Chemoradiotherapy: Treatment that combines chemotherapy with radiotherapy.Chemoradiotherapy, Adjuvant: Combined chemotherapy and radiotherapy given to augment some other form of treatment such as surgery. It is commonly used in the therapy of cancer.Combined Modality Therapy: The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used.Radiotherapy, Adjuvant: Radiotherapy given to augment some other form of treatment such as surgery or chemotherapy. Adjuvant radiotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.Esophageal Neoplasms: Tumors or cancer of the ESOPHAGUS.Fluorouracil: A pyrimidine analog that is an antineoplastic antimetabolite. It interferes with DNA synthesis by blocking the THYMIDYLATE SYNTHETASE conversion of deoxyuridylic acid to thymidylic acid.Neoadjuvant Therapy: Preliminary cancer therapy (chemotherapy, radiation therapy, hormone/endocrine therapy, immunotherapy, hyperthermia, etc.) that precedes a necessary second modality of treatment.Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle.Rectal Neoplasms: Tumors or cancer of the RECTUM.Carcinoma, Squamous Cell: A carcinoma derived from stratified SQUAMOUS EPITHELIAL CELLS. It may also occur in sites where glandular or columnar epithelium is normally present. (From Stedman, 25th ed)Antineoplastic Combined Chemotherapy Protocols: The use of two or more chemicals simultaneously or sequentially in the drug therapy of neoplasms. The drugs need not be in the same dosage form.Chemotherapy, Adjuvant: Drug therapy given to augment or stimulate some other form of treatment such as surgery or radiation therapy. Adjuvant chemotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.Radiotherapy Dosage: The total amount of radiation absorbed by tissues as a result of radiotherapy.Head and Neck Neoplasms: Soft tissue tumors or cancer arising from the mucosal surfaces of the LIP; oral cavity; PHARYNX; LARYNX; and cervical esophagus. Other sites included are the NOSE and PARANASAL SINUSES; SALIVARY GLANDS; THYROID GLAND and PARATHYROID GLANDS; and MELANOMA and non-melanoma skin cancers of the head and neck. (from Holland et al., Cancer Medicine, 4th ed, p1651)Esophagectomy: Excision of part (partial) or all (total) of the esophagus. (Dorland, 28th ed)Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Neoplasm Staging: Methods which attempt to express in replicable terms the extent of the neoplasm in the patient.Radiotherapy: The use of IONIZING RADIATION to treat malignant NEOPLASMS and some benign conditions.Disease-Free Survival: Period after successful treatment in which there is no appearance of the symptoms or effects of the disease.Dose Fractionation: Administration of the total dose of radiation (RADIATION DOSAGE) in parts, at timed intervals.Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.Adenocarcinoma: A malignant epithelial tumor with a glandular organization.Nasopharyngeal Neoplasms: Tumors or cancer of the NASOPHARYNX.Induction Chemotherapy: Initial drug treatment designed to bring about REMISSION INDUCTION. It is typically a short-term and high-dose drug treatment that is followed by CONSOLIDATION CHEMOTHERAPY and then MAINTENANCE CHEMOTHERAPY.DeoxycytidineNeoplasm Recurrence, Local: The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site.Antimetabolites, Antineoplastic: Antimetabolites that are useful in cancer chemotherapy.Hypopharyngeal Neoplasms: Tumors or cancer of the HYPOPHARYNX.Kaplan-Meier Estimate: A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)Organ Sparing Treatments: Techniques, procedures, and therapies carried out on diseased organs in such a way to avoid complete removal of the organ and preserve the remaining organ function.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Prognosis: A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.Lung Neoplasms: Tumors or cancer of the LUNG.Antineoplastic Agents: Substances that inhibit or prevent the proliferation of NEOPLASMS.Laryngeal Neoplasms: Cancers or tumors of the LARYNX or any of its parts: the GLOTTIS; EPIGLOTTIS; LARYNGEAL CARTILAGES; LARYNGEAL MUSCLES; and VOCAL CORDS.Carboplatin: An organoplatinum compound that possesses antineoplastic activity.Deglutition Disorders: Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the PHARYNX and UPPER ESOPHAGEAL SPHINCTER; and esophageal dysphagia due to malfunction of the ESOPHAGUS.Radiation Injuries: Harmful effects of non-experimental exposure to ionizing or non-ionizing radiation in VERTEBRATES.Drug Administration Schedule: Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.Oropharyngeal Neoplasms: Tumors or cancer of the OROPHARYNX.Preoperative Care: Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)Radiotherapy, Conformal: Radiotherapy where there is improved dose homogeneity within the tumor and reduced dosage to uninvolved structures. The precise shaping of dose distribution is achieved via the use of computer-controlled multileaf collimators.Positron-Emission Tomography: An imaging technique using compounds labelled with short-lived positron-emitting radionuclides (such as carbon-11, nitrogen-13, oxygen-15 and fluorine-18) to measure cell metabolism. It has been useful in study of soft tissues such as CANCER; CARDIOVASCULAR SYSTEM; and brain. SINGLE-PHOTON EMISSION-COMPUTED TOMOGRAPHY is closely related to positron emission tomography, but uses isotopes with longer half-lives and resolution is lower.Mucositis: An INFLAMMATION of the MUCOSA with burning or tingling sensation. It is characterized by atrophy of the squamous EPITHELIUM, vascular damage, inflammatory infiltration, and ulceration. It usually occurs at the mucous lining of the MOUTH, the GASTROINTESTINAL TRACT or the airway due to chemical irritations, CHEMOTHERAPY, or radiation therapy (RADIOTHERAPY).Carcinoma, Non-Small-Cell Lung: A heterogeneous aggregate of at least three distinct histological types of lung cancer, including SQUAMOUS CELL CARCINOMA; ADENOCARCINOMA; and LARGE CELL CARCINOMA. They are dealt with collectively because of their shared treatment strategy.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Digestive System Surgical Procedures: Surgery performed on the digestive system or its parts.Taxoids: A group of diterpenoid CYCLODECANES named for the taxanes that were discovered in the TAXUS tree. The action on MICROTUBULES has made some of them useful as ANTINEOPLASTIC AGENTS.Hydroxyurea: An antineoplastic agent that inhibits DNA synthesis through the inhibition of ribonucleoside diphosphate reductase.Paclitaxel: A cyclodecane isolated from the bark of the Pacific yew tree, TAXUS BREVIFOLIA. It stabilizes MICROTUBULES in their polymerized form leading to cell death.Radiation-Sensitizing Agents: Drugs used to potentiate the effectiveness of radiation therapy in destroying unwanted cells.Fluorodeoxyglucose F18: The compound is given by intravenous injection to do POSITRON-EMISSION TOMOGRAPHY for the assessment of cerebral and myocardial glucose metabolism in various physiological or pathological states including stroke and myocardial ischemia. It is also employed for the detection of malignant tumors including those of the brain, liver, and thyroid gland. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1162)Esophagogastric Junction: The area covering the terminal portion of ESOPHAGUS and the beginning of STOMACH at the cardiac orifice.Anus Neoplasms: Tumors or cancer of the ANAL CANAL.Remission Induction: Therapeutic act or process that initiates a response to a complete or partial remission level.Uterine Cervical Neoplasms: Tumors or cancer of the UTERINE CERVIX.Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues.Leucovorin: The active metabolite of FOLIC ACID. Leucovorin is used principally as an antidote to FOLIC ACID ANTAGONISTS.Organoplatinum Compounds: Organic compounds which contain platinum as an integral part of the molecule.Esophagitis: INFLAMMATION, acute or chronic, of the ESOPHAGUS caused by BACTERIA, chemicals, or TRAUMA.Otorhinolaryngologic Neoplasms: A general concept for tumors or cancer of any part of the EAR; the NOSE; the THROAT; and the PHARYNX. It is used when there is no specific heading.Radiotherapy, Intensity-Modulated: CONFORMAL RADIOTHERAPY that combines several intensity-modulated beams to provide improved dose homogeneity and highly conformal dose distributions.Oxonic Acid: Antagonist of urate oxidase.Pancreatic Neoplasms: Tumors or cancer of the PANCREAS. Depending on the types of ISLET CELLS present in the tumors, various hormones can be secreted: GLUCAGON from PANCREATIC ALPHA CELLS; INSULIN from PANCREATIC BETA CELLS; and SOMATOSTATIN from the SOMATOSTATIN-SECRETING CELLS. Most are malignant except the insulin-producing tumors (INSULINOMA).Gastrectomy: Excision of the whole (total gastrectomy) or part (subtotal gastrectomy, partial gastrectomy, gastric resection) of the stomach. (Dorland, 28th ed)Laryngectomy: Total or partial excision of the larynx.Pelvic Neoplasms: Tumors or cancer of the pelvic region.Feasibility Studies: Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.Tegafur: Congener of FLUOROURACIL with comparable antineoplastic action. It has been suggested especially for the treatment of breast neoplasms.Larynx: A tubular organ of VOICE production. It is located in the anterior neck, superior to the TRACHEA and inferior to the tongue and HYOID BONE.Radiation Pneumonitis: Inflammation of the lung due to harmful effects of ionizing or non-ionizing radiation.Lymphatic Metastasis: Transfer of a neoplasm from its primary site to lymph nodes or to distant parts of the body by way of the lymphatic system.Lymph Node Excision: Surgical excision of one or more lymph nodes. Its most common use is in cancer surgery. (From Dorland, 28th ed, p966)Stomatitis: INFLAMMATION of the soft tissues of the MOUTH, such as MUCOSA; PALATE; GINGIVA; and LIP.Radiopharmaceuticals: Compounds that are used in medicine as sources of radiation for radiotherapy and for diagnostic purposes. They have numerous uses in research and industry. (Martindale, The Extra Pharmacopoeia, 30th ed, p1161)Voice Disorders: Pathological processes that affect voice production, usually involving VOCAL CORDS and the LARYNGEAL MUCOSA. Voice disorders can be caused by organic (anatomical), or functional (emotional or psychological) factors leading to DYSPHONIA; APHONIA; and defects in VOICE QUALITY, loudness, and pitch.Lymphatic Irradiation: External or interstitial irradiation to treat lymphomas (e.g., Hodgkin's and non-Hodgkin's lymphomas) and lymph node metastases and also some autoimmune diseases, such as rheumatoid arthritis.Neoplasms, Squamous Cell: Neoplasms of the SQUAMOUS EPITHELIAL CELLS. The concept does not refer to neoplasms located in tissue composed of squamous elements.Postoperative Care: The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)Radiotherapy, High-Energy: Radiotherapy using high-energy (megavolt or higher) ionizing radiation. Types of radiation include gamma rays, produced by a radioisotope within a teletherapy unit; x-rays, electrons, protons, alpha particles (helium ions) and heavy charged ions, produced by particle acceleration; and neutrons and pi-mesons (pions), produced as secondary particles following bombardment of a target with a primary particle.Carcinoma: A malignant neoplasm made up of epithelial cells tending to infiltrate the surrounding tissues and give rise to metastases. It is a histological type of neoplasm but is often wrongly used as a synonym for "cancer." (From Dorland, 27th ed)Etoposide: A semisynthetic derivative of PODOPHYLLOTOXIN that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle.LeukopeniaTime Factors: Elements of limited time intervals, contributing to particular results or situations.Pneumonectomy: The excision of lung tissue including partial or total lung lobectomy.Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series.Radiation Dosage: The amount of radiation energy that is deposited in a unit mass of material, such as tissues of plants or animal. In RADIOTHERAPY, radiation dosage is expressed in gray units (Gy). In RADIOLOGIC HEALTH, the dosage is expressed by the product of absorbed dose (Gy) and quality factor (a function of linear energy transfer), and is called radiation dose equivalent in sievert units (Sv).Tomography, X-Ray Computed: Tomography using x-ray transmission and a computer algorithm to reconstruct the image.Clinical Trials, Phase II as Topic: Works about studies that are usually controlled to assess the effectiveness and dosage (if appropriate) of diagnostic, therapeutic, or prophylactic drugs, devices, or techniques. These studies are performed on several hundred volunteers, including a limited number of patients with the target disease or disorder, and last about two years. This concept includes phase II studies conducted in both the U.S. and in other countries.Mitomycin: An antineoplastic antibiotic produced by Streptomyces caespitosus. It is one of the bi- or tri-functional ALKYLATING AGENTS causing cross-linking of DNA and inhibition of DNA synthesis.Salvage Therapy: A therapeutic approach, involving chemotherapy, radiation therapy, or surgery, after initial regimens have failed to lead to improvement in a patient's condition. Salvage therapy is most often used for neoplastic diseases.Carcinoma, Small Cell: An anaplastic, highly malignant, and usually bronchogenic carcinoma composed of small ovoid cells with scanty neoplasm. It is characterized by a dominant, deeply basophilic nucleus, and absent or indistinct nucleoli. (From Stedman, 25th ed; Holland et al., Cancer Medicine, 3d ed, p1286-7)Muscle Neoplasms: Tumors or cancer located in muscle tissue or specific muscles. They are differentiated from NEOPLASMS, MUSCLE TISSUE which are neoplasms composed of skeletal, cardiac, or smooth muscle tissue, such as MYOSARCOMA or LEIOMYOMA.Stomach Neoplasms: Tumors or cancer of the STOMACH.Transplantation, Autologous: Transplantation of an individual's own tissue from one site to another site.Randomized Controlled Trials as Topic: Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.Bone Marrow Purging: Techniques for the removal of subpopulations of cells (usually residual tumor cells) from the bone marrow ex vivo before it is infused. The purging is achieved by a variety of agents including pharmacologic agents, biophysical agents (laser photoirradiation or radioisotopes) and immunologic agents. Bone marrow purging is used in both autologous and allogeneic BONE MARROW TRANSPLANTATION.Pharyngeal Neoplasms: Tumors or cancer of the PHARYNX.Dose-Response Relationship, Radiation: The relationship between the dose of administered radiation and the response of the organism or tissue to the radiation.Neoplasm Metastasis: The transfer of a neoplasm from one organ or part of the body to another remote from the primary site.Trismus: Spasmodic contraction of the masseter muscle resulting in forceful jaw closure. This may be seen with a variety of diseases, including TETANUS, as a complication of radiation therapy, trauma, or in association with neoplastic conditions.Bone Marrow Transplantation: The transference of BONE MARROW from one human or animal to another for a variety of purposes including HEMATOPOIETIC STEM CELL TRANSPLANTATION or MESENCHYMAL STEM CELL TRANSPLANTATION.Glottis: The vocal apparatus of the larynx, situated in the middle section of the larynx. Glottis consists of the VOCAL FOLDS and an opening (rima glottidis) between the folds.