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Short course radiotherapy rectal cancer

Corrado Spatola, Giuseppe Privitera, Roberto Milazzotto, Alessandra Tocco, Grazia Acquaviva, Francesco Marletta, Lorenza Marino, Alfio Di Grazia, Rosalba Salvo, Giovanni Cartia, Angelo Platania, Laura Molino, Anna Santacaterina, Marilena Mattace Raso, Pasquale Frosina, Roberto Ianni, Michele Bono, Luca Liardo, Salvatore Bonanno, Leonarda La Paglia, Manuela Federico, Ivan Fazio, Gianluca Mortellaro, Giuseppe Ferrera, Antonella Tripoli, Giovanna Evangelista, Antonino Daidone, Giampaolo Biti, Marco Badalamenti, Lucia Ognibene, Alberto Cacciola, Silvana Parisi, Stefano Pergolizzi
AIM: To conduct a survey among Sicilian centers of radiation oncology belonging to Associazione Italiana di Radioterapia ed Oncologia Clinica (AIRO), to record the different methods of integration of radio-chemotherapy both in neoadjuvant and adjuvant settings, to evaluate surgical procedures in relation to the sphincter preservation and to report the different toxicity profiles of the treatment strategies. METHODS: A questionnaire was sent at the end of 2017 to all the radiation oncology centers of Sicily region in order to collect the data from individual centers and the treatment characteristics retrospectively over the previous 5 years, from 2012 to 2016...
February 26, 2019: La Radiologia Medica
Angeliki Kotti, Annica Holmqvist, Maria Albertsson, Xiao-Feng Sun
OBJECTIVES: Increasing evidence suggests that statins may have antitumor effects but their role in rectal cancer appears inconclusive. The aim of this study was to investigate whether statins may have an impact on survival of older and younger patients with rectal cancer. MATERIALS AND METHODS: This study included 238 patients ≥70 years and 227 patients <70 years old, from the Southeast Health Care Region of Sweden, who were diagnosed with rectal adenocarcinoma between 2004 and 2013...
January 25, 2019: Journal of Geriatric Oncology
Alice M Couwenberg, Johannes P M Burbach, Martijn P W Intven, Esther C J Consten, Anandi H W Schiphorst, Anke B Smits, Niels A T Wijffels, Joost T Heikens, Miriam Koopman, Wilhemina M U van Grevenstein, Helena M Verkooijen
BACKGROUND: Neoadjuvant chemoradiation with delayed surgery (CRT-DS) and short-course radiotherapy with immediate surgery (SCRT-IS) are two commonly used treatment strategies for rectal cancer. However, the optimal treatment strategy for patients with intermediate-risk rectal cancer remains a discussion. This study compares quality of life (QOL) between SCRT-IS and CRT-DS from diagnosis until 24 months after treatment. METHODS: In a prospective colorectal cancer cohort, rectal cancer patients with clinical stage T2-3N0-2M0 undergoing SCRT-IS or CRT-DS between 2013 and 2017 were identified...
January 18, 2019: Acta Oncologica
Brandon C Chapman, Karyn Goodman, Patrick Hosokawa, Ana Gleisner, Michelle L Cowan, Elisa Birnbaum, Jon D Vogel
BACKGROUND: Randomized controlled trials have demonstrated comparable survival outcomes for short-course (SCRT) and long-course neoadjuvant radiotherapy (LCRT) in patients with rectal cancer. METHODS: Using the National Cancer Data Base (2004-2015), a propensity score was used to match 188 patients with rectal cancer receiving SCRT to 376 patients receiving LCRT. Perioperative, oncologic, and survival outcomes were compared. RESULTS: Patient and clinical tumor characteristics were similar between groups...
January 13, 2019: Journal of Surgical Oncology
Amy Downing, Adam W Glaser, Paul J Finan, Penny Wright, James D Thomas, Alexandra Gilbert, Jessica Corner, Mike Richards, Eva Ja Morris, David Sebag-Montefiore
BACKGROUND: There is a growing population of cancer survivors at risk of treatment-related morbidity. This study investigates how potentially curative rectal cancer treatment influences subsequent function and health-related quality of life (HRQL) using data from a large-scale survey of patient-reported outcomes. METHODS: All individuals 12-36 months post-diagnosis of colorectal cancer in England were sent a survey in January 2013. The survey responses were linked with cancer registration, hospital admissions and radiotherapy data through the National Cancer Registration and Analysis Service...
December 13, 2018: International Journal of Radiation Oncology, Biology, Physics
Ti-Hao Wang, Chia-Jen Liu, Tze-Fan Chao, Tzeng-Ji Chen, Yu-Wen Hu
AIM: To investigate second primary malignancy (SPM) risk after radiotherapy in rectal cancer survivors. METHODS: We used Taiwan's National Health Insurance Research Database to identify rectal cancer patients between 1996 and 2011. Surgery-alone, preoperative short course, preoperative long course, and post-operative radiotherapy groups were defined. The overall and site-specific SPM incidence rates were compared among the radiotherapy groups by multivariate Cox regression, taking chemotherapy and comorbidities into account...
