Preoperative FOLFOX in resectable locally advanced rectal cancer can be a safe and promising strategy: the R-NAC-01 study

Ichikawa, Nobuki; Homma, Shigenori; Funakoshi, Tohru; Hattori, Masahiro; Sato, Masanori; Kamiizumi, You; Omori, Kazuyoshi; Nomura, Masaru; Yokota, Ryoichi; Koike, Masahiko; Kon, Hirofumi; Takeda, Kazuki; Ishizu, Hideki; Hirose, Kunihiro; Kuraya, Daisuke; Ishikawa, Takahisa; Murata, Ryohei; Iijima, Hiroaki; Kawamata, Futoshi; Yoshida, Tadashi; Ohno, Yosuke; Minagawa, Nozomi; Takahashi, Norihiko; Taketomi, Akinobu

doi:10.1007/s00595-019-01788-8

Cited by 7 publications

(4 citation statements)

References 32 publications

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“…Вместе с тем, по мнению N. Ichikawa и соавт. [16], проведение НАХТ в количестве более 4 циклов у пациентов, не отвечающих на лечение, может привести к прогрессированию опухолевого процесса. У таких пациентов НАХТ является бесполезной опцией, увеличивающей интервал между первичным стадированием и хирургическим вмешательством, что говорит о необходимости проведения через каждые 4 цикла контрольного обследования для исключения больных с отсутствием опухолевого ответа.…”

Section: нахт с двухкомпонентными режимами химиотерапииunclassified

“…Частота полных ответов, суррогатный показатель эффективности лечения при проведении НАХТ с использовани-ем оксалиплатина в сочетании с препаратами фторпиримидинового ряда, колеблется в широких пределах [13-16, 20, 27, 33, 35-37] -от 0% в исследовании N. Ichikawa и соавт. [16] при использовании 4 циклов химиотерапии в режиме FOLFOX6 до 17,8% в исследовании S. ALGizawy и соавт. [27], в котором применяли 6 циклов НАХТ в том же режиме и исключали пациентов с T4b-категорией опухоли.…”

Section: нахт с двухкомпонентными режимами химиотерапииunclassified

“…Профилактика отдаленных метастазов у больных местнораспространенным РПК с наличием факторов неблагоприятного прогноза -глубина инвазии ≥cT3с, наличие пораженных лимфатических узлов, вовлечение циркулярной границы резекции по данным магнитно-резонансной терапии (мртЦГР+), наличие экстрамуральной сосудистой инвазии (ЭСИ+) -в настоящее время является одной из ключевых проблем онкоколопроктологии. В этой связи в последние годы все большее распространение получают подходы, основанные на включении системной лекарственной терапии в схему неоадъювантного лечения в виде индукционной [8,9], консолидирующей [6,10], тотальной неоадъювантной терапии [11,12], а также проведении только химиотерапии без использования ЛТ как таковой [9,11,[13][14][15][16]. Проведение неоадъювантной химиотерапии (НАХТ) вместо ЛТ дает возможность избежать лучевых реакций и повреждений, а также раньше начать системное лечение, направленное не только на первичную опухоль, но и на ее возможные микрометастазы.…”

Section: Introductionunclassified

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Neoadjuvant chemotherapy for treatment patients with rectal cancer with adverse prognostic factors: A review

Nevolskikh

Avdeenko²,

Belokhvostova³

et al. 2022

J. Mod. Onco.

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Rectal cancer (RC) is one of the leading tumor location in the structure of the incidence of malignant neoplasms in the Russian Federation and the world. And the standard approach to the treatment of patients with locally advanced forms of RC is preoperative chemo-radiotherapy (CRT) with delayed surgery. The use of such sort of approach in the recent decades has led to the reduction of the frequency of local recurrence up to 10% and even less. However, approximately a third of patients die of distant metastases. In this regard, one of the main tasks in the treatment of patients with locally advanced forms of RC with adverse prognostic factors is the prevention of distant metastasis formation. Early initiation of the systemic therapy before surgery is aimed at solving this issue. Conducting neoadjuvant chemotherapy (NCT) instead of CRT in RC treatment allows to avoid radiation reactions and injuries, occurring in some patients. Two-component oxaliplatin-containing regimens are the most well studied types of NCT in the treatment of patients with non-metastatic RC. In this connection, despite the differences in the treatment regimens and the number of cycles, a good tolerability of the method as well as no effect on the frequency of postoperative complications and in general a satisfactory results comparable to the effects of CRT were observed. The use of NCT in combination with targeted treatment modalities as well as three-component chemotherapy regimens are promising and encouraging treatment options for patients with RC with adverse prognostic factors.