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Nose Neoplasms: Tumors or cancer of the NOSE.Antineoplastic Agents, Alkylating: A class of drugs that differs from other alkylating agents used clinically in that they are monofunctional and thus unable to cross-link cellular macromolecules. Among their common properties are a requirement for metabolic activation to intermediates with antitumor efficacy and the presence in their chemical structures of N-methyl groups, that after metabolism, can covalently modify cellular DNA. The precise mechanisms by which each of these drugs acts to kill tumor cells are not completely understood. (From AMA, Drug Evaluations Annual, 1994, p2026)Maximum Tolerated Dose: The highest dose of a biologically active agent given during a chronic study that will not reduce longevity from effects other than carcinogenicity. (from Lewis Dictionary of Toxicology, 1st ed)Multimodal Imaging: The use of combination of imaging techniques or platforms (e.g., MRI SCAN and PET SCAN) encompassing aspects of anatomical, functional, or molecular imaging methods.Proportional Hazards Models: Statistical models used in survival analysis that assert that the effect of the study factors on the hazard rate in the study population is multiplicative and does not change over time.Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Carcinoma, Signet Ring Cell: A poorly differentiated adenocarcinoma in which the nucleus is pressed to one side by a cytoplasmic droplet of mucus. It usually arises in the gastrointestinal system.Vinblastine: Antitumor alkaloid isolated from Vinca rosea. (Merck, 11th ed.)Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Ifosfamide: Positional isomer of CYCLOPHOSPHAMIDE which is active as an alkylating agent and an immunosuppressive agent.Vincristine: An antitumor alkaloid isolated from VINCA ROSEA. (Merck, 11th ed.)Camptothecin: An alkaloid isolated from the stem wood of the Chinese tree, Camptotheca acuminata. This compound selectively inhibits the nuclear enzyme DNA TOPOISOMERASES, TYPE I. Several semisynthetic analogs of camptothecin have demonstrated antitumor activity.Clinical Trials as Topic: Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries.Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis.Drug-Related Side Effects and Adverse Reactions: Disorders that result from the intended use of PHARMACEUTICAL PREPARATIONS. Included in this heading are a broad variety of chemically-induced adverse conditions due to toxicity, DRUG INTERACTIONS, and metabolic effects of pharmaceuticals.Brain Neoplasms: Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain.Tumor Burden: The total amount (cell number, weight, size or volume) of tumor cells or tissue in the body.Pharyngectomy: Surgical removal of a part of the pharynx. (Dorland, 28th ed)Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Deglutition: The act of taking solids and liquids into the GASTROINTESTINAL TRACT through the mouth and throat.Cystectomy: Used for excision of the urinary bladder.Neoplasm, Residual: Remnant of a tumor or cancer after primary, potentially curative therapy. (Dr. Daniel Masys, written communication)Dacarbazine: An antineoplastic agent. It has significant activity against melanomas. (from Martindale, The Extra Pharmacopoeia, 31st ed, p564)Postoperative Period: The period following a surgical operation.Amifostine: A phosphorothioate proposed as a radiation-protective agent. It causes splenic vasodilation and may block autonomic ganglia.Esophageal Fistula: Abnormal passage communicating with the ESOPHAGUS. The most common type is TRACHEOESOPHAGEAL FISTULA between the esophagus and the TRACHEA.Tumor Markers, Biological: Molecular products metabolized and secreted by neoplastic tissue and characterized biochemically in cells or body fluids. They are indicators of tumor stage and grade as well as useful for monitoring responses to treatment and predicting recurrence. Many chemical groups are represented including hormones, antigens, amino and nucleic acids, enzymes, polyamines, and specific cell membrane proteins and lipids.Neoplasm Invasiveness: Ability of neoplasms to infiltrate and actively destroy surrounding tissue.Tracheal NeoplasmsRadiation Tolerance: The ability of some cells or tissues to survive lethal doses of IONIZING RADIATION. Tolerance depends on the species, cell type, and physical and chemical variables, including RADIATION-PROTECTIVE AGENTS and RADIATION-SENSITIZING AGENTS.Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols.Antibodies, Monoclonal, Humanized: Antibodies from non-human species whose protein sequences have been modified to make them nearly identical with human antibodies. If the constant region and part of the variable region are replaced, they are called humanized. If only the constant region is modified they are called chimeric. INN names for humanized antibodies end in -zumab.Carcinoma, Adenosquamous: A mixed adenocarcinoma and squamous cell or epidermoid carcinoma.JapanProbability: The study of chance processes or the relative frequency characterizing a chance process.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Neck Dissection: Dissection in the neck to remove all disease tissues including cervical LYMPH NODES and to leave an adequate margin of normal tissue. This type of surgery is usually used in tumors or cervical metastases in the head and neck. The prototype of neck dissection is the radical neck dissection described by Crile in 1906.Drug Combinations: Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.Cranial Irradiation: The exposure of the head to roentgen rays or other forms of radioactivity for therapeutic or preventive purposes.Area Under Curve: A statistical means of summarizing information from a series of measurements on one individual. It is frequently used in clinical pharmacology where the AUC from serum levels can be interpreted as the total uptake of whatever has been administered. As a plot of the concentration of a drug against time, after a single dose of medicine, producing a standard shape curve, it is a means of comparing the bioavailability of the same drug made by different companies. (From Winslade, Dictionary of Clinical Research, 1992)Recurrence: The return of a sign, symptom, or disease after a remission.Radiation Oncology: A subspecialty of medical oncology and radiology concerned with the radiotherapy of cancer.Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the LIVER to form the active aldophosphamide. It has been used in the treatment of LYMPHOMA and LEUKEMIA. Its side effect, ALOPECIA, has been used for defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Lymphoma, Non-Hodgkin: Any of a group of malignant tumors of lymphoid tissue that differ from HODGKIN DISEASE, being more heterogeneous with respect to malignant cell lineage, clinical course, prognosis, and therapy. The only common feature among these tumors is the absence of giant REED-STERNBERG CELLS, a characteristic of Hodgkin's disease.Endosonography: Ultrasonography of internal organs using an ultrasound transducer sometimes mounted on a fiberoptic endoscope. In endosonography the transducer converts electronic signals into acoustic pulses or continuous waves and acts also as a receiver to detect reflected pulses from within the organ. An audiovisual-electronic interface converts the detected or processed echo signals, which pass through the electronics of the instrument, into a form that the technologist can evaluate. The procedure should not be confused with ENDOSCOPY which employs a special instrument called an endoscope. The "endo-" of endosonography refers to the examination of tissue within hollow organs, with reference to the usual ultrasonography procedure which is performed externally or transcutaneously.Carcinoma, Large Cell: A tumor of undifferentiated (anaplastic) cells of large size. It is usually bronchogenic. (From Dorland, 27th ed)Urinary Bladder Neoplasms: Tumors or cancer of the URINARY BLADDER.Infusions, Intravenous: The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.Dilatation: The act of dilating.Mouth Neoplasms: Tumors or cancer of the MOUTH.Clinical Trials, Phase III as Topic: Works about comparative studies to verify the effectiveness of diagnostic, therapeutic, or prophylactic drugs, devices, or techniques determined in phase II studies. During these trials, patients are monitored closely by physicians to identify any adverse reactions from long-term use. These studies are performed on groups of patients large enough to identify clinically significant responses and usually last about three years. This concept includes phase III studies conducted in both the U.S. and in other countries.Neoplasms, Second Primary: Abnormal growths of tissue that follow a previous neoplasm but are not metastases of the latter. The second neoplasm may have the same or different histological type and can occur in the same or different organs as the previous neoplasm but in all cases arises from an independent oncogenic event. The development of the second neoplasm may or may not be related to the treatment for the previous neoplasm since genetic risk or predisposing factors may actually be the cause.Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetius. It is a hydroxy derivative of DAUNORUBICIN.Thoracotomy: Surgical incision into the chest wall.Whole-Body Irradiation: Irradiation of the whole body with ionizing or non-ionizing radiation. It is applicable to humans or animals but not to microorganisms.Small Cell Lung Carcinoma: A form of highly malignant lung cancer that is composed of small ovoid cells (SMALL CELL CARCINOMA).Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents.Lymph Nodes: They are oval or bean shaped bodies (1 - 30 mm in diameter) located along the lymphatic system.Triazines: Heterocyclic rings containing three nitrogen atoms, commonly in 1,2,4 or 1,3,5 or 2,4,6 formats. Some are used as HERBICIDES.Fatal Outcome: Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept.Neutropenia: A decrease in the number of NEUTROPHILS found in the blood.Pelvic Bones: Bones that constitute each half of the pelvic girdle in VERTEBRATES, formed by fusion of the ILIUM; ISCHIUM; and PUBIC BONE.Thrombocytopenia: A subnormal level of BLOOD PLATELETS.Glioblastoma: A malignant form of astrocytoma histologically characterized by pleomorphism of cells, nuclear atypia, microhemorrhage, and necrosis. They may arise in any region of the central nervous system, with a predilection for the cerebral hemispheres, basal ganglia, and commissural pathways. Clinical presentation most frequently occurs in the fifth or sixth decade of life with focal neurologic signs or seizures.Preoperative Period: The period before a surgical operation.Antibodies, Monoclonal: Antibodies produced by a single clone of cells.Medical Oncology: A subspecialty of internal medicine concerned with the study of neoplasms.Melphalan: An alkylating nitrogen mustard that is used as an antineoplastic in the form of the levo isomer - MELPHALAN, the racemic mixture - MERPHALAN, and the dextro isomer - MEDPHALAN; toxic to bone marrow, but little vesicant action; potential carcinogen.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Radiotherapy Planning, Computer-Assisted: Computer-assisted mathematical calculations of beam angles, intensities of radiation, and duration of irradiation in radiotherapy.ROC Curve: A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.UracilVomiting: The forcible expulsion of the contents of the STOMACH through the MOUTH.Defecation: The normal process of elimination of fecal material from the RECTUM.Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body.Carcinoma, Transitional Cell: A malignant neoplasm derived from TRANSITIONAL EPITHELIAL CELLS, occurring chiefly in the URINARY BLADDER; URETERS; or RENAL PELVIS.Thymidylate Synthase: An enzyme of the transferase class that catalyzes the reaction 5,10-methylenetetrahydrofolate and dUMP to dihydrofolate and dTMP in the synthesis of thymidine triphosphate. (From Dorland, 27th ed) EC 2.1.1.45.Hodgkin Disease: A malignant disease characterized by progressive enlargement of the lymph nodes, spleen, and general lymphoid tissue. In the classical variant, giant usually multinucleate Hodgkin's and REED-STERNBERG CELLS are present; in the nodular lymphocyte predominant variant, lymphocytic and histiocytic cells are seen.Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant.Nelfinavir: A potent HIV protease inhibitor. It is used in combination with other antiviral drugs in the treatment of HIV in both adults and children.Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Neuroblastoma: A common neoplasm of early childhood arising from neural crest cells in the sympathetic nervous system, and characterized by diverse clinical behavior, ranging from spontaneous remission to rapid metastatic progression and death. This tumor is the most common intraabdominal malignancy of childhood, but it may also arise from thorax, neck, or rarely occur in the central nervous system. Histologic features include uniform round cells with hyperchromatic nuclei arranged in nests and separated by fibrovascular septa. Neuroblastomas may be associated with the opsoclonus-myoclonus syndrome. (From DeVita et al., Cancer: Principles and Practice of Oncology, 5th ed, pp2099-2101; Curr Opin Oncol 1998 Jan;10(1):43-51)

