Combined modality therapy of resectable rectal cancer: current approaches

Abstract

There are two conventional treatments for clinically resectable rectal cancer. First is surgery and, if the tumor is in stage T3 or N1-2, this is followed by postoperative combined modality therapy. The second is preoperative combined modality therapy followed by surgery and postoperative combined modality therapy if the tumor is classified at ultrasound as uT3-4 or N+. A number of new chemotherapeutic agents have been developed for the treatment of patients with colorectal cancer. Ongoing phase I and II trials are examining the use of these new chemotherapeutic agents in combination with pelvic radiation therapy, most commonly in the preoperative setting; early results suggest that the complete response rates are higher. Based on results from phase I and II trials, the standard regimen for patients who receive combined modality therapy is continuous infusion 5-fluorouracil (5-FU) and pelvic radiation. Regimens using CPT-11 or oxaliplatin-based combined modality therapy plus either continuous infusion 5-FU or capecitibine are under active development.

The value of endorectal ultrasonography in rectal cancer staging

“…Ova pojava je opisana u literaturi i procenat kompletne histoloske regresije se krece u rasponu 5 do 15%, no to zavisi pre svega od vrste i doze primenjene zracne terapije, vrste citostatika koji je kombinovan sa zracnorn terapijom i naravno stadijuma bolesti pacijenta [2,3]. Ova pojava je opisana u literaturi i procenat kompletne histoloske regresije se krece u rasponu 5 do 15%, no to zavisi pre svega od vrste i doze primenjene zracne terapije, vrste citostatika koji je kombinovan sa zracnorn terapijom i naravno stadijuma bolesti pacijenta [2,3].…”

DNA preference of indenoisoquinolines: a computational approach

“…11 The semi-synthetic derivatives of CPT such as topotecan (TPT; Hycamine, GlaxoSmithKline) and irinotecan (Campostar, Pfizer) are currently available for use in the market. [12][13][14] Although these derivatives are more water-soluble and potent for hTopoIB inhibition compared to the parent molecule, they contain a lactone ring that causes a stability problem for the molecule through its lactone-carboxylate interconversion under high pH conditions. 15,16 Moreover, the carboxylate form is not effective since hTopoIB is inhibited only by the lactone form which forms strong interactions with the Lys532 residue.…”