October 28, 2018: World Journal of Gastroenterology: WJG
Roberta Fusco, Mario Sansone, Vincenza Granata, Robert Grimm, Ugo Pace, Paolo Delrio, Fabiana Tatangelo, Gerardo Botti, Antonio Avallone, Biagio Pecori, Antonella Petrillo
PURPOSE: To assess preoperative short-course radiotherapy (SCR) tumor response in locally advanced rectal cancer (LARC) by means of Standardized Index of Shape (SIS) by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) parameters derived from diffusion-weighted MRI (DW-MRI). MATERIALS AND METHODS: Thirty-four patients with LARC who underwent MRI scans before and after SCR followed by delayed surgery, retrospectively, were enrolled...
October 25, 2018: Abdominal Radiology
Anna Gasinska, Beata Biesaga, Anna Janecka Widla, Zbigniew Darasz
BACKGROUND/AIMS: This is a retrospective analysis of 103 patients having locally advanced rectal cancer who received short-course radiotherapy (SCRT). The objective of the study was to check whether a polymorphism in the RAD51 gene (135 G>C), Ku70 protein expression, and tumor microenvironment: proliferation rate measured by BrdUrdLI and Ki-67LI, hypoxia (glucose transporter-1 expression), P53 protein expression, and DNA ploidy can influence DNA repair capacity, the factors contributing to patient overall survival (OS) and the incidence of recurrences and metastases...
October 5, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Yongjun Yu, Yuwei Li, Chen Xu, Zhao Zhang, Xipeng Zhang
BACKGROUND: rectal cancer (RC) is one of the most prevalent malignancies worldwide and different preoperative radiotherapies may lead to different outcomes. This meta-analysis aimed to compare the effectiveness of long-course (LC) and short-course radiotherapy (SC), with or without chemotherapy, for locally advanced rectal cancer. METHODS: studies published up to March 31st 2018 were retrieved from PubMed, Medline, Cochrane and EMABSE. Randomized control or consort control trials that reported the outcomes of short or long course radiotherapy were eligible...
October 4, 2018: Revista Española de Enfermedades Digestivas
Iosief Abraha, Cynthia Aristei, Isabella Palumbo, Marco Lupattelli, Stefano Trastulli, Roberto Cirocchi, Rita De Florio, Vincenzo Valentini
BACKGROUND: This is an update of the original review published in 2007.Carcinoma of the rectum is a common malignancy, especially in high income countries. Local recurrence may occur after surgery alone. Preoperative radiotherapy (PRT) has the potential to reduce the risk of local recurrence and improve outcomes in rectal cancer. OBJECTIVES: To determine the effect of preoperative radiotherapy for people with localised resectable rectal cancer compared to surgery alone...
October 3, 2018: Cochrane Database of Systematic Reviews
R Glynne-Jones, M R Hall, A Lopes, S Pearce, V Goh, S Bosompem, J Bridgewater, I Chau, H Wasan, B Moran, L Melcher, N P West, P Quirke, W-L Wong, S Beare, N Hava, M Duggan, M Harrison
Background: Chemoradiation (CRT) or short-course radiotherapy (SCRT) are standard treatments for locally advanced rectal cancer (LARC). We evaluated the efficacy/safety of two neoadjuvant chemotherapy (NACT) regimens as an alternative prior to total mesorectal excision (TME). Methods/design: This multi-centre, phase II trial in patients with magnetic resonance imaging (MRI) defined high-risk LARC (>cT3b, cN2+ or extramural venous invasion) randomised patients (1:1) to FOLFOX + Bevacizumab (Arm 1) or FOLFOXIRI + bevacizumab (Arm 2) every 14 days for 6 cycles prior to surgery...
September 2018: Heliyon
Bin Ma, Peng Gao, Yongxi Song, Xuanzhang Huang, Hongchi Wang, Qingzhou Xu, Shan Zhao, Zhenning Wang
BACKGROUND: To assess whether preoperative short-course radiotherapy (PSRT) could be the treatment of choice compared to preoperative long-course chemoradiotherapy (PLCRT) METHODS: The PubMed, Embase, and Web of Science Databases were searched to conduct a systematic review and meta-analysis. Perioperative and survival outcomes between PSRT and PLCRT were selected as end points for our meta-analysis. In addition, health-related quality-of-life outcomes were also systematically reviewed between PSRT and PLCRT...
December 2018: Clinical Colorectal Cancer
I Masson, G Delpon, V Vendrely
Intensity-modulated radiation therapy is recommended in anal squamous cell carcinoma treatment and is increasingly used in rectal cancer. It adapts the dose to target volumes, with a high doses gradient. Intensity-modulated radiation therapy allows to reduce toxicity to critical normal structures and to consider dose-escalation studies or systemic treatment intensification. Image-guided radiation therapy is a warrant of quality for intensity-modulated radiation therapy, especially for successful delivery of the dose as planned...