Neoadjuvant chemotherapy followed by concurrent chemoradiation for locally advanced nasopharyngeal carcinoma. (1/605)

BACKGROUND AND OBJECTIVE: Concurrent chemoradiation therapy (CCRT) is the standard treatment for patients with locally advanced nasopharyngeal carcinoma (NPC). The effect of neoadjuvant chemotherapy followed by CCRT has not been determined. Therefore, we conducted 2 phase II studies to evaluate the efficacy and safety of neoadjuvant chemotherapy with a regimen of docetaxel, cisplatin, and 5 fluorouracil (5-Fu) (TPF) followed by radiotherapy and concurrent cisplatin in patients with stage III and IV(A - B) NPC. This article is the preliminary report on treatment related toxicities and response. METHODS: Graded according to the 2002 American Joint Committee on Cancer (AJCC) staging criteria, only patients with stage III or IV(A-B) poorly differentiated or undifferentiated NPC (World Health Organization type II/III) were included. We planned to recruit 52 patients with stage III disease and 64 patients with stage IV(A - B) disease. All patients received neoadjuvant chemotherapy with TPF (docetaxel 75 mg/m(2), day 1; cisplatin 75 mg/m(2), day 1; 5 Fu 500 mg/(m2 x day), continuous intravenous infusion for 120 h), every 3 weeks for 3 cycles, followed by weekly cisplatin (40 mg/m(2)) concurrent with radiotherapy. Three dimensional conformal radiotherapy (3D CRT) and intensity modulated radiotherapy (IMRT) were used. Gross disease planning target volume (PTV), high risk and low risk subclinical PTV doses were prescribed at 70-76 Gy, 66-70 Gy, and 60-61.25 Gy at 1.75-2.0 Gy per fraction. The lower neck or supraclavicular fields may be treated with conventional AP/PA fields for a total of 54 Gy at 1.8 Gy per fraction. Patients were evaluated for tumor response after the completion of neoadjuvant chemotherapy, and at 3 months after radiation according to the Response Evaluation Criteria In Solid Tumors (RECIST). The latest version of the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE 3.0) was used for grading all adverse events. RESULTS: Fifty nine patients were evaluable for treatment response. Thirty patients had stage III disease and 29 patients had stage IV(A-B). All patients completed RT to the prescribed dose and 2 cycles of neoadjuvant chemotherapy, with 51 patients (86.4%) completing 3 cycles. A total of 50 (84.7%) and 39 patients (66.1%) completed 4 weeks and 5 weeks of cisplatin during CCRT, respectively. The overall response rate in the primary site and the neck region were 94.9% [complete response (CR) in 25.4%] and 100% (CR in 19.6%) after completing neoadjuvant chemotherapy. At 3 months after RT, the CR rates increased to 96.6% and 90.2%, respectively. After a median follow up of 14.3 months, we observed 5 treatment failures and 2 deaths. The 1 year overall survival, distant metastasis free survival, and locoregional relapse free survival rates were 100%, 95.7%, and 97.7%, respectively. The rates of grade 3/4 myelosuppression and anorexia/nausea/vomiting during neoadjuvant chemotherapy were 55.9% and 16.9%, respectively. The corresponding rates were 11.9% and 23.7% during CCRT. Grade 3/4 mucositis, skin desquamation, and xerostomia occurred in 6.8%, 44.1%, and 27.1% of patients, respectively. There were no treatment related deaths. CONCLUSIONS: Neoadjuvant chemotherapy with TPF followed by CCRT was well tolerated with a manageable toxicity profile. Preliminary results are encouraging and warrant further investigation.  (+info)

Radiotherapy in the treatment of patients with unresectable extrahepatic cholangiocarcinoma. (2/605)

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Esophageal cancer: diagnosis and management. (3/605)

Esophageal cancer is the 7th leading cause of cancer deaths worldwide. While squamous cell carcinoma is the most prevalent histology internationally, adenocarcinoma of the distal esophagus accounts for nearly 50% of cases in developed countries due to the differences in the etiologic factors such as gastroesophageal reflux disease (GERD) and obesity that predominate. While surgery is the mainstay of treatment of this disease, the utilization of chemoradiation, either used postoperatively or neoadjuvantly, has become a standard practice in the United States. What is the optimal management approach is still an area of contention, however, and may be different in different regions around the world. This article reviews some of these controversies, including the role for surgery in patients treated with definitive chemoradiation. At the end, we will also outline recommendations regarding radiotherapy procedures and techniques.  (+info)

Treatment guideline of radiotherapy for Chinese esophageal carcinoma (draft). (4/605)

Esophageal carcinoma is one of the most common human cancers in China. Radiotherapy plays an important role in combination therapy of esophageal carcinoma. With regret, there is still no unified standard for the treatment of esophageal carcinoma in China, and there are many controversies in the treatment regimens, indications, methods and efficacy. Clinically, the clinical practice guidelines of the National Comprehensive Cancer Network (NCCN) of the United States were often consulted, but the data of them were mainly from the patients from Europe and America, and they might not be applicable for Chinese patients. In order to standardize clinical process of radiotherapy for esophageal carcinoma in China, the Esophageal Carcinoma Cooperative Group of Radiation Oncology Society of Chinese Medical Association wrote a consensus and controversies on the radiotherapy for esophageal carcinoma (draft) after years of research and discussion. We hope it be tried out and discussed with advice and valuable suggestions, in order to accelerate the process of standardization of esophageal carcinoma treatment in China.  (+info)

Considerations of treatment standardization from the procession of NCCN guideline of esophageal cancer. (5/605)

Esophageal carcinoma is one of the most common malignant tumors, especially in China which is the high incidence area. As a result of mild symptoms of early-stage esophageal cancer, the majority of patients cannot be diagnosed until they develop to advanced cancer, and the treatment outcome of surgery or chemoradiotherapy is still unsatisfactory at present. The guidelines of esophageal cancer issued by National Comprehensive Cancer Network (NCCN) are regarded as important reference tools by clinical oncologists, and provide uniform criteria for the diagnosis and treatment of esophageal carcinoma. However, the guidelines are not always suitable for Chinese patients because the data come from European and American population which have significant ethnical difference from Chinese. We retrospectively analyzed the changes of treatment strategy of esophageal cancer in NCCN guidelines and the advance of treatment for esophageal carcinoma in China, aiming to provide our oncologists with new research ideas. We also hope to set up clinical cancer cooperation organizations, and release our own cancer guidelines to serve Chinese patients and oncologists.  (+info)

Literature analysis of radiotherapy for esophageal cancer in China. (6/605)

BACKGROUND AND OBJECTIVE: Many patterns of treatment have been used to treat esophageal carcinoma in the past years, however, an optimal treatment is still the key issue to be explored. Therefore, we analyzed the published literature about radiotherapy for esophageal cancer in recent 15 years in China, and observed the survival rate, local control rate, adverse events, and so on. METHODS: A total of 56 eligible papers about radiotherapy for esophageal squamous cell carcinoma published in Chinese core periodicals between 1994 and 2009 were selected. The survival rates, local control rates, and adverse events were analyzed. RESULTS: The 1-, 2-, 3-, and 5-year overall survival rates of the patients reported in the 56 papers were (67.99 +/- 12.55)%, (49.59 +/- 11.79)%, (34.50 +/- 11.49)%, and (23.31 +/- 10.21)%, respectively. The 1-, 2-, 3-, and 5-year local control rates were (73.04 +/- 13.37)%, (61.60 +/- 15.50)%, (51.77 +/- 15.00)%, and (50.15 +/- 21.36)%, respectively. The acute esophageal toxicity rate was (44.84 +/- 25.71)% in 32 papers reported in recent 15 years, and the acute esophageal toxicity over grade II accounted for (35.93 +/- 22.90)%. The rates of acute esophageal toxicity were (26.84 +/- 13.12)% for conventional radiation, (53.72 +/- 21.82)% for late course accelerated hyperfractionation radiation, (61.33 +/- 28.69)% for concurrent chemoradiotherapy, and (40.31 +/- 27.22)% for other ways of radiation. The late toxicity rate described in 23 papers was (5.13 +/- 4.07)% in recent 15 years. The late toxicity rates were (5.66 +/- 3.42)% for conventional radiation, (4.53+/- 4.07)% for late course accelerated hyperfractionation radiation, (2.24+/-1.31)% for concurrent chemoradiotherapy, and (7.34 +/- 5.06)% for other ways of radiation. The Meta analysis indicated that concurrent chemoradiotherapy was better than late course accelerated hyperfractionation radiation and conventional radiation. CONCLUSIONS: The long-term survival of patients with esophageal cancer is still disappointed in recent years. Concurrent chemoradiotherapy shows advantages in treating esophageal cancer and, currently, is the best non-surgical treatment of esophageal cancer.  (+info)

A phase I trial of tipifarnib with radiation therapy, with and without temozolomide, for patients with newly diagnosed glioblastoma. (7/605)

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Efficacy of concurrent chemoradiotherapy plus adjuvant chemotherapy on advanced cervical cancer. (8/605)

BACKGROUND AND OBJECTIVE: Concurrent chemoradiotherapy for cervical carcinoma develops rapidly and has become a common and standard therapy in recent years. Both the local control rate and survival rate of patients were increased and the risk of death fell by 30%-50%. This study aimed to explore the efficacy of concurrent chemoradiotherapy plus adjuvant chemotherapy on and the treatment compliance of the patients with advanced cervical squamous cell carcinoma. METHODS: A total of 156 patients with stage IIa-IIIb cervical squamous cell carcinoma were randomly divided into the concurrent chemoradiotherapy group (experimental group) and radiotherapy group (control group). Intracavity and external beam radiation therapy were administered. At point A, 40-48 Gy were given by 10-12 fractions; at point B, 46-50 Gy were given by 23-25 fractions. In the same time, experimental group was treated by cisplatin (DDP, 40 mg) on day 1, repeated every week. Ten days after radiation therapy, TP regimen was administered as adjuvant chemotherapy. RESULTS: For the experimental and control groups, the objective response rates were 88.61% and 75.32%, 1-year survival rates were 88.57% and 70.77%, 1-year local control rates were 81.43% and 64.62%, 3-year survival rates were 82.14% and 57.69%, and 3-year local control rates were 75.00% and 46.15%, with significant differences (P<0.05). Quality of life of all patients were significantly improved after treatment (P<0.05). CONCLUSION: Concurrent chemoradiotherapy plus adjuvant chemotherapy for advanced cervical cancer can improve short-term and long-term survival and local control rates of patients, improve the quality of life, and the toxicity can be tolerated.  (+info)

