Systematic review of treatment intensification using novel agents for chemoradiotherapy in rectal cancer. BJS 2018; 105: 1553-1572.
Published: 12th October 2018
Authors: R. Clifford, N. Govindarajah, J. L. Parsons, S. Gollins, N. P. West, D. Vimalachandran et al.
With the well established shift to neoadjuvant treatment for locally advanced rectal cancer, there is increasing focus on the use of radiosensitizers to improve the efficacy and tolerability of radiotherapy. There currently exist few randomized data exploring novel radiosensitizers to improve response and it is unclear what the clinical endpoints of such trials should be.
A qualitative systematic review was performed according to the PRISMA guidelines using preset search criteria across the PubMed, Cochrane and Scopus databases from 1990 to 2017. Additional results were generated from the reference lists of included papers.
A total of 123 papers were identified, of which 37 were included; a further 60 articles were obtained from additional referencing to give a total of 97 articles. Neoadjuvant radiosensitization for locally advanced rectal cancer using fluoropyrimidine‐based chemotherapy remains the standard of treatment. The oral derivative capecitabine has practical advantages over 5‐fluorouracil, with equal efficacy, but the addition of a second chemotherapeutic agent has yet to show a consistent significant efficacy benefit in randomized clinical assessment. Preclinical and early‐phase trials are progressing with promising novel agents, such as small molecular inhibitors and nanoparticles.
Despite extensive research and promising preclinical studies, a definite further agent in addition to fluoropyrimidines that consistently improves response rate has yet to be found.Full text
You may also be interested in
Authors: D. S. Keller, C. Reali, A. Spinelli, M. Penna, F. Di Candido, C. Cunningham et al.
Authors: C. F. Justiniano, Z. Xu, A. Z. Becerra, C. T. Aquina, C. I. Boodry, L. K. Temple et al.
Functional outcomes from a randomized trial of early closure of temporary ileostomy after rectal excision for cancer.
Authors: C. Keane, J. Park, S. Öberg, A. Wedin, D. Bock, G. O'Grady et al.
Authors: R. J. Meinds, A. F. W. van der Steeg, C. E. J. Sloots, M. J. Witvliet, I. de Blaauw, W. G. van Gemert et al.
Influence of the level of sacrectomy on survival in patients with locally advanced and recurrent rectal cancer.
Authors: Y. C. Lau, K. Jongerius, C. Wakeman, A. G. Heriot, M. J. Solomon, P. M. Sagar et al.
Cost‐effectiveness analysis of a multicentre randomized clinical trial comparing surgery with conservative management for recurrent and ongoing diverticulitis (DIRECT trial).
Authors: H. E. Bolkenstein, G. A. de Wit, E. C. J. Consten, B. J. M. Van de Wall, I. A. M. J. Broeders, W. A. Draaisma et al.
Notes: Maintained benefits
Authors: L. Koskenvuo, N. Malila, J. Pitkäniemi, J. Miettinen, S. Heikkinen, V. Sallinen et al.
Notes: Only of benefit in men.
Authors: I. van 't Sant, W. J. van Eden, M. P. Engbersen, N. F. M. Kok, K. Woensdregt, D. M. J. Lambregts et al.
Notes: Promising staging tool
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. BJS 2019; 106: 132-141.
Authors: G. M. W. Bjørnelv, S. Dueland, P.‐D. Line, P. Joranger, Å. A. Fretland, B. Edwin et al.
Notes: Not cost effective for everyone
Authors: R. Ahl, P. Matthiessen, X. Fang, Y. Cao, G. Sjolin, R. Lindgren et al.
Notes: Reduces mortality
Bowel dysfunction after sigmoid resection for cancer and its impact on quality of life. BJS 2019; 106: 142-151.
Authors: H. Elfeki, H. M. Larsen, K. J. Emmertsen, P. Christensen, M. Youssef, W. Khafagy et al.
Notes: Substantial impairment common