Prediction of histologic regression on the basis of colonoscopic findings in patients with locally advanced middle and lower rectal cancer who receive preoperative chemoradiotherapy.
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OBJECTIVE: Preoperative chemoradiotherapy significantly reduces local recurrence in patients with locally advanced rectal cancer (LARC). Various biomarkers have been proposed as predictors of the response to chemoradiotherapy, but their reliability remains uncertain. METHODS: Surgery in combination with preoperative radiation and UFT- or S-1-based chemotherapy was used to treat 102 patients with LARC. Colonoscopy was performed before the start of chemoradiotherapy and immediately before surgery. Patients in whom the tumor mound flattened remarkably or disappeared were evaluated as responders. The endoscopic response was compared with histologic regression and the degree of tumor shrinkage. RESULTS: Histologic regression was marked in 59.8% of patients according to the Tumor Regression Grade criteria and 44.1% according to the Japanese Classification of Colorectal Carcinoma criteria. The degree of tumor shrinkage was 34.3% on average. Marked histologic regression was present in a significantly higher proportion of responders than non-responders (p = 0.01). The degree of tumor shrinkage was significantly greater in responders (38.8%) than in non-responders (30.9%; p < 0.01). T-downstaging was significantly more common among responders (64.3%) than non-responders (26.7%; p = 0.04). CONCLUSIONS: Morphologic changes on colonoscopy were associated with the degree of tumor shrinkage, histologic regression, and T-downstaging, suggesting that such findings can be used to predict the response to preoperative chemoradiotherapy. (+info)
Phase III trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection: the ARTIST trial.
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Endoscopic ultrasound: current role and future perspectives in managing rectal cancer patients.
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As therapeutic regimens for rectal cancer have seen considerable changes, an accurate staging is mandatory for choosing the adequate strategy. Locoregional staging is the decisive factor in selecting patients for neoadjuvant chemoradiation therapy and for determining the extent of surgery. Endoscopic ultrasound (endorectal ultrasound--ERUS) is a very effective method for assessing the local extent of rectal cancer, especially regarding the depth of tumor infiltration. Although a significant limitation is represented by its lower accuracy for diagnosis of lymph node metastases, this is still a point of concern for other imaging tests as well. In this review we report the current data on ERUS, presenting both its advantages and limitations, and making a comparison to other staging methods. Recent developments of the technology that might enhance staging accuracy are also discussed. (+info)
Skull base metastases from a malignant solitary fibrous tumor of the liver. A case report and literature review.
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Reoxygenation of glioblastoma multiforme treated with fractionated radiotherapy concomitant with temozolomide: changes defined by 18F-fluoromisonidazole positron emission tomography: two case reports.
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A clinical review of treatment outcomes in glioblastoma multiforme--the validation in a non-trial population of the results of a randomised Phase III clinical trial: has a more radical approach improved survival?
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Results of the GYNECO 02 study, an FNCLCC phase III trial comparing hysterectomy with no hysterectomy in patients with a (clinical and radiological) complete response after chemoradiation therapy for stage IB2 or II cervical cancer.
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Perineural and intraneural invasion in posttherapy pancreaticoduodenectomy specimens predicts poor prognosis in patients with pancreatic ductal adenocarcinoma.
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