Loco-regional recurrences after intial surgery in patients with esophageal cancer remain a serious challenge to clinical oncologists. The NCCN Guidelines pointed out that a highly selected group of patients with local-regional tumor recurrence after initial surgery may be considered fit and able to tolerate concurrent radio-chemotherapy with a potential for cure [18]. In a line with the previous studies, our data indicated that salvage concurrent radio-chemotherapy was an active and promising treatment strategy for such patients, reaching a median OS of 13.3 months with tolerable side-effects.. The present protocol of concurrent radio-chemotherapy was completed in 74% (37/50) of the patients, and no serious treatment related toxicities were observed. The tumor response rate was nearly 72% in R-TP and R-FP group respectively, with a 3-year survival rate of 14%. These results are very similar to those reported in previous studies [13, 15]. Yamashita et al.[13] reported the results of radiotherapy ...
TY - JOUR. T1 - Adjuvant therapy in colorectal cancer. A randomized trial comparing radio-chemotherapy and radio-chemotherapy combined with methanol extraction residue of BCG, MER. AU - Robinson, E.. AU - Bartal, A.. AU - Cohen, Y.. AU - Milstein, D.. AU - Mekori, T.. PY - 1979/12/1. Y1 - 1979/12/1. N2 - Fifty-three patients with colorectal cancer (Dukes B 2 and C) were randomized after surgery. One group was treated by radio-and/or chemotherapy and the second by radio-and/or chemotherapy and MER. After 24 and 36 months a significant longer disease free interval, lower recurrence rate and better survival was found in the group treated by radio-chemo-and immunotherapy. Treatment was well tolerated and there were few local side effects from the MER injections. The long time efficacy of this adjuvant treatment whether it increases the cure rate or only delays recurrence requires longer follow-up.. AB - Fifty-three patients with colorectal cancer (Dukes B 2 and C) were randomized after surgery. ...
Preoperative chemoradiotherapy followed by radical surgical resection represents the standard of care for patients with locally advanced rectal cancer (4, 11, 26). However, the response of individual tumors to preoperative multimodal treatment is highly heterogeneous and ranges from complete clinical response to absence of any histopathologic tumor regression (complete resistance). This poses a clinical dilemma, because patients with resistant tumors are exposed to the potential side effects of chemotherapy and irradiation with no clear benefit. It is therefore critical to uncover mechanisms and pathways of treatment resistance for the identification of strategies to increase the fraction of patients with rectal cancer who benefit from multimodal neoadjuvant treatment (10).. In an attempt to identify novel molecular targets and pathways that may be manipulated to sensitize tumors to chemoradiotherapy, we previously demonstrated that the Wnt transcription factor TCF7L2 is overexpressed in ...
A phase 3 noninferiority study has found that in patients with nonoperable locally advanced squamous cell cancer of the head and neck, concurrent chemoradiotherapy remains the standard treatment, according to results presented at the ASCO 2016 Annual Meeting.
Once-daily radiotherapy is not superior to twice-daily treatment for patients with small-cell lung cancer receiving concurrent chemoradiotherapy.
CROSS and beyond: a clinical perspective on the results of the randomized ChemoRadiotherapy for Oesophageal cancer followed by Surgery Study
After matching at a 1:2 ratio, 150 patients were treated with CCRT and 75 with CCRT plus C were selected. The 3-year PFS rates (83.7% vs 72.0%, P = 0.036) and 3-year LRFS rates (98.6% vs 90.2%, P = 0.034) were higher for patients in the CCRT plus C arm than with CCRT alone. Furthermore, a marginal trend of increasing risk of 3-year DMFS rates (83.9% vs 78.4%, P = 0.301) and 3-year OS rates (91.2% vs 85.8%, P = 0.123) was found. The results indicated that CCRT plus C treatment was a significant and independent protective predictor for 3-year PFS (P = 0.015) and LRFS rates(P = 0.047). When focusing on stage T4 and/or N3 in the subgroup, the CCRT plus C arm achieved significantly prolonged 3-year PFS (79.9% vs 62.6%, P = 0.022) and a marginally increased OS (88.0% vs 77.9%, P = 0.086) compared with that of CCRT alone. Additionally, the 3-year LRFS (97.0% vs 90.9%, P = 0.246) and DMFS (79.9% vs 67.8%, P = 0.161) were enhanced in patients with CCRT plus C compared to CCRT alone. When concentrating on ...
The purpose of this study is to evaluate the efficiency and safety of weekly Cisplatin /Liposome paclitaxel concurrent chemoradiothrapy in the treatment
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In this phase I trial neoadjuvant CCRT combining IMRT with three escalated dose levels (45 Gy, 50 Gy, and 55 Gy in 25 fractions) and BV-fluorouracil/ le
The EORTC QLQ-LC13 is a lung cancer specific module from the EORTC comprising 13 questions to assess lung cancer symptoms (cough, hemoptysis, dyspnea, chest pain, arm/shoulder pain, and other pain), treatment related side-effects (sore mouth, dysphagia, peripheral neuropathy and alopecia) and pain medication. Scores from 0 to 100 were derived for each symptom item with higher scores representing greater symptom severity. Time to symptom deterioration was defined as time from randomization until the date of first clinically meaningful symptom deterioration (an increase in the score from baseline of ≥10) or death (by any cause) in the absence of a clinically meaningful symptom deterioration. Results are presented for time to deterioration in the following PRO endpoints identified as primary for EORTC QLQ-LC13: dyspnea, cough, hemoptysis and chest pain. Time to deterioration was calculated using the Kaplan-Meier technique ...
Patients with clinical stage T3-4N1/N2-3 (UICC 7th edition)are divided into two groups according to informed consent:intensity-modulated radiation therapy(IMRT(group and conventional fractionation radiotherapy(CRT)group. Then the patients in IMRT group/CRT group are randomly assigned to receive nedaplatin+docetaxel in neoadjuvant chemotherapy plus nedaplatin alone in concurrent chemoradiotherapy or cisplatin+docetaxel in neoadjuvant chemotherapy plus cisplatin alone in concurrent chemoradiotherapy.Evaluate the overall survival, the distant metastases free survival, and disease free survival of the patients treated with these regimens.Furthermore,analyze the cost-effectiveness of the regimens ...
In an observational study reported in JAMA Oncology, Kelly et al found that overall survival was similar with upfront surgery and definitive chemoradiotherapy among patients with newly diagnosed cT1-2 N1-2b human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma.. Study Details. The study involved 1,044 patients from the National Cancer Database who were newly diagnosed between 2010 and 2012. Among them, 460 patients (44.1%) received upfront surgery, and 584 patients (55.9%) received chemoradiotherapy. Median age was 59 years (range, 25-90 years), and 77.8% were male. Adjuvant chemoradiotherapy was received by 59% of surgical patients.. Survival Outcomes. Median follow-up was 30 months. Overall, 3-year overall survival was 81.4% in the surgery group vs 79.2% in the chemoradiotherapy group (P = .65). On multivariable analysis, the adjusted hazard ratio for death for surgery vs chemoradiotherapy was 1.01 (P = .93). In a propensity score-matched cohort of 822 patients, the hazard ...
TY - JOUR. T1 - Concurrent chemoradiotherapy with S-1 as first-line treatment for patients with oropharyngeal cancer. AU - Ohnishi, Kayoko. AU - Shioyama, Yoshiyuki. AU - Nakamura, Katsumasa. AU - Nakashima, Torahiko. AU - Ohga, Saiji. AU - Nonoshita, Takeshi. AU - Yoshitake, Tadamasa. AU - Terashima, Kotarou. AU - Komune, Shizuo. AU - Honda, Hiroshi. PY - 2011/2/14. Y1 - 2011/2/14. N2 - Purpose: S-1 is an oral fluoropyrimidine. The purpose of this study was to review the clinical outcomes of S-1 with concurrent radiotherapy for patients with oropharyngeal cancer. Materials and Methods: Between 2002 and 2007, 38 patients with oropharyngeal cancer treated concurrently with S-1 and definitive radiotherapy were reviewed. The clinical stage was Stage I in 4 patients, Stage II in 7, Stage III in 7, and Stage IV in 20. S-1 was administered orally twice daily for 4 consecutive weeks followed by a 2-week drug withdrawal. The initial dose of S-1 was 65 mg/m2/day. All patients were treated using ...
This study investigated the role of hyperthermia combined with preoperative concurrent chemoradiotherapy (CCRT) for locally advanced rectal cancer (LARC) according to hypoxic marker expression. One hundred and nine LARC patients with tissue blocks available for immunohistochemical assessment of carbonic anhydrase 9 (CA9) expression were reviewed. CA9 expression was considered positive when the staining percentage of tumor cells was |25% (n = 31). Pelvic radiotherapy with a total dose of 39.6-45 Gy was delivered concurrently with fluorouracil-based chemotherapy. Hyperthermia was administered to 52 patients twice a week during CCRT. Treatment response and outcomes were compared between hyperthermochemoradiotherapy (HCRT) and CCRT groups. In patients with positive CA9 expression, the rates of downstaging (p = 0.060) and pathologic complete response (p = 0.064) tended to be higher in the HCRT group than in the CCRT group. Distant metastasis-free survival (p = 0.029) and cancer-specific survival (p = 0.020)
Thirty-one patients were recruited according to the Simons two-stage design method. The median age was 62 years (range, 41-74) and the primary site was oropharynx; 11 (35%), hypopharynx; 18 (58%), larynx; 2 (7%). Twenty-four patients (77%) completed chemoradiotherapy as planned, and 9 patients (29%) completed adjuvant TPF chemotherapy. Thirty patients were evaluated for response without 1 early death before post-treatment assessment, and the response rates were CR, 10%; PR, 66.7%; SD, 6.7%; PD, 16.6%. At a median follow-up of 31 months (range, 4.5-113), the median time to progression and overall survival was 13.2 months (95% CI, 7.6-22.4) and 39.9 months (95% CI, 15.7-), respectively. The estimated overall survival with functional larynx at 3 years was 35.5% (95% CI, 20.9-53.4). The most common grade 3 or 4 adverse events during the treatment were lymphocytopenia (100%), mucositis (77%), pain (45%), hyponatremia (32%) and leukocytopenia (13%). Toxicities related to the kidney were minimal and ...
The purpose of this study was to compare outcomes in patients with anal canal squamous cell carcinoma (SCCA) who were treated with definitive chemoradiotherapy by either intensity-modulated radiation therapy (IMRT) or conventional radiotherapy (CRT).Forty-six patients who received definitive chemoradiotherapy from January 1993 to August 2009 were included. Forty-five patients received 5-fluorouracil with mitomycin C (n = 39) or cisplatin (n = 6). Seventeen (37%) were treated with CRT and 29 (63%) with IMRT. The median dose was 54 Gy in both groups. Median follow-up was 26 months (CRT) and 32 months (IMRT). T3-T4 stage (P = .18) and lymph node-positive disease (P = .6) were similar between groups.The CRT group required longer treatment duration (57 days vs 40 days, P , .0001), more treatment breaks (88% vs 34.5%, P = .001), and longer breaks (12 days vs 1.5 days, P , .0001) than patients treated with IMRT. Eleven (65%) patients in the CRT group experienced grade ,2 nonhematologic toxicity ...
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This trial will investigate the tolerability and preliminary efficacy of midostaurin + chemoradiotherapy (fluorouracil + radiotherapy) in patients with locally
This study determined the maximum tolerated dose (MTD) and the recommended dose (RD) according to dose limiting toxicity (DLT).This study evaluated the
Dr. Abbas and colleagues delineate the current status of chemoradiation for anal carcinoma. Their thorough and thoughtful review serves as an excellent summation of the current therapeutic approach of the past few years. 1
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In a Chinese phase III trial reported in The New England Journal of Medicine, Yuan Zhang, MD, PhD, and colleagues found that the addition of gemcitabine/cisplatin induction chemotherapy to standard platinum-based chemoradiotherapy improved recurrence-free survival vs chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma.. Study Details. The open-label trial included 480 patients with newly diagnosed disease from 12 centers. Patients were randomly assigned between December 2013 and September 2016 to receive gemcitabine at 1 g/m2 on days 1 and 8 and cisplatin at 80 mg/m2 on day 1 every 3 weeks for three cycles plus standard chemoradiotherapy (n = 242) or standard chemoradiotherapy alone (n = 238). Chemoradiotherapy consisted of 100 mg/m2 of cisplatin every 3 weeks on days 1, 22, and 43, plus intensity-modulated radiotherapy. Randomization was stratified by treatment center and disease stage III or IV. It was recommended that patients in the induction chemotherapy group begin ...
Esophageal carcinoma (EC) is one of the major malignant diseases worldwide. Surgery alone cannot obtain satisfactory effects in patients with EC. Neoadjuvant chemoradiotherapy has been a hotspot for EC treatment research. Several related randomized controlled trials (RCTs) have been published, but opinions vary among clinicians as to the therapeutic effect of the new method. It remains uncertain whether patients with resectable EC can benefit from neoadjuvant chemoradiotherapy.. A research article to be published on December 21, 2009 in the World Journal of Gastroenterology addresses this question. The research team from China selected eleven randomized controlled trials (RCTs) including 1308 patients. The reuslts showed neoadjuvant chemoradiotherapy significantly improved the overall survival compared with surgery alone. Histological subgroup analysis indicated that esophageal squamous cell carcinoma did not benefit from neoadjuvant chemoradiotherapy.. Their meta-analysis suggest that patients ...
TY - JOUR. T1 - Phase I trial of neoadjuvant concurrent chemoradiotherapy with S-1 and weekly irinotecan in locally advanced rectal cancer. AU - Choi, Hye Jin. AU - Kim, Nam Kyu. AU - Keum, Ki Chang. AU - Cheon, Seong Ha. AU - Shin, Sang Jun. AU - Baik, Seung Hyuk. AU - Choen, Jae Hee. AU - Rha, Sun Young. AU - Roh, Jae Kyung. AU - Jeung, Hei Cheul. AU - Chung, Hyun Cheol. AU - Ahn, Joong Bae. PY - 2008/6/1. Y1 - 2008/6/1. N2 - S-1 is a novel, oral fluoropyrimidine and a known radiosensitizer. We conducted a phase I trial to establish a schedule of S-1/irinotecan with standard pelvic radiotherapy as a preoperative treatment of locally advanced rectal cancer. Our findings suggest that this new combination is feasible and well tolerable.. AB - S-1 is a novel, oral fluoropyrimidine and a known radiosensitizer. We conducted a phase I trial to establish a schedule of S-1/irinotecan with standard pelvic radiotherapy as a preoperative treatment of locally advanced rectal cancer. Our findings suggest ...
Concurrent Chemoradiotherapy Using Intensity Modulated Radiotherapy (IMRT) & Docetaxel-cisplatin (or Carboplatin) Followed by Adjuvant Chemotherapy for Inoperable Stage III Non-small-cell Lung ...
Concurrent Chemoradiotherapy Using Intensity Modulated Radiotherapy (IMRT) & Docetaxel-cisplatin (or Carboplatin) Followed by Adjuvant Chemotherapy for Inoperable Stage III Non-small-cell Lung ...
