Survival Impact of Neoadjuvant Chemotherapy Alone Versus Neoadjuvant Chemoradiation Therapy for Patients With T2N1, T3N0, and T3N1 Rectal Adenocarcinomas

Abstract

in the remaining patient. The T-stages were as follows: cT1, one patient; cT2, one patient; cT3, 15 patients; and cT4, one patient. According to the Classification of Pancreatic Carcinoma by the Japan Pancreas Society, we selected the lymph node stations around major arteries which were visible on the CE-4DCT images: common hepatic, celiac, splenic, superior mesenteric, and abdominal aortic stations. We delineated the GTV and these arteries on the CE-4DCT images at all respiratory phases. The margins from the arteries to the lymph node stations were decided with reference to the Pancreas Atlas of the Radiation Therapy Oncology Group. The respiratory motion was calculated from the movement of the center of the GTV and the lymph node stations in the craniocaudal direction. The Wilcoxon signed-rank test was used to analyze the differences in the respiratory motion between the GTV and the lymph node stations. The Wilcoxon rank-sum test was used to analyze the relationship between the respiratory motion and clinical factors. Results: The respiratory motion values of the GTV and the lymph node stations are listed in Table 1. The respiratory motion of the celiac (P < 0.001), superior mesenteric (P < 0.001), and abdominal aortic (P < 0.001) stations was significantly smaller than that of the GTV. Patients aged 70 years had significantly larger respiratory motion of the GTV (P Z 0.010) and the common hepatic (P Z 0.038), celiac (P Z 0.012) and superior mesenteric (P Z 0.034) stations. Conclusion: We observed significant differences in the respiratory motion between the GTV and the lymph node stations for pancreatic cancer. The smaller internal margin for the celiac, superior mesenteric, and abdominal aortic stations than that for the GTV may be acceptable.

Neoadjuvant chemotherapy without radiation as a potential alternative treatment for locally advanced rectal cancer: A meta-analysis

“…Six studies compared the OS of patients with RC treated with Neo-CT vs Neo-CRT. Sun et al [ 19 ] and Cassidy et al [ 20 ] reported that Neo-CRT improved OS, while Deng et al [ 10 ], He et al [ 27 ], Fan et al [ 13 ], and Kim et al [ 21 ] reported no benefit. After merging all studies, Neo-CRT did not improve OS [HR = 1.09, 95% confidence interval (CI) = 0.93–1.24; p = 0.19] (Figure 3 ).…”