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Section: нахт с двухкомпонентными режимами химиотерапииunclassified

Section: Introductionunclassified

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Neoadjuvant chemotherapy for treatment patients with rectal cancer with adverse prognostic factors: A review

Nevolskikh

Avdeenko²,

Belokhvostova³

et al. 2022

J. Mod. Onco.

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“…The shortest interval was 2-4 weeks [44]. Sixteen studies [44,46,[54][55][56][57][58][59][60][61][62][63][64][65][66]69] report a mean anastomotic leak rate of 6.8%.…”

Section: Surgerymentioning

confidence: 99%

Neo-adjuvant chemotherapy alone for the locally advanced rectal cancer: a systematic review

et al. 2020

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Neo-adjuvant chemoradiation (NA-CRT) is the standard of management for the locally advanced rectal cancer (LARC), achieving very low rates of local recurrence (LR). However, NA-CRT fails to control distant recurrence and improve survival, whilst it is associated with increased postoperative morbidity and increased acute and late toxicity. In recent years, neoadjuvant chemotherapy (NACTx) appears in the literature as an alternative to NA-CRT in patients with LARC. In the present study, the authors review all current evidence on the specific subject. Following a systematic search of the literature, 25 studies were identified reporting on short-or long-term outcomes of NACTx for LARC. Seventeen studies were prospective or retrospective series, and 8 comparative. Of the comparative studies, one was a randomized control trial (RCT) comparing NACTx to NA-CRT and to the combination of NACTx/NA-CRT, and another a non-randomized study comparing NACTx to NA-CRT. Chemotherapeutic regimens were 5-fluoropyrimidine and oxaliplatin based. In some of them, irinotecan or/and bevacizumab was added. A pooled analysis showed that NACTx is associated with a mean anastomotic leak rate of 6.8%. In the RCT, postoperative morbidity and overall toxicity was significantly less in the NACTx group. Mean T downstaging (ypStage 0-I) was 49.6%, mean N downstaging 69.6% and mean pathologic complete response (pCR) 10.7%. The RCT showed an inferior pCR rate after NACTx than after NA-CRT, but similar rates of T downstaging. Mean LR was 8.6% and mean distant recurrence 17.2%. Satisfactory survival rates are reported by several studies. NACTx seems to be an alternative to NA-CRT for patients with LARC, associated with low anastomotic leak, adequate tumour downstaging, low LR and rather high survival rates. Further data deriving from high-quality studies are necessary to assess safety and efficacy of NACTx as a substitute to NA-CRT, for at least a subset of patients with LARC.

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A prospective, single-arm, multicenter trial of neoadjuvant chemotherapy with mFOLFOX6 plus panitumumab without radiotherapy for locally advanced rectal cancer

Toritani

Watanabe

Suwa

et al. 2020

Int J Colorectal Dis

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Preoperative FOLFOX in resectable locally advanced rectal cancer can be a safe and promising strategy: the R-NAC-01 study

Cited by 7 publications

References 32 publications

Neoadjuvant chemotherapy for treatment patients with rectal cancer with adverse prognostic factors: A review

Neoadjuvant chemotherapy for treatment patients with rectal cancer with adverse prognostic factors: A review

Neo-adjuvant chemotherapy alone for the locally advanced rectal cancer: a systematic review

A prospective, single-arm, multicenter trial of neoadjuvant chemotherapy with mFOLFOX6 plus panitumumab without radiotherapy for locally advanced rectal cancer

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