Objectives: The main aims of study were to compare toxicity profile of IMRT with conventional Radiotherapy (2D RT) in head and neck cancer. Methods: The Study was a prospective one in which we included Eligible patients known case of head and neck cancer like oral cavity, nasopharaynx, oropharaynx, and hypopharyanx to received either definitive chemoradiation alone or adjuvant. Eligible patients in conventional group randomized to receive radiotherapy with parallel opposed lateral fields and one direct anterior lower neck. In IMRT group patients received either 7 fields or 5 fields or parotid sparing radiation. Patients Toxicity pattern (grades of mucositis, skin reaction, xerostomia, odynophagia) of both groups was noted down. Toxicity of Radio-Therapy (RT) developing within 90 days and more than 90 days from the beginning of RT assessed according to Radiation Therapy Oncology Group (RTOG) and European Organization for the Research and Treatment of Cancer (EORTC) criteria. Results: A total of ...
PURPOSE: The purpose of this study was to combine gene expression profiles and clinical factors to provide a better prediction model of local control after chemoradiotherapy for advanced head and neck cancer. MATERIAL AND METHODS: Gene expression data were available for a series of 92 advanced stage head and neck cancer patients treated with primary chemoradiotherapy. The effect of the Chung high-risk and Slebos HPV expression profiles on local control was analyzed in a model with age at diagnosis, gender, tumor site, tumor volume, T-stage and N-stage and HPV profile status. RESULTS: Among 75 patients included in the study, the only factors significantly predicting local control were tumor site (oral cavity vs. Pharynx, hazard ratio 4.2 [95% CI 1.4-12.5]), Chung gene expression status (high vs. Low risk profile, hazard ratio 4.4 [95% CI 1.5-13.3]) and HPV profile (negative vs. Positive profile, hazard ratio 6.2 [95% CI 1.7-22.5]). CONCLUSIONS: Chung high-risk expression profile and a negative ...
The researchers identified 6 eligible randomized controlled trials. The team found that chemoradiotherapy plus surgery, compared with surgery alone, significantly reduced the 3 year mortality rate (odds ratio 0.53). They also found that preoperative chemoradiotherapy downstaged the tumor. However, the risk for postoperative mortality was higher in the chemoradiotherapy plus surgery group (odds ratio 2.10). Dr Fiorica and colleagues concluded, In patients with resectable esophageal cancer, chemoradiotherapy plus surgery significantly reduces 3 year mortality compared with surgery alone . However, postoperative mortality was significantly increased by neoadjuvant chemoradiotherapy . Further large scale multicenter randomized controlled trials may prove useful to substantiate the benefit on overall survival . ...
The present study contains novel findings to support the concept of immunogenic cell death induced by chemoradiotherapy in patients with ESCC. First, tumor antigen-specific T-cell responses were confirmed in 6 (38%) of 16 patients with ESCC following chemoradiotherapy. Second, the serum level of HMGB1 following chemoradiation in the patients with antigen-specific T-cell responses was significantly elevated in comparison to that in the patients without antigen-specific T-cell responses. Third, upregulation of HMGB1 within tumor microenvironments was significantly related to preoperative chemoradiotherapy and the degree of HMGB1 positively correlated with patients survival. Fourth, both irradiation and chemodrugs could induce upregulation of HMGB1 and calreticulin on ESCC cell lines in vitro. Finally, HMGB1 was able to induce maturation of DCs in an in vitro culture system.. In general, chemoradiotherapy is thought to induce an immunosuppressive state in both T-cell and natural killer-cell ...
From a clinical perspective, although T2 stage cancer is not an indication for CCRT in the National Comprehensive Cancer Networkguidelines [2-6], some patients with T2 stage cancers undergo CCRT. CCRT was associated with a high pCR rate in some studies, including in our study. Therefore, CCRT may be suitable for selected patients who require analsparing procedures. A major factor in selecting CCRT for T2 stage cancer is precise T staging using appropriate imaging modalities, and this attempts to predict pCR. A long interval between finishing CCRT and surgery was a significant predictive factor in the multivariate analysis in our study. Thus, the timing of surgery is important. Some studies reported the interval between CCRT and surgery [25,26], in which the interval ranged from 4 to 8 weeks. Based on the findings of these studies, all patients could undergo complete resection without an increased rate of postoperative complications. According to these results, an interval of 4-8 weeks from ...
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Noordman, B.J.; Spaander, M.C.W.; Valkema, R.; Wijnhoven, B.P.; Berge Henegouwen, M.I. van; Shapiro, J.; Siersema, P.D.; Janssen, M.J.R.; Post, R.S. van der; Radema, S.A.; Rosman, C. ; Rütten, H.; Lanschot, J.J. van; Steyerberg, E.W. ...
All the cancer patients should receive a full course of chemotherapy rather than chemoradiotherapy following surgical treatment for pancreatic cancer.
(HealthDay) -- For most patients with locally advanced pancreatic carcinoma (LAPC), induction with a combination of gemcitabine and oxaliplatin (GEMOX) followed by chemoradiotherapy (CRT) is feasible, resulting in clinical ...
Our aim was to document the health-related quality of life (QoL) of patients with squamous cell carcinoma (SCC) of the oral cavity who were treated with chemoradiotherapy, and to compare it with that of patients treated with conventional surgery with or without adjuvant treatment. All patients who presented with SCC of the oral cavity treated with chemoradiotherapy alone at the Royal Brisbane & Womens Hospital between 2000 and 2011 and who were alive without disease were included. Health-related QoL was assessed by the University of Washington QoL questionnaire version 4, and the European Organisation for the Research and Treatment of Cancer (EORTC) QoL questionnaires C30 and HN35. The questionnaires were sent to all survivors. Those who responded to chemoradiotherapy were matched with patients who were treated by conventional surgery with or without adjuvant treatment by age, sex, subsite of tumour, and TNM stage. Sixteen patients completed the questionnaires (8 in each group). There was no ...
The impact of cumulative dose of cisplatin on clinical outcomes of nasopharyngeal carcinoma (NPC) patients who received intensity-modulated radiotherapy (IMRT) was evaluated. This study included 491 consecutive patients with histologically confirmed NPC who were treated with concurrent chemoradiotherapy with IMRT. The patients were divided into three groups: low- (cumulative dose ≤100 mg/m2), medium- (cumulative dose |100 mg/m2 and ≤200 mg/m2), and high- (cumulative dose |200 mg/m2) dose groups. Subgroups of patients included pre-treatment levels of Epstein-Barr Virus DNA (EBV DNA) |4000 copies/ml and pre-treatment EBV DNA ≥4000 copies/ml. To test for independent significance, the Kaplan-Meier with the log-rank test and the Cox proportional hazards model were used. The 5-year overall survival (OS) rates of the low-, medium-, and high-dose groups were 64.1 %, 91.1 %, and 89.4 %, respectively (P = 0.002). Based on multivariate analysis, patients who were in the medium- and high-dose groups had
Cancer stem cells are associated with metastatic potential, treatment resistance, and poor patient prognosis. Distant recurrence remains the major cause of mortality in rectal cancer patients with preoperative chemoradiotherapy (CRT). We investigated the role of three stem cell markers (CD133, OCT4, and SOX2) in rectal cancer and evaluated the association between these gene levels and clinical outcome in rectal cancer patients with preoperative CRT. Thirty-three patients with rectal cancer underwent preoperative CRT. Total RNAs of rectal cancer cells before and after CRT were isolated. Residual cancer cells after CRT were obtained from formalin-fixed paraffin-embedded (FFPE) specimens using microdissection. The expression levels of three stem cell genes were measured using real-time reverse-transcription polymerase chain reaction (RT-PCR). The association between these gene levels and radiation was evaluated using colon cancer cell lines. Immunohistochemical staining of these markers after CRT was also
This study aims to treat locally-advanced nasopharyngeal cancer by concurrent conventional irradiation at 2.0 Gy/day five days per week up to a total dose of 68 Gy, and daily intra-arterial infusion of cisplatin 3 mg/m2 plus 24 hours intravenous drip infusion of 5-fluorouracil 150 mg/m2 per day, five days per week. All of five enrolled patients completed the schedule, and treatment compliance was considered to be identical. Of the five patients evaluable for response, four with complete response (80%) and one with partial response (20%), with an overall response rate of 100% was achieved. The median survival time was 26 months. Two-year survival of the patients was 80%. This regimen showed marginal mucositis but well tolerated. We concluded that this treatment option is safe and effective for the locally-advanced nasopharyngeal cancer.. Keywords: chemoradiotherapy, low dose intra-arterial cisplatin, 5-fluorouracil, stage IV nasopharyngeal ...
What are the safety, toxicity and oncologic outcomes of patients undergoing transoral robotic surgery (TORS), neck dissection and adjuvant therapy for advanced oropharyngeal squamous cell carcinoma (AOC)? Background: Most patients with AOC in the U.S. are treated with definitive chemoradiation therapy. The U.S. Food and Drug Administration recently approved TORS for surgical treatment of AOC. Study […]. ...
Locally advanced rectal cancer is regularly treated with trimodality therapy consisting of neoadjuvant chemoradiation, surgery and adjuvant chemotherapy. There is a need for biomarkers to assess treatment response, and aid in stratification of patient risk to adapt and personalise components of the therapy. Currently, pathological stage and tumour regression grade are used to assess response. Experimental markers include proteins involved in cell proliferation, apoptosis, angiogenesis, the epithelial to mesenchymal transition and microsatellite instability. As yet, no single marker is sufficiently robust to have clinical utility. Microarrays that screen a tumour for multiple promising candidate markers, gene expression and microRNA profiling will likely have higher yield and it is expected that a combination or panel of markers would prove most useful. Moving forward, utilising serial samples of circulating tumour cells or circulating nucleic acids can potentially allow us to demonstrate tumour
4159 Concurrent chemoradiotherapy has been proven efficaciously superior than sequential therapy and is the current standard of care for a number of malignancies, including rectal, head and neck, lung, and esophageal cancers. However, combining chemotherapy and radiotherapy also significantly increases toxicity. Nanoparticle formulations of chemotherapy have been shown to increase efficacy and decrease toxicity when compared to small molecule counterparts. Therefore, we have developed a multifunctional nanoparticle platform for targeted delivery of concurrent chemoradiotherapy. A novel polymer-lipid nanoparticle platform was synthesized by nanoprecipitation of poly (D,L-lactide-co-glycolide) (PLGA) in an aqueous solution containing 1,2-distearoyl-glycero-3-phosphoethanolamine-carboxy polyethylene glycol 2000 (DSPE-PEG), 1,2-dimyristoyl glycero-3-phosphoethanolamine diethylene triamine pentaacetate (DMPE-DTPA) and lecithin. The resulting nanoparticles have a hydrophobic PLGA polymeric core ...
Inclusion Criteria:. Patients must have recurrent SCCHN that has been previously treated with cetuximab as part of potentially curative therapy (i.e. with induction therapy, radiotherapy or chemoradiotherapy); the interval from completion of cetuximab and study treatment should be , 3 months. Measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. One prior curative regimen (induction, primary or postoperative chemoradiotherapy) should have been given AND all patients should have been exposed to cetuximab as part of prior potentially curative treatment (i.e. with radiotherapy or induction therapy); the last cetuximab dose should be , 3 months. Unlimited prior treatment with radiation or chemoradiotherapy. Any number of prior regimens for recurrent or metastatic SCCHN (i.e. palliative treatment) but without cetuximab or another EGFR inhibitor. Eastern Cooperative Oncology Group (ECOG) performance status =, 2 (Karnofsky ,= 60%). Life expectancy of greater than 12 ...
Establishing a treatment strategy for elderly patients with rectal cancer is a difficult process. Meta-analysis of randomized studies has shown the benefit of RT in local control regardless of patients age[7]. However, the improvement in overall survival due to RT is still controversial. Studies from two population based cohorts in the Netherlands and the Dutch Trial showed that patients aged 75 years or older had significantly lower overall survival and higher mortality within 6 months after treatment than patients younger than 75 years. Meanwhile, no survival improvement was observed with the introduction of standard preoperative RT/CRT and surgical resection in patients more than 75 years old[7]. It is important for clinicians to select optimal treatment modalities in elderly patients with rectal cancer by careful assessment of patients outcomes, treatment risks, life expectancy and comorbidities. Higher rates of surgical complications, more prevalent co-morbidities, and poorer performance ...
Mean and median pre-treatment GTV were 146cm3 and 109cm3 (range 3-679cm3). The median overall survival for all patients was 16.0 months (CI 13.0-19.0). We defined two groups based on the median value of the GTV. The overall survival of patients with a GTV < 109cm3 was 24.0 months (CI 15.5-32.5) compared to 11.0 months (CI 9.7-12.3) for those with GTV > 109cm3 (log-rank p=0.002). A simple Cox regression model was constructed entering age, gender, stage, histology, chemotherapy and GTV as covariates. Pre-treatment GTV (p=0.004) and the use of chemotherapy (p=0.03) were significant variables predictive of survival. 53 patients received induction chemotherapy. In 45 patients with retrievable data, mean GTV pre chemotherapy and post chemotherapy were 177 cm3 and 99 cm3 retrospectively with mean shrinkage of 44%.. ...
The immune checkpoint inhibitor pembrolizumab demonstrated antitumor activity in a small trial of patients with advanced cervical cancer. The agent had a similar toxicity profile to that seen in other malignancies.
Patients with rectal cancer reported aerobic exercise during neoadjuvant chemoradiotherapy to be more enjoyable and less difficult.
Increasing the Rates of Complete Response to Neoadjuvant Chemoradiotherapy for Distal Rectal Cancer: Results of a Prospective Study Using Additional Chemotherap
