The INTERACT Trial: Long-term results of a randomised trial on preoperative capecitabine-based radiochemotherapy intensified by concomitant boost or oxaliplatin, for cT2 (distal)–cT3 rectal cancer

Valentini, Vincenzo; Gambacorta, Maria Antonietta; Cellini, Francesco; Aristei, Cynthia; Coco, Claudio; Barbaro, Brunella; Alfieri, Sergio; D’Ugo, Domenico; Persiani, Roberto; Deodato, Francesco; Crucitti, Antonio; Lupattelli, Marco; Mantello, G.; Navarria, Federico; Belluco, Claudio; Buonadonna, Angela; Boso, Caterina; Lonardi, Sara; Caravatta, L.; Barba, Maria Cristina; Vecchio, Fabio Maria; Maranzano, Ernesto; Genovesi, Domenico; Doglietto, Giovanni Battista; Morganti, Alessio Giuseppe; Torre, Giuseppe La; Pucciarelli, Salvatore; Paoli, Antonino De

doi:10.1016/j.radonc.2018.11.023

Cited by 48 publications

(48 citation statements)

References 29 publications

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“…The neoadjuvant approach can be applied to up-front resectable presentations in order (i) to reduce the rate of unresected patients (reported in the literature in spite of presurgical resectability-assigned status), (ii) to further decrease the non-microscopically radical resection rates [20] and (iii) to possibly increase survival outcomes as for other primary diseases (e.g., rectal cancer [22][23][24] or gastro-esophageal cancer [25,26]. As for doubt about delaying surgery for up-front resectable or doubtfully operable (BRPC) patients, some authors have highlighted that patients developing distant metastases through the neoadjuvant course would have probably been at risk of this during the postoperative phase anyway; thus, the neoadjuvant approach can also be exploited to gauge the intrinsic biological aggressiveness of the disease [27].…”

Section: Neoadjuvant Therapymentioning

confidence: 99%

Basics and Frontiers on Pancreatic Cancer for Radiation Oncology: Target Delineation, SBRT, SIB Technique, MRgRT, Particle Therapy, Immunotherapy and Clinical Guidelines

Cellini

Arcelli

Simoni

et al. 2020

Cancers

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Pancreatic cancer represents a modern oncological urgency. Its management is aimed to both distal and local disease control. Resectability is the cornerstone of treatment aim. It influences the clinical presentation’s definitions as up-front resectable, borderline resectable and locally advanced (unresectable). The main treatment categories are neoadjuvant (preoperative), definitive and adjuvant (postoperative). This review will focus on (i) the current indications by the available national and international guidelines; (ii) the current standard indications for target volume delineation in radiotherapy (RT); (iii) the emerging modern technologies (including particle therapy and Magnetic Resonance [MR]-guided-RT); (iv) stereotactic body radiotherapy (SBRT), as the most promising technical delivery application of RT in this framework; (v) a particularly promising dose delivery technique called simultaneous integrated boost (SIB); and (vi) a multimodal integration opportunity: the combination of RT with immunotherapy.

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Section: Neoadjuvant Therapymentioning

confidence: 99%

Basics and Frontiers on Pancreatic Cancer for Radiation Oncology: Target Delineation, SBRT, SIB Technique, MRgRT, Particle Therapy, Immunotherapy and Clinical Guidelines

Cellini

Arcelli

Simoni

et al. 2020

Cancers

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“…Patients from the INTERACT study treated from 2010 to 2013 who met the inclusion criteria were included in this study [24].…”

Section: Patients' Selection Criteria and Study Designmentioning

confidence: 99%

“…All patients underwent a long course chemo-radiotherapy. The total radiotherapy (RT) dose on the pelvis was 45 Gy in 25 fractions of 1.8 Gy/die, while the dose on the gross tumor volume (GTV) was 55 Gy in 25 fractions (with a concomitant boost of 2 Gy per week) or in 25 fractions of 2.2 Gy/die with simultaneous integrated boost [24,25]. Radiotherapy was delivered by three-dimensional conformational RT (3D-CRT) or intensity modulated RT (IMRT) or Volumetric Modulated Arc Therapy (VMAT) techniques.…”

