protection rate, and reduce the risk of tumor recurrence and metastasis (24–30). In the treatment of rectal cancer, radiotherapy and chemotherapy are often used in combination, as chemotherapy often induces systemic toxicity (31). As technology advances, modern radiation therapy technology enables a high degree of conformity, including the use of computed tomography images to provide high precision and precise treatment, optimizing treatment planning (32,33); however, the limitation of radiation exposure remains an issue with radiotherapy.…”

Preoperative short course radiotherapy with concurrent and consolidation chemotherapies followed by delayed surgery in locally advanced rectal cancer: preliminary results

“…Currently, this hypothesis is being tested in adjunct to SRT in RAPIDO trial [ 29 ]. However, the above studies used chemotherapy in a sequential fashion with SRT but in trials implementing concurrent chemotherapy protocols, the rate of cPR ranged from 1.4% to 21.1% [ 9 , 10 , 20 , 21 ]. It is noteworthy that regimens that contain oral capecitabine are associated with absolutely better and higher responses than bolus and infusional 5FU.…”

“…Other investigators tested the addition of preoperative chemotherapy following SRT [ 8 ] and delayed surgery with results comparable to conventional chemoradiation. Due to the concerns of increased toxicity, only a few studies are available regarding the addition of concurrent chemotherapy to SRT but with appropriate results and acceptable complications rate [ 9 , 10 ].…”

External validation of a rectal cancer outcome prediction model with a cohort of patients treated with preoperative radiochemotherapy and deep regional hyperthermia

“…While local failures after preoperative radiochemotherapy followed by 'perfect' total mesorectal excision have become a rare event, there is still a great interest in establishing therapeutic regimens that can increase tumour downstaging and therefore qualify a relevant number of patients for organ-preservation strategies. Besides dose-escalated radiotherapy, intensified chemotherapy regimens and total neoadjuvant therapy, hyperthermia is a treatment modality that is currently under investigation in prospective phase II trials [32][33][34][35][36][37][38].…”