This course aims to provide in-depth knowledge in the value of MRI during the management of rectal cancer. Attendees will learn how to accurately interpret staging and restaging MR images and deal with difficulties by evaluating numerous cases from daily practice on a personal computer. A faculty of experts in rectal cancer will provide intensive teaching. The goal is that after attending this course the participants will not only be able to implement high quality MR protocol in own center but also to accurately interpret MR images both before and after chemoradiotherapy and to gain own confidence. ...
Multiparametric MRI in the assessment of response of rectal cancer to neoadjuvant chemoradiotherapy: A comparison of morphological, volumetric and functional MRI parameters Academic Article ...
BACKGROUND: Definitive chemoradiotherapy is a curative treatment option for oesophageal carcinoma, especially in patients unsuitable for surgery. The PRODIGE5/ACCORD17 trial aimed to assess the efficacy and safety of the FOLFOX treatment regimen (fluorouracil plus leucovorin and oxaliplatin) versus fluorouracil and cisplatin as part of chemoradiotherapy in patients with localised oesophageal cancer. METHODS: We did a multicentre, randomised, open-label, parallel-group, phase 2/3 trial of patients aged 18 years or older enrolled from 24 centres in France between Oct 15, 2004, and Aug 25, 2011. Eligible participants had confirmed stage I-IVA oesophageal carcinoma (adenocarcinoma, squamous-cell, or adenosquamous), Eastern Cooperative Oncology Group (ECOG) status 0-2, sufficient caloric intake, adequate haematological, renal, and hepatic function, and had been selected to receive definitive chemoradiotherapy. Patients were randomly assigned (1:1) to receive either six cycles (three concomitant to ...
The initial literature search identified 7,453 studies. We excluded 1,931 duplicates and excluded 5,504 studies by title screening because they did not meet the eligibility criteria. Eighteen randomized controlled trials were selected for full-text review, and 15 papers were discarded; 6 trials compared surgery alone and surgery plus postoperative radiation, 2 compared surgery alone and preoperative longcourse radiation plus surgery, 6 compared surgery alone and preoperative short-course radiation and surgery, and one was long-term results of a previous reported trial. Three randomized trials comparing preoperative CRT with postoperative CRT in resectable stage II-III rectal cancer were finally identified; Park et al. [9] in 2011, Roh et al. [10] in 2009, and Sauer et al. [5] in 2004 (Fig. 1). All patients in both preoperative and postoperative arms received conventionally fractionated radiotherapy of 50-54 Gy with 1.8-2 Gy per fraction for 5-6 weeks. Concurrent chemotherapy of intravenous ...
We aimed to assess whether high-dose preoperative chemoradiotherapy (CRT) improves outcome in esophageal cancer patients compared to surgery alone and to define possible prognostic factors for overall survival. Hundred-and-seven patients with disease stage IIA - III were treated with either surgery alone (n = 45) or high-dose preoperative CRT (n = 62). The data were collected retrospectively. Sixty-seven patients had adenocarcinomas, 39 squamous cell carcinomas and one undifferentiated carcinoma. CRT was given as three intensive chemotherapy courses by cisplatin 100 mg/m2 on day 1 and 5-fluorouracil 1000 mg/m2/day, from day 1 through day 5 as continuous infusion. One course was given every 21 days. The last two courses were given concurrent with high-dose radiotherapy, 2 Gy/fraction and a median dose of 66 Gy. Kaplan-Meier survival analysis with log rank test was used to obtain survival data and Cox Regression multivariate analysis was used to define prognostic factors for overall survival. Toxicity
Stinchcombe TE, Zhang Y, Vokes EE, Schiller JH, Bradley JD, Kelly K, Curran WJ, Schild SE, Movsas B, Clamon G, Govindan R, Blumenschein GR, Socinski MA, Ready NE, Akerley WL, Cohen HJ, Pang HH, Wang X. Pooled Analysis of Individual Patient Data on Concurrent Chemoradiotherapy for Stage III Non-Small-Cell Lung Cancer in Elderly Patients Compared With Younger Patients Who Participated in US National Cancer Institute Cooperative Group Studies. J Clin Oncol. 2017 Sep 01; 35(25):2885-2892 ...
RANCHO MIRAGE, Calif. -- Chemoradiation allows many patients with node-positive head-and-neck cancer to avoid additional surgery to the neck, a researcher reported here.
EBV status was an independent prognostic factor for patients with stage III-IVB NPC. Neoadjuvant chemotherapy (NCT) plus concurrent chemoradiotherapy (CCRT) should be better treatment regimen for EBV-positive patients since distant metastasis was the main failure pattern, and CCRT may be enough for …
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Conclusions. In addition to the correlation of transforming growth factor (TGF)-β1 levels to the radiation toxicity, both Epstein-Barr virus (EBV) infection and postoperative status play roles in the change in plasma TGF-β1 levels in patients with head and neck cancers. Objectives. To assess the parameters involved in the change in plasma TGF-β1 level during concurrent chemoradiotherapy (CCRT). Patients and methods. Blood samples (n=307) before, during, and after treatment were obtained from 39 patients with head and neck cancers treated with definitive or adjuvant CCRT. In situ hybridization (ISH) was used to identify EBV-encoded RNA (EBER) in tissues from the primary tumor or metastatic lymph nodes. Plasma TGF-β1 level, white blood cell (WBC), and platelet count were assayed immediately before the first fraction of radiotherapy (RT), once a week during RT, and at the end of the RT course. The grades of mucositis and dermatitis were recorded weekly during CCRT. Results. Pretreatment TGF-β1 ...
Phase III Study of ADXS11-001 Administered Following Chemoradiation as Adjuvant Treatment for High Risk Locally Advanced Cervical Cancer
Erm/Pea3 are downstream of FGF signaling from the mesenchyme, but their responses toward different FGFs are not the same. Further evidence for oxidant-induced vascular endothelial growth factor up-regulation in the bronchoalveolar lavage fluid of lung cancer patients undergoing radio-chemotherapy. Whole-genome sequencing ...
UroToday - GU OncToday brings coverage of the clinically relevant content needed to stay at the forefront of the dynamic field of GU oncology and urology.
microRNAs (miRNAs) are small non-coding RNAs with important post-transcriptional regulatory functions. miRNA-21 (miR-21) is upregulated and miR-143 and miR-145 are downregulated in colorectal carcinoma. The aim of our study was to determine if these miRNAs change their expression levels in response to neoadjuvant chemoradiotherapy in advanced rectal cancer. Forty patients with advanced rectal cancer (clinical uT3/T4 Nx) were included. All patients underwent neoadjuvant chemoradiotherapy and surgical resection. Expression of miR-21, -143 and -145 was examined in macrodissected tumor tissue before and after chemoradiotherapy and normal rectal tissue from the resection specimen. RNA was extracted from formalin-fixed and paraffin-embedded tissue by TRIzol method, polyadenylated, reverse transcribed and analyzed by real-time PCR. Therapy response was assessed according to pathological tumor regression. miR-21 was more highly expressed in tumor tissue than in non-tumorous tissue. However, there was a ...
TY - JOUR. T1 - Current Concepts on the Distal Margin of Resection of Rectal Cancer Tumors after Neoadjuvant Chemoradiation. AU - Imran, Jonathan. AU - Yao, Jie J.. AU - Madni, Tarik. AU - Huerta, Sergio. PY - 2017/1/23. Y1 - 2017/1/23. N2 - Purpose of Review: The following review addresses concepts regarding the appropriate distal margin of resection for adenocarcinoma of the rectum in the era of preoperative chemoradiation. Recent Findings: The management of adenocarcinoma of the rectum continues to improve in all aspects of its tri-modality treatment (preoperative chemoradiation, surgery, and adjuvant therapy). The multidisciplinary approach to the management of this disease continues to evolve with a goal to provide better oncologic outcomes with less morbidity in patients affected by this disease. For locoregionally advanced disease, total mesorectal excision continues to be the standard of care for an intended cure for this cohort of patients. As we understand more regarding the oncologic ...
We performed a meta-analysis to compare the efficacy of neoadjuvant CRT with OXP plus 5FU to 5FU alone in LARC. The main result of this meta-analysis was that addition of OXP to standard 5FU-based CRT was related to significant clinical benefit in term of DF. Whereas, there was no significant increase in OS, as well as no lower DFS and LF rates were observed between groups, although globally a higher proportion of events was recorded in patients treated with standard CRT.. Nowadays, the treatment of LARC is multidisciplinary and it is developed from clinical trials evidence. The trimodality approach, including neoadjuvant CRT, total mesorectal excision surgery and adjuvant chemotherapy, represents the standard of care in this setting of patients, due to its value to improve local control up to 90% of cases [18]. However it does not decrease distant failures and year after year the concept of intensify treatment regimen has become progressively more common in order to improve systemic control. ...
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An Absolute Standardized Uptake Value Is More Useful than the Decreased Rate of Uptake of FDG-PET to Predict Responses to Neoadjuvant Chemoradiotherapy for Esophageal Cancer. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.
Cancer Research UK are offering the opportunity for women affected by cervical cancer to try a new treatment regime where chemotherapy is given before chemoradiation. The trial is available across the UK at various sites. When you make contact, the team can specific which locations are available.
TY - JOUR. T1 - 18Fluoro-deoxy-glucose positron emission tomography in assessing tumor response to preoperative chemoradiation therapy for locally advanced rectal cancer. AU - Hur, Hyuk. AU - Kim, Nam Kyu. AU - Yun, Mijin. AU - Min, Byung Soh. AU - Lee, Kang Young. AU - Keum, Ki Chang. AU - Ahn, Jung Bai. AU - Kim, Hoguen. PY - 2011/1/1. Y1 - 2011/1/1. N2 - Background This study aims to evaluate the efficacy of 18F-FDG PET in assessing tumor response after preoperative chemoradiation therapy (CRT) for rectal cancer. Methods Maximum standardized uptake value (SUV) was measured for 37 patients who underwent 18F-FDG PET before and 4 weeks after completion of preoperative CRT. Pre-SUV, post-SUV, the difference between pre- and post-SUV (ΔSUV), and reduction rate (RR) were correlated with tumor response. Results A lower mean post-SUV and a higher mean RR were shown in good tumor response (T-downstaging(+) and tumor regression grade 1, 2). Considering pathologic complete response (pCR), the mean ...
Oesophageal adenocarcinoma (OAC) is the sixth most common cause of cancer deaths worldwide, and the 5-year survival rate for patients diagnosed with the disease is approximately 17%. The standard of care for locally advanced disease is neoadjuvant chemotherapy or, more commonly, combined neoadjuvant chemoradiation therapy (neo-CRT) prior to surgery. Unfortunately, ~60-70% of patients will fail to respond to neo-CRT. Therefore, the identification of biomarkers indicative of patient response to treatment has significant clinical implications in the stratification of patient treatment. Furthermore, understanding the molecular mechanisms underpinning tumour response and resistance to neo-CRT will contribute towards the identification of novel therapeutic targets for enhancing OAC sensitivity to CRT. MicroRNAs (miRNA/miR) function to regulate gene and protein expression and play a causal role in cancer development and progression. MiRNAs have also been identified as modulators of key cellular ...
To evaluate the benefit of adjuvant treatments, such as chemoradiotherapy (CRT) and chemotherapy (CTx), compared with no adjuvant treatment (No-AT) in resected gallbladder (GB) cancer patients, 151 patients were analyzed: 98 (64.9%) patients received adjuvant treatment with CRT (n = 59, 39.1%) or CTx (n = 39, 25.8%), and the remaining 53 (35.1%) did not (No-AT). The clinicopathological factors, patterns of failure, locoregional recurrence-free survival (LRFS), recurrence-free survival (RFS) and overall survival (OS) were compared among the three groups according to tumor stage. In patients with T2-3N0M0 stage disease, the incidences of locoregional recurrence and distant recurrence and 5-year LRFS, RFS and OS rates were not significantly different among the No-AT, CTx, and CRT groups (p | 0.05 each). In those with T2-3N1-2M0 stage disease, the incidences of locoregional recurrence (11.4%, 78.1%, and 68.4%, respectively) and distant recurrence (42.8%, 73.9% and 66.7%, respectively) in the CRT group were
Abstract: Objective: To evaluate the clinical relevance of preoperative airway colonisation in patients undergoing oesophagectomy for cancer after a neoadjuvant chemoradiotherapy. Methods: From 1998 to 2005, 117 patients received neoadjuvant chemoradiotherapy for advanced stage oesophageal cancer. Among them, 45 non-randomised patients underwent a bronchoscopic bronchoalveolar lavage (BAL group) prior to surgery to assess airways colonisation. The remaining patients (n =72) constituted the control group. The two groups were similar with respect to various clinical or pathological characteristics. Results: Thirteen of the 45 BAL patients (28%) had a preoperative bronchial colonisation by either potentially pathogenic micro-organisms (PPMs) (n =7, 16%) or non-potentially pathogenic micro-organisms (n =6, 13%). Cytomegalovirus (CMV) was cultured from BAL in four patients. Pre-emptive therapy was administrated in seven patients: four antiviral and three antibiotic prophylaxes. Postoperatively, 14 ...
A Randomized, Placebo Controlled Phase IIb/III Study of ABT-414 with Concurrent Chemoradiation and Adjuvant Temozolomide in Subjects with Newly Diagnosed Glioblastoma (GBM) with Epidermal Growth Factor Receptor (EGFR) Amplification (Intellance 1)
One RCT and two non-randomised studies that allowed for multivariate analyses met the inclusion criteria and included a total of 141 women.. One RCT found that neoadjuvant chemoradiation did not appear to offer longer survival compared to primary surgery in advanced vulval tumours (RR = 1.29, 95% confidence interval (CI) 0.87 to 1.91). There was also no statistically significant difference in survival between primary chemoradiation and primary surgery in a study that included 63 women (pooled adjusted HR= 1.09, 95% CI 0.37 to 3.17) and in another study that only included 12 eligible women and compared the same interventions (HR was non-informative when statistical adjustment was made).. Adverse events were extensively reported in only one study, which found no statistically significant difference in risk of adverse events between primary chemoradiation and primary surgery due to the very small numbers in each group. In the RCT there was no observed statistically significant difference between ...
received concurrent chemotherapy arms could In conclusion, for radiochemotherapy of stage receive all 3 courses of 100 mg/m2 cisplatin.19 This III/IV head and neck cancer, the regimen includ- rate may be higher than in our series, because the ing 2 courses of fractionated cisplatin (20 mg/m2/d authors did not consider patients who needed a on radiotherapy days 1-5 and 29-33) and 5-FU reduction of the chemotherapy dose. In our study, (600 mg/m2/d on radiotherapy days 1-5 and 29- both cessation of chemotherapy and dose reduc- 33) was associated with significantly less acute tions were considered as uncompleted chemother- toxicity than 3 courses of cisplatin (100 mg/m2 on radiotherapy days 1, 22, and 43). Adding 5-FU The randomized RTOG 97-03 study compared was tolerated by group B patients, because these 3 different radiochemotherapy regimens for toxic- patients received less cisplatin and because cis- ity and outcome in 241 patients with squamous platin was fractionated. The results of this ...