October 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Chris Beekman, Baukelien van Triest, Suzanne van Beek, Jan-Jakob Sonke, Peter Remeijer
PURPOSE: Day-to-day shape variation in the rectum CTV results in considerable geometric uncertainties during rectal cancer radiotherapy. To ensure coverage a large CTV-to-PTV margin is required. The purpose of this study was to increase the accuracy of treatment delivery by building a population based library of planning CTVs for rectal cancer patients and to evaluate its potential for rectum PTV margin and PTV volume reduction. METHODS: Analysis was done retrospectively on 33 early-stage rectal cancer patients with daily repeat CTs who received short-course pre-operative radiotherapy in 5 fractions of 5 Gy...
October 2018: Medical Physics
Simon Gollins, Nicholas West, David Sebag-Montefiore, Shabbir Susnerwala, Stephen Falk, Nick Brown, Mark Saunders, Philip Quirke, Ruby Ray, Philip Parsons, Gareth Griffiths, Tim Maughan, Richard Adams, Chris Hurt
BACKGROUND: Neoadjuvant chemotherapy (NAC) allows earlier treatment of rectal cancer micro-metastases but is not standard of care. There are currently no biomarkers predicting long-term progression-free survival (PFS) benefit from NAC. PATIENTS AND METHODS: In this single arm phase II trial, patients with non-metastatic magnetic resonance imaging (MRI)-defined operable rectal adenocarcinoma at high risk of post-operative metastatic recurrence, received 8 weeks of oxaliplatin/fluorouracil NAC then short-course preoperative radiotherapy (SCPRT) before immediate surgery...
September 2018: British Journal of Cancer
D P Schaap, A Ogura, J Nederend, M Maas, J S Cnossen, G J Creemers, I van Lijnschoten, G A P Nieuwenhuijzen, H J T Rutten, M Kusters
BACKGROUND: Lateral nodal disease in rectal cancer remains a subject of debate and is treated differently in the East and the West. The predictive value of lateral lymph node and MRI-detected extramural vascular invasion (mrEMVI) features on oncological outcomes was assessed in this study. METHODS: In this retrospective cohort study, data on patients with cT3-4 rectal cancer within 8 cm from the anal verge were considered over a 5-year period (2009-2013). Lateral lymph node size, malignant features and mrEMVI features were evaluated and related to oncological outcomes...
August 6, 2018: British Journal of Surgery
Clayton A Smith, Lisa A Kachnic
Locally advanced rectal cancer (LARC) carries higher risks of local and distant recurrence when treated with surgical resection alone. Multiple treatment strategies have been investigated to reduce recurrence risk and improve survival. Currently, there are 3 primary strategies for managing LARC: (1) preoperative long-course radiotherapy (RT) combined with radiosensitizing chemotherapy, which is better tolerated than postoperative chemoradiotherapy and provides tumor downstaging and improved pathologic complete response (pCR), followed by postoperative chemotherapy; (2) preoperative short-course RT alone as an alternative strategy for reducing the risk of local recurrence, followed by adjuvant postoperative chemotherapy; and (3) total neoadjuvant therapy with induction chemotherapy followed by chemoradiotherapy to improve pCR and reduce the difficulty of delivering chemotherapy in the postoperative setting...
July 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Xin Wang, Bobo Zheng, Xinlan Lu, Ruhai Bai, Linlin Feng, Quan Wang, Yan Zhao, Shuixiang He
BACKGROUND AND PURPOSE: The role of preoperative short-course radiotherapy (SCRT) in rectal cancer treatment, when compared to long-course radiochemotherapy (LCRT), is still controversial. Thus the meta-analysis with trial sequential analysis (TSA) was performed to evaluate the long-term survival of SCRT and LCRT as therapeutic regimens for locally advanced rectal cancer. MATERIAL AND METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched up to August 2017 for eligible studies...
2018: PloS One
Daniëlle D Huijts, Julia T van Groningen, Onno R Guicherit, Jan Willem T Dekker, Leti van Bodegom-Vos, Esther Bastiaannet, Johannes A Govaert, Michel W Wouters, Perla J Marang-van de Mheen
Background: It is unclear whether emergency weekend colon and rectal cancer surgery are associated with worse outcomes (ie, weekend effect) because previous studies mostly used administrative data, which may insufficiently adjust for case-mix. Materials and Methods: Prospectively collected data from the 2012-2015 Dutch ColoRectal Audit (n=5,224) was used to examine differences in 30-day mortality and severe complication and failure-to-rescue rates for emergency weekend (Saturday and Sunday) versus Monday surgery, stratified for colon and rectal cancer...
June 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Haoyan Wu, Chao Fang, Libin Huang, Chuanwen Fan, Cun Wang, Lie Yang, Yuan Li, Zongguang Zhou
BACKGROUND: The safety and efficacy of preoperative short-course radiotherapy had been verified in rectal cancer. However, the timing of surgery after radiation had not been well defined. Thus, we performed this meta-analysis to compare the interval time of surgery after short-course radiotherapy in rectal cancer: immediate surgery (<4 weeks) vs delayed surgery (>4 weeks). METHODS: We searched the PubMed, EMBASE, MEDLINE, and Cochrane Library database. The primary endpoints were survival rates and pathological outcomes, and the second endpoints included sphincter preservation rate, R0 resection rate and postoperative complications...
August 2018: International Journal of Surgery
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