Section: Clinical Workflowmentioning

confidence: 99%

Could the conservative approach be considered safe in the treatment of locally advanced rectal cancer in case of a clinical near-complete or complete response? A retrospective analysis

Chiloiro

Meldolesi

Giraffa

et al. 2021

Clinical and Translational Radiation Oncology

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Background: Conservative approach has emerged as an option for the management of rectal cancer (RC) patients with a near or complete clinical response after neoadjuvant chemoradiotherapy (nCRT). The aim of this study is to assess the impact of the conservative approach by comparing patients' survival outcomes and quality of life with those who had surgical resection. Methods: A single-institution and retrospective study including RC patients who reached a near complete or complete clinical response after nCRT from January 2010 to September 2019. Conservative approaches included local excision or watch and wait strategy; surgery approaches included anterior resection or abdominal-perineal resection. Local regrowth (LR), overall survival, disease free survival, metastasis free survival and colostomy free survival were evaluated through Kaplan-Meier curves and compared trough log-rank tests. Quality of life was measured by the following validated questionnaires: EORTC QLC30, EORTC QLQ-CR29 and Fecal Incontinence Quality of Life scale. Results: Overall 157 patients were analyzed: 105 (66,9%) underwent radical surgery and 52 (33,1%) had a conservative approach. With a median follow-up of 51 months, 2 patients in the surgical group had a local recurrence and 8 in the conservative group had a LR, respectively. Distance metastasis occurred in 7 and 1 patients of surgical and conservative group, respectively. No differences were detected in terms of survival outcomes except for colostomy free survival (p: 0,01). The conservative group showed better intestinal (p < 0.01) and sexual (p: 0,04) function and emotional status (p: 0,02). Conclusions: Conservative approach seems to be safe in terms of survival outcomes with a significant advantage on quality of life in RC patients who achieved clinical complete response after nCRT.

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“…In order to reduce toxicity and improve the patients quality of life, a new generation of studies proposed risk adapted strategies including intensified programs in high risk patients and the possibility to avoid nCRT in low risk patients. Several trials were previously conducted in order to clarify the potential benefit of adopting a chemotherapy association regimen combining FP to other agents, as oxaliplatin or irinotecan (Valentini et al, 2019), or to anti-epidermal growth factor receptor (EGFR) monoclonal antibodies as cetuximab. On the other hand, nCRT intensification including a higher dose of RT appears as a promising approach (Burbach et al, 2014).…”

Section: Neo-adjuvant Therapeutic Approaches In Locally Advanced Rectmentioning

confidence: 99%

Germline and Somatic Pharmacogenomics to Refine Rectal Cancer Patients Selection for Neo-Adjuvant Chemoradiotherapy

et al. 2020

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The INTERACT Trial: Long-term results of a randomised trial on preoperative capecitabine-based radiochemotherapy intensified by concomitant boost or oxaliplatin, for cT2 (distal)–cT3 rectal cancer

Cited by 48 publications

References 29 publications

Basics and Frontiers on Pancreatic Cancer for Radiation Oncology: Target Delineation, SBRT, SIB Technique, MRgRT, Particle Therapy, Immunotherapy and Clinical Guidelines

Basics and Frontiers on Pancreatic Cancer for Radiation Oncology: Target Delineation, SBRT, SIB Technique, MRgRT, Particle Therapy, Immunotherapy and Clinical Guidelines

Could the conservative approach be considered safe in the treatment of locally advanced rectal cancer in case of a clinical near-complete or complete response? A retrospective analysis

Germline and Somatic Pharmacogenomics to Refine Rectal Cancer Patients Selection for Neo-Adjuvant Chemoradiotherapy

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