ALONSO M, Catalina; BRAVO O, Erasmo; ROJAS S, Sergio e PARRY R, Santiago. Histerectomía extrafascial en cáncer de cuello uterino IB2 posterior a radio-quimioterapia. Rev. chil. obstet. ginecol. [online]. 2012, vol.77, n.2, pp.93-97. ISSN 0717-7526. http://dx.doi.org/10.4067/S0717-75262012000200003.. Aim: To evaluate overall and disease free survival in cervical cáncer IB2 patients with concomitant chemo-radiotherapy and posterior extrafascial hysterectomy treatment. Methods: Between July 2005 to December 2009, a total of 31 eligible patients with IB2 cervical cancer were treated with chemoradiotherapy and posterior hysterectomy in the Carlos Van Buren Hospital Oncology Unit. Radiotherapy consisted in external pelvic radiation and a utero-vaginal brachitherapy with low rate doses to get preoperatory doses between 70 and 75 Gy to the A point and a concomitant Cisplatin based chemotherapy. After this treatment, the patients received extrafascial hysterectomy 4 to 6 weeks completed ...
Radiation oncologists in the US are less likely to offer neoadjuvant short-course radiotherapy over long-course chemoradiotherapy.
Treatments for anal cancer include radiation therapy with chemotherapy (chemoradiation) and surgery. Learn about treatment plans and options.
Background and purpose: To analyze the recurrence pattern in relation to target volumes and 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography in head and neck squamous cell carcinoma (HNSCC) patients treated with definitive chemoradiation. Material and methods: 520 patients received radiotherapy for HNSCC from 2005 to 2009. Among 100 patients achieving complete clinical response and a later recurrence, 39 patients with 48 loco-regional failures had a recurrence CT scan before any salvage therapy. The estimated point of origin of each recurrence was transferred to the planning CT by deformable image co-registration. The recurrence position was then related to the delineated target volumes and iso-SUV-contours relative to the maximum standard uptake value (SUV). We defined the recurrence density as the total number of recurrences in a sub-volume divided by the sum of that volume for all patients. Results: 54% (95% CI 37-69%) of recurrences originated inside the FDG-positive ...
Intensive chemoradiotherapy, with or without additional local radiotherapy, and unpurged autologous marrow transplantation was given to 68 patients with progressive non-Hodgkins lymphoma. Responses were attained in 44 patients (65%, 95% confidence intervals [CI], 52% to 76%), including 37 who achieved complete responses. Fifteen patients (22%, 95% C.I. 13% to 34%) remain free of disease (including 11 continuously) at a median of 5.3 (range 3.1 to 9.1) years later. Higher Karnofsky scores (P less than .01, Mann-Whitney U test) and the absence of a history of prior radiotherapy (P = .02, chi 2 test) were associated with achievement of complete plus partial responses. Higher Karnofsky scores (P less than .01, Mann-Whitney U test) and less resistant disease status at transplantation (P = .04, chi 2 test) were significant when calculations were limited to complete responses. Karnofsky scores were also associated with the probability of freedom from progression (P = .02, log-rank) for responding ...
Dr. Rebeccah Baucom of Vanderbilt University in Nashville, Tennessee and colleagues presented the results of the study June 11 at the 2017 American Society of Colon and Rectal Surgeons Annual Scientific Meeting in Seattle, Washington.. "Patients who have rectal cancer with clinical nodal disease, high-grade tumors, or tumors with perineural or lymphovascular invasion should undergo total mesorectal excison regardless of their tumor response to neoadjuvant radiation," said senior author Dr. Alexander T. Hawkins of Vanderbilt University.. "The findings showed that more aggressive tumors, based on histology and stage, do not respond as well to neoadjuvant chemoradiation therapy," he told Reuters Health by phone.. "In a relatively new treatment modality for patients with rectal cancer called watch and wait, patients undergo neoadjuvant chemoradiation therapy, it looks like their tumor goes away, and they can be observed rather than undergo surgery," Dr. Hawkins explained. "Our findings are very ...
Objective: Surgical staging was recently recommended for the decision of treatment in locally advanced cervical cancer. We aimed to investigate clinical outcomes as well as factors associated with overall survival (OS) in patients with locally advanced cervical cancer who had undergone extraperitoneal lymph node dissection and were managed according to their lymph node status. ...
BACKGROUND: The aim of the study was to evaluate the added value of the apparent diffusion coefficient (ADC) of diffusion-weighted magnetic resonance imaging (DW-MRI) in patients with rectal cancer who received neoadjuvant chemoradiotherapy (CRT). The use of DW-MRI for response evaluation in rectal cancer still remains a widely investigated issue, as the accurate detection of pathologic complete response (pCR) is critical in making therapeutic decisions. PATIENTS AND METHODS: Thirty-three patients with locally advanced rectal cancer were evaluated retrospectively by MRI in addition to diffusion-weighted images (DWI) and its ADC pre- and post-neoadjuvant CRT ...
Majority of the patients (58%) in our study were above 40 years old. Data from cancer registries in developing countries reported the same finding; 80%-90% of women with cervical cancer in the developing countries were above the age of 40 [12]. Eighty percent of women with cervical cancer in developing countries are diagnosed at advanced stages [13]. In our study, 47 patients (56.6%) presented with cervical cancer at stage III and IV, and these results were similar to other reports [14,15]. This might be attributed to the lack of screening services in our country and women tend to seek medical advice only when they have developed symptoms. In England, 23.8% of 382 women were diagnosed in stages III and IV [16] which contributes to the longer survival [17].. Many series reported pelvic failure rate of (20%-25%) and distant failure rate of (10%-25%) after concurrent chemoradiotherapy [18-22]. Our study reported local recurrence rate of 31.2%, and distant metastasis of 20.8%. The high local ...
Rectal cancer is the eight most common cancer diagnosis in Sweden in both men and women, with almost 2000 new cases per year. Radiotherapy, which is an important treatment modality for rectal cancer, has evolved during the past decades. Diagnostic tools have also improved, allowing better staging and offering information used to make well-founded decisions in multidisciplinary team conferences.. In a retrospective study (n=46) with locally advanced rectal cancer (LARC) patients, unfit for chemoradiotherapy, patients were treated with short-course radiotherapy. Delayed surgery was done when possible. Radical surgery was possible in 89% of the patients who underwent surgery (80%). Grade IV diarrhoea affected three elderly patients. Target radiation volume should be reduced in elderly or metastatic patients.. In a prospective study (n=68) with LARC patients, magnetic resonance imaging (MRI) and 2-18F-fluoro-2-D-deoxyglucose (FDG) positron emission tomography (PET) were used to determine if FDG-PET ...
Treatments for recurrent esophageal cancer include surgery, chemoradiation, laser and targeted therapy. Learn about treatment options.
TY - JOUR. T1 - Chemoradiotherapy for poor-risk stage III non-small cell lung cancer.. AU - Lau, Derick H. AU - Ryu, J. K.. AU - Gandara, David R. PY - 1997/8. Y1 - 1997/8. N2 - Cisplatin-based chemoradiotherapy is becoming a standard treatment for patients with stage III non-small cell lung cancer (NSCLC). However, a significant proportion of patients with lung cancer also present with co-morbid conditions that indicate a poor prognosis and poor tolerance of treatment. We have completed a phase I/II study to evaluate the tolerability and efficacy of carboplatin-based chemoradiotherapy for patients with poor-risk stage III NSCLC. Twenty-four patients with stage IIIA/B NSCLC and concurrent medical conditions rendering them ineligible for cisplatin-based chemoradiotherapy protocols were treated with thoracic irradiation, 1.8 to 2 Gy daily to the primary tumor and regional lymph nodes, for a total dose of 61 Gy. Concurrently, patients received carboplatin 200 mg/m2/d intravenously on days 1, 3, 29, ...
TY - JOUR. T1 - Association between intensity modulated radiotherapy and survival in patients with stage III non-small cell lung cancer treated with chemoradiotherapy. AU - Koshy, Matthew. AU - Malik, Renuka. AU - Spiotto, Michael. AU - Mahmood, Usama. AU - Rusthoven, Chad G.. AU - Sher, David J.. PY - 2017/6/1. Y1 - 2017/6/1. N2 - Purpose To determine the effect of radiotherapy (RT) technique on treatment compliance and overall survival (OS) in patients with stage III non-small lung cancer (NSCLC) treated with definitive chemoradiotherapy (CRT). Methods and Materials This study included patients with stage III NSCLC in the National Cancer Database treated between 2003 and 2011 with definitive CRT to 60-63 Gray (Gy). Radiation treatment interruption (RTI) was defined as a break of ≥4 days. Treatment technique was dichotomized as intensity modulated (IMRT) or non-IMRT techniques. Results Out of the cohort of 7492, 35% had a RTI and 10% received IMRT. With a median follow-up of surviving ...
In this Phase III trial, 243 high risk patients were randomised to receive adjuvant RT (n=116) alone vs combined concurrent chemoradiotherapy (n=127). High risk patients were defined as Stage 1A2, 1B or 2A cervical malignancy with any of the following: positive pelvic lymph node, positive parametrium or positive surgical margin. Patients were randomised to receive pelvic radiotherapy (RT) or pelvic RT with 4 cycles of chemotherapy (CRT). Patients receiving RT were prescribed a dose 49.3Gy in 29 fractions, and chemotherapy consisted of 4 cycles of cisplatin (70 mg/m2, day 1) and infusional 5FU (1000mg/m2/day, days 1-4), with the first two cycles given concurrent with RT. The primary end point was overall survival, and secondary end points included progression-free survival, recurrence rates and toxicity. Data was analysed after a median follow-up of 42 months.r. ...
Hiura, Y., Takiguchi, S., Yamamoto, K., Takahashi, T., Kurokawa, Y., Yamasaki, M., Nakajima, K., Miyata, H., Fujiwara, Y., Mori, M., Kangawa, K. and Doki, Y. (2012), Effects of ghrelin administration during chemotherapy with advanced esophageal cancer patients. Cancer, 118: 4785-4794. doi: 10.1002/cncr.27430 ...
In this review, based mostly on the distribution traits of HLA course I alleles in Chinese populace, we determined putative CD8+ T-mobile epitopes of NS5 protein of Chinese DENV isolates utilizing various immunoinformatics methods. Our benefits provide putative protective CD8+ T-cell epitope candidates or their blend for the advancement of a T-cell epitope-dependent universal vaccine to effectively avoid all four DENV serotypes that are endemic in China.The absolute variety of metastatic lymph nodes has been regarded as as an essential prognostic element for colorectal most cancers. In addition to the quantity of metastatic LNs, the amount of examined LNs has been proven to be an independent prognostic element for survival. Meanwhile, neoadjuvant chemoradiotherapy followed by whole mesorectal excision has become the remedy of option for individuals with LN-constructive rectal cancer. This NCRT can end result in a substantial lessen in the amount and size of examined LNs in the TME specimen. For ...
Over the past twenty years there has been a significant shift from surgery towards chemoradiation therapy as primary treatment for certain head and neck cancers. While primary chemoradiation allows many patients to avoid surgery and its concurring postoperative complications, it may be associated with significant post-treatment dysphagia, or difficulty in swallowing, which can be debilitating and potentially lethal.. During treatment, radiation is typically given over a wide field which encompasses both the primary tumor and its associated lymphatic drainage. As a consequence, structures vital to swallowing are subjected to high doses of radiation which may result in complications such as silent aspiration and feeding tube dependence. The addition of chemotherapy to radiation provides a synergistic effect which has been shown to further improve locoregional control. While chemotherapeutic agents act as radiosensitizers and thereby increasing tumor control rates, they also result in increased ...
The rectal cancer pipeline has grown as pharmaceutical companies are attracted by the high incidence and success of other developers. Cytotoxics will remain an integral part of treatment, but with key brands expected to come off patent over the forecast period and the approval of new therapies, treatment of this growing market is set to evolve.
How molecular imaging biomarkers can be applied to estimate howan experimental radiochemotherapy for locally advanced rectal cancer will work revealed by study.
Assess whether the use of calcium cyanamide as a fertiliser may pose an unacceptable risk to human health and/or the environment. The report should take into account information in the REACH registration dossier for the substance, in the SCHER opinion and in dossiers submitted for other regulatory processes (e.g. under the Biocidal Products Regulation and the Plant Protection Products Regulation3 ...
Electric Chemistry is next! "When youre around that special someone, there is an indescribable allure that consumes you with sparks of passion. It is a sultry and spectacular experience and this nail polish evokes such feelings. Electric chemistry is comprised of micro gunmetal and silver holographic glitters as well as medium light pink accents and black hearts. " This can be worn over a base color as a topper or as I did below with three coats to full coverage. I wanted to show that it definitely is buildable on its own. The black hearts got covered by my multiple layers of glitter so Id suggest wearing one or two coats over a base color if the hearts are what you are after. Three coats with a glitter smoothing top coat shown below. No issues to report ...
The study protocol was approved by the institutional review board. From a prospectively collected database of all patients undergoing colorectal surgery in our department, 46 consecutive patients were selected who underwent laparoscopic surgery after preoperative chemoradiation for rectal cancer from January 2009 to June 2014. All patients were diagnosed with adenocarcinoma in the rectum with tumors ,15 cm from the anal verge. Preoperative assessment included digital rectal examination, colonoscopy with biopsy, rectal ultrasound, abdominopelvic computed tomography (CT), chest x-ray, and laboratory data including complete blood cell count, biochemical profiles, serum carcinoembryonic antigen (CEA), and cancer antigen (CA 19-9).. Patients with CTs showing locally advanced tumor (i.e., penetrating through the rectal wall, T3), and/or tumor with lymph node involvement without evidence of distant metastasis were given the option of preoperative chemoradiation therapy. As preoperative chemoradiation ...
