Neoadjuvant oral vs. infusional chemoradiotherapy on locally advanced rectal cancer: Prognostic factors

Conde, S.; Borrego, Margarida; Teixeira, Tânia; Teixeira, Rui; Sá, Anabela; Soares, Paula

doi:10.1016/j.rpor.2012.07.010

Cited by 5 publications

(4 citation statements)

References 38 publications

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“…Treatment interruptions are another important indicator of quality that can have a marked effect on outcomes. 14 – 16 The usual causes of interruptions include machine malfunction or maintenance, toxicity, holidays, or unplanned quality control checks. In such cases, it is essential to have a protocol in place to compensate for the interruption.…”

Section: Discussionmentioning

confidence: 99%

Preoperative radiotherapy for rectal cancer: a comparative study of quality control adherence at two cancer hospitals in Spain and Poland

Fundowicz

Maciá

Marin

et al. 2014

Radiology and Oncology

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BackgroundWe performed a clinical audit of preoperative rectal cancer treatment at two European radiotherapy centres (Poland and Spain). The aim was to independently verify adherence to a selection of indicators of treatment quality and to identify any notable inter-institutional differences.MethodsA total of 162 patients, in Catalan Institute of Oncology (ICO) 68 and in Greater Poland Cancer Centre (GPCC) 94, diagnosed with locally advanced rectal cancer and treated with preoperative radiotherapy or radio-chemotherapy were included in retrospective study. A total of 7 quality control measures were evaluated: waiting time, multidisciplinary treatment approach, portal verification, in vivo dosimetry, informed consent, guidelines for diagnostics and therapy, and patient monitoring during treatment.ResultsSeveral differences were observed. Waiting time from pathomorphological diagnosis to initial consultation was 31 (ICO) vs. 8 (GPCC) days. Waiting time from the first visit to the beginning of the treatment was twice as long at the ICO. At the ICO, 82% of patient experienced treatment interruptions. The protocol for portal verification was the same at both institutions. In vivo dosimetry is not used for this treatment localization at the ICO. The ICO utilizes locally-developed guidelines for diagnostics and therapy, while the GPCC is currently developing its own guidelines.ConclusionsAn independent external clinical audit is an excellent approach to identifying and resolving deficiencies in quality control procedures. We identified several procedures amenable to improvement. Both institutions have since implemented changes to improve quality standards. We believe that all radiotherapy centres should perform a comprehensive clinical audit to identify and rectify deficiencies.

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Section: Discussionmentioning

confidence: 99%

Preoperative radiotherapy for rectal cancer: a comparative study of quality control adherence at two cancer hospitals in Spain and Poland

Fundowicz

Maciá

Marin

et al. 2014

Radiology and Oncology

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“…The standard association for LCRCT is with 5-FU in continuous infusion, 14 but some evidence reported the equivalence of oral capecitabine. 27,28 The efficacy of the integration of oxaliplatin into the concurrent schedules is still controversial; some evidence suggests no benefit from such association due to increased toxicity without a significant improvement of pCR rates. That was basically reported by the STAR-01 29 and the ACCORD 12 30 trials, whereas the German trial (CAO/ARO/AIO-04) 31 reported on significant improvement for the oxaliplatin-based arm.…”

Section: Concomitant Chemotherapymentioning

confidence: 99%

Current treatment of rectal cancer adapted to the individual patient

Cerezo

Ciria

Arbea

et al. 2013

Reports of Practical Oncology & Radiotherapy

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Preoperative radiochemotherapy and total mesorectal excision surgery is a recommended standard therapy for patients with locally advanced rectal cancer. However, some subgroups of patients benefit more than others from this approach. In order to avoid long-term complications of radiation and chemotherapy, efforts are being made to subdivide T3N0 stage using advanced imaging techniques, and to analyze prognostic factors that help to define subgroup risk patients. Long-course radiochemotherapy has the potential of downsizing the tumor before surgery and may increase the chance of sphincter preservation in some patients. Short-course radiotherapy (SCRT), on the other hand, is a practical schedule that better suits patients with intermediated risk tumors, located far from the anal margin. SCRT is also increasingly being used among patients with disseminated disease, before resection of the rectal tumor. Improvements in radiation technique, such as keeping the irradiation target below S2/S3 junction, and the use of IMRT, can reduce the toxicity associated with radiation, specially long-term small bowel toxicity.

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“…Consiste en quimioterapia con base en fluoropirimidinas [16][17] , que se administra con dosis biológicas efectivas de radioterapia concomitante [14][15]18 . La efectividad se demuestra con el mayor tiempo libre de enfermedad, disminución del volumen tumoral, de la estadificación inicial y de la tasa de recaída local y regional, aunque no se ha demostrado aumento de la supervivencia global [12][13]19 .…”

Section: Introductionunclassified

Desenlaces del manejo no quirúrgico posterior a neoadyuvancia del cáncer localmente avanzado de recto

Torres-Mesa

Oliveros

Mesa

et al. 2014

Revista Colombiana de Cancerología

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Neoadjuvant oral vs. infusional chemoradiotherapy on locally advanced rectal cancer: Prognostic factors

Cited by 5 publications

References 38 publications

Preoperative radiotherapy for rectal cancer: a comparative study of quality control adherence at two cancer hospitals in Spain and Poland

Preoperative radiotherapy for rectal cancer: a comparative study of quality control adherence at two cancer hospitals in Spain and Poland

Current treatment of rectal cancer adapted to the individual patient

Desenlaces del manejo no quirúrgico posterior a neoadyuvancia del cáncer localmente avanzado de recto

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