Preliminary results of a cohort study of induction chemotherapy‐based treatment for locally recurrent rectal cancer. BJS 2018; 105: 447-452.
Published: 23rd November 2017
Authors: D. M. G. I. van Zoggel, S. J. Bosman, M. Kusters, G. A. P. Nieuwenhuijzen, J. S. Cnossen, G. J. Creemers et al.
A significant number of patients treated for locally recurrent rectal cancer have local or systemic failure, especially after incomplete surgical resection. Neoadjuvant treatment regimens in patients who have already undergone preoperative (chemo)radiotherapy for the primary tumour are limited. The objective of the present study was to evaluate the influence of a neoadjuvant regimen incorporating induction chemotherapy (ICT) in patients with locally recurrent rectal cancer who had preoperative (chemo)radiotherapy for the primary cancer or an earlier local recurrence.
Patients were treated with a sequential neoadjuvant regimen including three or four cycles of 5‐fluorouracil and oxaliplatin‐containing chemotherapy. When no progressive disease was found at evaluation, neoadjuvant treatment was continued with chemoradiation therapy (CRRT) using 30 Gy with concomitant capecitabine. If there was a response to ICT, the patient was advised to continue with systemic chemotherapy after CRRT as consolidation chemotherapy while waiting for resection. These patients were compared with patients who received CRRT alone in the same time interval.
Of 58 patients who had ICT, 32 (55 per cent) had surgery with clear resection margins, of whom ten (17 per cent) exhibited a pathological complete response (pCR). The remaining 26 patients had 23 R1 and three R2 resections. In 71 patients who received CRRT, a similar rate of R0 (35 patients) and R1 (36) resection was found (
The incorporation of ICT in neoadjuvant regimens for locally recurrent rectal cancer is a promising strategy.Full text
You may also be interested in
Authors: C. T. Aquina, A. Z. Becerra, Z. Xu, C. F. Justiniano, K. Noyes, J. R. T. Monson et al.
Notes: Non‐operative management better
Cost‐effectiveness of liver transplantation in patients with colorectal metastases confined to the liver.
Authors: G. M. W. Bjørnelv, S. Dueland, P.‐D. Line, P. Joranger, Å. A. Fretland, B. Edwin et al.
Notes: Not for every country
Systematic review of treatment intensification using novel agents for chemoradiotherapy in rectal cancer. BJS 2018; 105: 1553-1572.
Authors: R. Clifford, N. Govindarajah, J. L. Parsons, S. Gollins, N. P. West, D. Vimalachandran et al.
Notes: Promising agents coming
Authors: R. Ahl, P. Matthiessen, X. Fang, Y. Cao, G. Sjolin, R. Lindgren et al.
Notes: Reduces mortality
Authors: H. Elfeki, H. M. Larsen, K. J. Emmertsen, P. Christensen, M. Youssef, W. Khafagy et al.
Notes: Sigmoid resection associated with bowel dysfunction
Authors: J. Segelman, C. Buchli, A. Svanström Röjvall, P. Matthiessen, S. Arver, M. Bottai et al.
Notes: Ovarian androgens reduced
Randomized clinical trial
Randomized clinical trial of short or long interval between neoadjuvant chemoradiotherapy and surgery for rectal cancer. BJS 2018; 105: 1417-1425.
Authors: E. Akgun, C. Caliskan, O. Bozbiyik, T. Yoldas, M. Sezak, S. Ozkok et al.
Notes: Worth waiting
Authors: M. Baré, L. Mora, N. Torà, M. J. Gil, I. Barrio, P. Collera et al.
Notes: Defines risk
Preoperative oral care and effect on postoperative complications after major cancer surgery. BJS 2018; 105: 1688-1696.
Authors: M. Ishimaru, H. Matsui, S. Ono, Y. Hagiwara, K. Morita, H. Yasunaga et al.
Notes: Preoperative dental care reduces postoperative pneumonia
Prognostic implications of MRI‐detected lateral nodal disease and extramural vascular invasion in rectal cancer.
Authors: D. P. Schaap, A. Ogura, J. Nederend, M. Maas, J. S. Cnossen, G. J. Creemers et al.
Notes: Defines recurrence risk
Multicentre international trial of laparoscopic lavage for Hinchey III acute diverticulitis (LLO Study).
Authors: G. A. Binda, M. A. Bonino, G. Siri, S. Di Saverio, G. Rossi, R. Nascimbeni et al.
Notes: Successful in the majority