Neoadjuvant therapy for adenocarcinoma of the rectum

Read, Thomas E.; McNevin, Michael S.; Gross, E; Whiteford, Heather M.; Lewis, J. B.; Ratkin, Gary; Picus, Joel; Birnbaum, Elisa H.; Fleshman, James W.; Kodner, Ira J.; Myerson, Robert J.

doi:10.1007/bf02234323

Cited by 71 publications

(56 citation statements)

References 42 publications

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“…Preoperative radiotherapy is superior to the postoperative radiotherapy (Sauer et al, 2004). With the wide application of radiotherapy in rectal cancer, more and more studies have found clinical efficacy and adverse effects of radiotherapy showed significant individual difference (Read et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

DNA Repair Gene Polymorphisms Do Not Predict Response to Radiotherapy-Based Multimodality Treatment of Patients with Rectal Cancer: a Meta-analysis

Guo

Yang²,

Pei³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: : A number of association studies have been carried out to investigate the relationship between genetic polymorphisms in DNA repair genes and response to radiotherapy-based multimodality treatment of patients with rectal cancer. However, their conclusions were inconsistent. The objective of the present study was to assess the role of DNA repair gene genetic polymorphisms in predicting genetic biomarkers of the response in rectal cancer patients treated with neoadjuvant chemoradiation. Materials and Methods: Studies were retrieved by searching the PubMed database, Cochrane Library, Embase, and ISI Web of Knowledge. We conducted a meta-analysis to evaluate the association between genetic polymorphisms and the response in rectal cancer treated with neoadjuvant chemoradiation by checking odds ratios (ORs) and 95% confidence intervals (CIs). Results: Data were extracted from 5 clinical studies for this meta-analysis. The results showed that XRCC1 RS25487, XRCC1 RS179978, XRCC3 RS861539, ERCC1 RS11615 and ERCC2 RS13181 were not associated with the response in the radiotherapy-based multimodality treatment of patients with rectal cancer (p>0.05). Conclusions: This study shows that DNA repair gene common genetic polymorphisms are not significantly correlated with the radiotherapy-based multimodality treatment in rectal cancer patients.

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Section: Introductionmentioning

confidence: 99%

DNA Repair Gene Polymorphisms Do Not Predict Response to Radiotherapy-Based Multimodality Treatment of Patients with Rectal Cancer: a Meta-analysis

Guo

Yang²,

Pei³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Prior studies demonstrated that the DS rates for unselected patients with rectal cancer treated with CRT was 45% (range, 40% to 60%), with a pCR rate of 8% to 14%. 2,7,8 By selecting a population likely to respond to standard CRT using TYMS genotyping, DS and ypT0 rates among patients with germline TSER *2/*2 or TSER *2/*3 were 64.4% and 20%, respectively. The DS rate was significantly better than the predicted DS rate of 45% (P ϭ .0001) and also higher than the 60% rate observed by Villafranca et al 27 in that particular subset of patients.…”

Section: Discussionmentioning

confidence: 99%

“…The two-stage study design proposed by Simon 33 was used for sample size calculations for both groups: good-risk genotype (study 1) and poor-risk genotype (study 2). On the basis of both local and literature data, the DS rate for the general T3/T4 population was set at 45% with conventional therapy, 7,8,10,12 and the predicted DS rate for good-risk TYMS was 60%.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…2,3 Preoperative chemoradiotherapy resulted in tumor T stage downstaging (DS) rates of approximately 45% (40% to 60%) [7][8][9][10][11][12] and a pathologic complete response (pCR) rate of 15% to 30%.…”

Section: Introductionmentioning

confidence: 99%

“…3, [8][9][10][11][12][13] Pathologic DS or a pCR after preoperative CRT has been correlated with improved survival, decreased recurrence, and a higher rate of sphincterpreserving surgeries.…”

Section: Introductionmentioning

confidence: 99%

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Thymidylate Synthase Genotype-Directed Neoadjuvant Chemoradiation for Patients With Rectal Adenocarcinoma

Tan

Thomas

Myerson

et al. 2011

JCO

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A B S T R A C TPurpose Downstaging (DS) of rectal cancers is achieved in approximately 45% of patients with neoadjuvant fluorouracil (FU) -based chemoradiotherapy (CRT). Polymorphisms in the thymidylate synthase gene (TYMS) had previously defined two risk groups associated with disparate tumor DS rates (60% v 22%). We conducted a prospective single-institution phase II study using TYMS genotyping to direct neoadjuvant CRT for patients with rectal cancer. Patients and MethodsPatients with T3/T4, N0-2, M0-1 rectal adenocarcinoma were evaluated for germline TYMS genotyping. Patients with TYMS *2/*2, *2/*3, or *2/*4 (good risk) were treated with standard chemoradiotherapy using infusional FU at 225 mg/m 2 /d. Patients with TYMS *3/*3 or *3/*4 (poor risk) were treated with FU/RT plus weekly intravenous irinotecan at 50 mg/m 2 . The primary end point was pathologic DS. Secondary end points included complete tumor response (ypT0), toxicity, recurrence rates, and overall survival. ResultsOverall, 135 patients were enrolled, of whom 27.4% (37 of 135) were considered poor risk. The prespecified statistical goals were achieved, with DS and ypT0 rates reaching 64.4% and 20% for good-risk and 64.5% and 42% for poor-risk patients, respectively. ConclusionTo our knowledge, this is the first study to prospectively use TYMS genotyping to direct neoadjuvant CRT in patients with rectal cancer. High rates of DS and ypT0 were achieved among both risk groups when personalized treatment was based on TYMS genotype. These results are encouraging, and further evaluation of this genotype-based strategy using a randomized study design for locally advanced rectal cancer is warranted. J Clin

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Induction Chemoradiation for Rectal Cancer

Han

Galandiuk²

2006

Arch Surg

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To review the application, outcome, and recent developments of neoadjuvant chemoradiation therapy with respect to rectal cancer. Data Sources and Study Selection: Articles written in English after 1980 selected from MEDLINE and PubMed from the National Library of Medicine. Case reports were excluded. There were no other criteria for exclusion of published information pertaining to this topic. Data Extraction and Synthesis: Articles were obtained and organized from MEDLINE and PubMed as well as the reference lists of pertinent literature. Conclusions: Published reports have demonstrated that neoadjuvant chemoradiation improves survival and decreases local recurrence in patients with stage II and III rectal cancers. It is anticipated that advances and technical developments in both chemotherapy and radiation therapy will lead to improved oncologic results with decreased toxic side effects.

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Neoadjuvant therapy for adenocarcinoma of the rectum

Cited by 71 publications

References 42 publications

DNA Repair Gene Polymorphisms Do Not Predict Response to Radiotherapy-Based Multimodality Treatment of Patients with Rectal Cancer: a Meta-analysis

DNA Repair Gene Polymorphisms Do Not Predict Response to Radiotherapy-Based Multimodality Treatment of Patients with Rectal Cancer: a Meta-analysis

Thymidylate Synthase Genotype-Directed Neoadjuvant Chemoradiation for Patients With Rectal Adenocarcinoma

Induction Chemoradiation for Rectal Cancer

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