Disease Control, Survival, and Toxicity Outcome After Intensified Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: A Single-Institution Experience

Felice, Francesca De; Musio, Daniela; Magnante, Anna Lisa; Bulzonetti, Nadia; Benevento, Ilaria; Caiazzo, Rossella; Tombolini, Vincenzo

doi:10.1016/j.clcc.2016.02.006

Cited by 19 publications

(11 citation statements)

References 13 publications

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“…The use of adjuvant chemotherapy was another confounding factor identified in 12 studies. However, it did not affect DFS and/or OS in univariate or multivariate analysis across all studies [5,6,12,13,15,20,23,24,[27][28][29][30].…”

Section: Resultsmentioning

confidence: 80%

“…A total of 579 titles and abstracts were screened, with 58 studies selected for full text review, and a further nine were added after scanning the associated reference lists. Seventeen studies met the inclusion and exclusion criteria, with an overall patient number of 4785, in which 15.9% had a pCR and 84.1% a non-pCR (shown in Table 1) [4][5][6][11][12][13]15,16,20,[22][23][24][25][26][27][28][29]. There were 12 retrospective studies [4,[11][12][13]16,20,22,[24][25][26][27][28], four prospective observational studies [5,6,15,29] and one randomized controlled trial [23] comparing preoperative CRT with postoperative CRT.…”

Section: Resultsmentioning

confidence: 99%

“…Prognostic markers such as ypN, LVI and PNI are commonly used to assess patient's risk of recurrence and therefore negate recommendation for adjuvant chemotherapy. However inconsistent reports on the significance of these markers to predict patient's prognosis is a concern [11- 13,15,22,23,29]. By comparing the pooled HR results for each covariate, no response has the highest HR of 2.97, compared with the LVI HR of 1.4, the ypN HR of 2.2 and the PNI HR of 2.3.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of tumour regression grade in locally advanced rectal cancer: a systematic review and meta‐analysis

et al. 2018

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Section: Resultsmentioning

confidence: 80%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prognostic value of tumour regression grade in locally advanced rectal cancer: a systematic review and meta‐analysis

et al. 2018

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“…e different outcomes from the previous studies could be due to variations in the type of regimens used (FOLFOX vs. XELOX, etc.) for adjuvant and neoadjuvant (chemoradiotherapy) therapy, duration of therapy, and dosage in an attempt to balance between patient treatment compliance and achieving disease-free survival [18,20,[27][28][29][30][31][32][33]. is implies…”

Section: Discussionmentioning

confidence: 99%

Variability of Oxaliplatin-Induced Neuropathic Pain Symptoms in Each Cycle and Its Implications on the Management of Colorectal Cancer Patients: A Retrospective Study in South Western Sydney Local Health District Hospitals, Sydney, Australia

Gebremedhn

Shortland

Mahns

2019

Journal of Oncology

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Oxaliplatin-induced neuropathic pain limits treatment compliance. However, the variability of neuropathic pain symptoms in each cycle for individual patients and the impacts on treatment compliance remain untested. Data from 322 adult patients who received oxaliplatin-based chemotherapy were extracted based on pattern of chemotherapy, adverse events, and patient survival. Cox regression and survival analyses were employed. Seventy-eight percent of patients developed neuropathic pain that oscillated between a complete absence and presence on a cycle-by-cycle basis. Consequently, the presence of neuropathy in one cycle did not predict the incidence of neuropathy in subsequent cycles. This implies that neuropathic pain need not be a sufficient criterion to reduce, delay, or cease chemotherapy. In the case of multiple system adverse events during combined drug treatment, the responsible cause for dose reduction was not identified. Cox regression analysis revealed that middle age (61–78 years old,P=0.003) and oxaliplatin cumulative dose <850 mg/m2(P=0.002) were associated with patient mortality. Completion of chemotherapy (8 cycles) and cumulative dose >850 mg/m2of oxaliplatin prolonged the median survival time by 8 and 5 months, respectively. As oxaliplatin-induced neuropathic pain fluctuates across cycles in a manner that varies from patient-to-patient, current assumptions on the predictive nature of the emergence of neuropathy (and its impact on treatment compliance) need to be reconsidered. Detailed patient-by-patient analysis of adverse events should be applied to future studies in order to determine the efficacy of current treatments (and future interventions) and whether neuropathic pain should be retained as a criterion to vary the treatment. Additionally, when two or more system toxicities occurred in cases of combined drug treatment, the causes for drug reduction should be separately recorded.

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“…This management is effective on both pathological complete response (pCR) and locoregional control, whereas distant metastasis remains the major issue, with a reported rate of more than 30% [2,3,4]. In light of these discouraging distant metastasis data, the development of alternative strategies for LARC has become a priority.…”

Section: Introductionmentioning

confidence: 99%

The Addition of Target Therapy to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer: A Review

Benevento

Felice²,

Musio³

et al. 2017

Chemotherapy

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Currently, neoadjuvant fluoropyrimidine-based chemoradiotherapy (CRT) is standard practice in the management of locally advanced rectal cancer (LARC). In the last decade there has been a lively interest in the improvement of clinical outcomes by modifying this standard regimen by the addition of further agents. We review combinations of targeted therapies and conventional CRT currently under investigation in LARC patients.

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Disease Control, Survival, and Toxicity Outcome After Intensified Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: A Single-Institution Experience

Cited by 19 publications

References 13 publications

Prognostic value of tumour regression grade in locally advanced rectal cancer: a systematic review and meta‐analysis

Prognostic value of tumour regression grade in locally advanced rectal cancer: a systematic review and meta‐analysis

Variability of Oxaliplatin-Induced Neuropathic Pain Symptoms in Each Cycle and Its Implications on the Management of Colorectal Cancer Patients: A Retrospective Study in South Western Sydney Local Health District Hospitals, Sydney, Australia

The Addition of Target Therapy to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer: A Review

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