Preoperative radiation therapy has shown to be of benefit for the prevention of local recurrence rates in rectal cancer patients (11, 12). Long-course preoperative chemoradiotherapy is of benefit in stage T3/T4 rectal cancer patients, and long-course preoperative chemoradiation is the standard of care in the United States (27). However, considering the extensive morbidity of preoperative radiation therapy (13-15), it is of great importance to identify patients with a low risk of local recurrence in which radiation therapy is redundant. With this intention, the current study was done in patients with stage III rectal cancer, as these patients are at the highest risk for local recurrence (12). Our results show that biochemical detection of caspase-3 levels can be used as a marker to identify patients with a very high probability for local cure with surgery alone.. To select patients who can be refrained from preoperative radiation therapy, a marker should provide accurate prediction of clinical ...
A margin distance analysis of the impact of adjuvant chemoradiation on survival after pancreatoduodenectomy for pancreatic adenocarcinoma
The role of combined chemoradiotherapy in this setting is unclear. However, if the tumor tissue margins are positive, ... December 2006). "Predictors of disease recurrence following neoadjuvant chemoradiotherapy and liver transplantation for ...
"Dose-intensity temozolomide after concurrent chemoradiotherapy in operated high-grade gliomas". Journal of Neuro-Oncology. 90 ( ...
"Dose-intensity temozolomide after concurrent chemoradiotherapy in operated high-grade gliomas". Journal of Neuro-Oncology. 90 ( ... Signature and High Epidermal Growth Factor Receptor Expression Associated with Resistance to Concomitant Chemoradiotherapy in ...
... chemo)radiotherapy in head and neck cancer". Head Neck. 27: 175-81. doi:10.1002/hed.20130. PMID 15627258. 3. Sandro V Porceddu ... "Postoperative chemoradiotherapy for high-risk head-and-neck squamous cell carcinoma". International Journal of Radiation ... 2011 Cancer Council Australia board Trans Tasman Radiation Oncology Group Post-operative Concurrent Chemo-radiotherapy Versus ... control based on pretreatment nodal size in squamous cell carcinoma of the head and neck treated with chemoradiotherapy: a ...
January 2007). "HSP60 may predict good pathological response to neoadjuvant chemoradiotherapy in bladder cancer". Jpn. J. Clin ...
Chemoradiotherapy is a standard treatment for advanced esophageal squamous cell carcinoma (ESCC). Reduced PINX1 expression did ...
"ZNF695 methylation predicts a response of esophageal squamous cell carcinoma to definitive chemoradiotherapy". J. Cancer Res. ...
Impact of the extent of surgery and postoperative chemoradiotherapy on recurrence patterns in gastric cancer. „J Clin Oncol". ... A pilot study of preoperative chemoradiotherapy for resectable gastric cancer. „Ann Surg Oncol". 8 (6), s. 519-524, Jul 2001. ... Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced ...
"Olfactory neuroblastoma with epithelial and endocrine differentiation transformed into ganglioneuroma after chemoradiotherapy ...
MacDonald (6 September 2001). "Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or ...
"Prognostic Significance of Two Dimensional AgNOR Evaluation in Local Advanced Rectal Cancer Treated with Chemoradiotherapy". ...
Bishop, S; Reed, WM (December 2015). "The provision of enteral nutritional support during definitive chemoradiotherapy in head ...
"Hypermethylation of RAD51L3 and XRCC2 genes to predict late toxicity in chemoradiotherapy-treated cervical cancer patients". ...
"A Specific miRNA Signature Correlates with Complete Pathological Response to Neoadjuvant Chemoradiotherapy in Locally Advanced ...
... usually definitive combination chemoradiotherapy. APRs involves removal of the anus, the rectum and part of the sigmoid colon ...
"Effect of injection of brucea javanica oil emulsion plus chemoradiotherapy for lung cancer: a review of clinical evidence". J ...
... immunotherapy and combined treatment modalities such as chemo-radiotherapy. Starting in the mid-1990s, the emphasis in clinical ...
... chemoradiotherapy and prostate cancer. Dr Joensuu was the first doctor in Nordic countries to use IMRT (Intensity-modulated ...
... as would be expected with the concurrent chemoradiotherapy, which is the current gold standard treatment for advanced head and ... interpretation is difficult since cetuximab-radiotherapy was not directly compared to chemoradiotherapy. The results of ongoing ...
... as a predictive marker of distant recurrence after preoperative chemoradiotherapy in rectal cancer". Oncol. Rep. 22 (4): 709-17 ...
... or concurrent chemoradiotherapy for stage I and II with either of two regimens. Asparaginase containing regimens have been used ... "Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan Clinical Oncology ...
... with concurrent chemoradiotherapy (CRT) for locoregionally advanced head and neck carcinoma". Journal of Clinical Oncology. 33 ...
18F-FDG PET Tumor Textural Features in Non-Small Cell Lung Cancer Associated with Response and Survival After Chemoradiotherapy ... and quantitative assessment of 18F-FDG PET for the prediction of pathologic complete response to preoperative chemoradiotherapy ...
... relates to poor vascularization and resistance of squamous cell head and neck cancer to chemoradiotherapy". Clinical Cancer ...
... the insensitivity of tumours to chemoradiotherapy. At present, over-expression of RAD51 has been found in many kinds of human ...
Medical Definition of Chemoradiotherapy Neuner G, Patel A, Suntharalingam M. "Chemoradiotherapy for esophageal cancer". ... Chemoradiotherapy as neoadjuvant therapy before surgery has been shown to be effective in various cancers.[clarification needed ... Chemoradiotherapy (CRT, CRTx) is the combination of chemotherapy and radiotherapy to treat cancer. Synonyms include ... CS1 maint: Multiple names: authors list (link) Older Patients with GI Cancers Dont Always Receive Tx Chemoradiotherapy in the ...
... such as chemoradiotherapy (CRT) and chemotherapy (CTx), compared with no adjuvant treatment (No-AT) in resected gallbladder (GB ... Benefit of Adjuvant Chemoradiotherapy in Resected Gallbladder Carcinoma. *Tae Hyun Kim. ORCID: orcid.org/0000-0001-8413-33851. ... Kim, T.H., Woo, S.M., Lee, W.J. et al. Benefit of Adjuvant Chemoradiotherapy in Resected Gallbladder Carcinoma. Sci Rep 9, ... Nomogram for predicting the benefit of adjuvant chemoradiotherapy for resected gallbladder cancer. J Clin Oncol 29, 4627-4632, ...
Neoadjuvant chemoradiotherapy was connected with a little higher mortality after surgery. But it did not increase the incidence ... Neoadjuvant chemoradiotherapy has been a hotspot for EC treatment research. Several related randomized controlled trials (RCTs ... Patients With Resectable Esophageal Adenocarcinoma Benefit From Neoadjuvant Chemoradiotherapy. by Sam Savage ... Compared with patients treated by surgery alone, patients receiving neoadjuvant chemoradiotherapy more likely obtained complete ...
Experimental: Valporoic acid + chemoradiotherapy Drug: Valproic acid Valproic acid given concurrent with chemoradiotherapy for ... Valproic Acid With Chemoradiotherapy for Pancreatic Cancer. The safety and scientific validity of this study is the ... This is non-randomized phase 2 study to evaluate toxicity and efficacy of valproic acid (VA) with concurrent chemoradiotherapy ... Valproic Acid in Combination With Concurrent Chemoradiotherapy Using Gemcitabine for Unresectable Locally Advanced Pancreatic ...
Chemoradiotherapy (CRT) represents a standard treatment for many human cancers, frequently combined with radical surgical ... Keywords: STAT3; cancer; radiotherapy; chemoradiotherapy; chemoradiotherapy-resistance; chemoradiotherapy-sensitization; ... molecular target STAT3; cancer; radiotherapy; chemoradiotherapy; chemoradiotherapy-resistance; chemoradiotherapy-sensitization ... STAT3: A Novel Molecular Mediator of Resistance to Chemoradiotherapy. Melanie Spitzner 1,* , Reinhard Ebner 2. ...
Postoperative Chemoradiotherapy Regimens. Uses of the following postoperative chemoradiotherapy regimens include cancers of the ... Neoadjuvant Chemoradiotherapy Regimens. Preferred regimens. A higher level of evidence supports use of the following regimens; ... Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012 May 31. 366(22):2074-84. [Medline]. [ ... Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N ...
Chemoradiotherapy: Concurrent Uses, Efficacy and Impact on Prognosis. Daniel Sullivan (Editor). Series: Cancer Etiology, ... Chemoradiotherapy is the use of both chemotherapy and radiotherapy for the treatment of cancer. This book discusses its ... Home / Shop / Books / Medicine and Health / Chemoradiotherapy: Concurrent Uses, Efficacy and Impact on Prognosis. ...
... definitive chemoradiotherapy, postoperative chemoradiotherapy, and metastatic disease. Category 1 and 2A regimens are indicated ... Neoadjuvant Chemoradiotherapy, Resectable Disease. Neoadjuvant chemoradiotherapy appears to be associated with better survival ... Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012; May 31. 366(22):2074-84. [Full Text]. ... Postoperative Chemoradiotherapy for Adenocarcinomas. Surgery can be the initial treatment of choice for patients with ...
FertiPROTEKT Network for Fertility Preservation Techniques before Chemo- & Radiotherapy. Journal f r Reproduktionsmedizin und ...
Concurrent chemoradiotherapy with proton radiation can reduce short-term side effects that caused unplanned hospitalizations, ... Concurrent Chemoradiotherapy With Proton Radiation Reduces Short-Term Side Effects. Concurrent chemoradiotherapy with proton ... but limited data are available comparing results of proton chemoradiotherapy with chemoradiotherapy delivered with photon ... Proton chemoradiotherapy was associated with a significantly lower relative risk of 90-day side effects of at least grade 3, 90 ...
ConclusionThe vast divergence in prognosis between young and old GBM patients is largely caused by choice of treatment rather than age ‐related tumor genomic characteristics. Postoperative standard radio‐ and chemotherapy provide strong benefits to primary glioblastoma patients of all ages....
Chemoradiotherapy for cervical cancer: results of a meta-analysis. Women with cervical cancer that is too big to be removed by ... Women who received chemoradiotherapy were also less likely to have the cancer come back or spread to other parts of the body. ... This is called chemoradiotherapy (or chemoradiation). This review brought together 18 randomised controlled trials (RCTs) that ... Chemoradiotherapy helped all women, even those with bigger tumours, or tumours that had spread more. Also, the different drugs ...
Background Clinical trials report improved overall survival following neoadjuvant chemoradiotherapy in patients undergoing ... Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366(22):2074-84.CrossRefPubMedGoogle ... Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results ... MicroRNA expression profiling of esophageal cancer before and after induction chemoradiotherapy. Ann Thorac Surg. 2012;94(4): ...
... is potentially the only treatment available that can offer a chance of long-term survival when definitive chemoradiotherapy ( ... Cooper JS, Guo MD, Herskovic A et al (1999) Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a ... Hironaka S, Ohtsu A, Boku N et al (2003) Nonrandomized comparison between definitive chemoradiotherapy and radical surgery in ... Tachimori Y, Kanamori N, Uemura N et al (2009) Salvage esophagectomy after high-dose chemoradiotherapy for esophageal squamous ...
... studies evaluated the correlations of CD133 expression with the clinical outcomes in patients treated with chemoradiotherapy ( ... Elevated CD133, but not VEGF or EGFR, as a predictive marker of distant recurrence after preoperative chemoradiotherapy in ... Upregulation of trefoil factor 3 (TFF3) after rectal cancer chemoradiotherapy is an adverse prognostic factor and a potential ... Pathological complete response following pre-operative chemoradiotherapy in rectal cancer: analysis of phase II/III trials. Br ...
Hamai Y, Hihara J, Emi M et al (2015) Results of neoadjuvant chemoradiotherapy with docetaxel and 5-fluorouracil followed by ... van Hagen P, Hulshof MC, van Lanschot JJ et al (2012) Preoperative chemoradiotherapy for esophageal or junctional cancer. N ... Berger AC, Farma J, Scott WJ et al (2005) Complete response to neoadjuvant chemoradiotherapy in esophageal carcinoma is ... Hamai Y, Hihara J, Taomoto J et al (2015) Effects of neoadjuvant chemoradiotherapy on postoperative morbidity and mortality ...
Twenty-three NPC patients with diplopia after concurrent chemoradiotherapy were enrolled in this study. Unilateral cranial VI ... We retrospectively reviewed the medical records of NPC patients with new onset diplopia after concurrent chemoradiotherapy from ... New Onset Diplopia in Patients with Nasopharyngeal Carcinoma following Concurrent Chemoradiotherapy: Clinical Features and ... and radiotherapy or concurrent chemoradiotherapy (CCRT) is the mainstay treatment for this disease. The proximity of ...
Early Prediction of Pathology Response of Chemoradiotherapy With FLT PET. The safety and scientific validity of this study is ... Chemoradiotherapy, Chemotherapy or Radiation Therapy) prior to surgery. Achievement in pathCR after pre-operative Neoadjuvant ...
Experimental: Arm2-concurrent chemoradiotherapy group Arm2-concurrent chemoradiotherapy group, the eligibility patients will ... The Value of Concurrent Chemoradiotherapy for Stage II Nasopharyngeal Carcinoma. The safety and scientific validity of this ... nasopharyngeal carcinoma will be benefit from concurrent chemoradiotherapy. ...
Mucinous Adenocarcinoma Arising in Chronic Perianal Fistula: Good Results with Neoadjuvant Chemoradiotherapy Followed by ... The patient underwent a laparoscopic colostomy followed by neoadjuvant chemoradiotherapy and then laparoscopic abdominoperineal ...
... features that predict treatment outcomes following preoperative chemoradiotherapy (CCRT) and surgery... ... Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 ... After the landmark randomized trial [1], preoperative chemoradiotherapy (CCRT) followed by total mesorectal excision (TME) has ... Comparison of two neoadjuvant chemoradiotherapy regimens for locally advanced rectal cancer: results of the phase III trial ...
A Pilot Study Investigating Neoadjuvant Temozolomide-based Proton Chemoradiotherapy for High-Risk Soft Tissue Sarcomas. Trial ... A Pilot Study Investigating Neoadjuvant Temozolomide-based Proton Chemoradiotherapy for High-Risk Soft Tissue Sarcomas ... Assess treatment feasibility of neoadjuvant temozolomide-based proton chemoradiotherapy for high-risk soft tissue sarcoma ...
France and colleagues assessed whether chemoradiotherapy improves overall survival of patients with locally advanced pancreatic ... Chemoradiotherapy vs. chemotherapy for locally advanced pancreatic cancer. May 03, 2016. In a study appearing in the May 3 ... With a median follow-up of 36.7 months, the researchers found no survival benefit of chemoradiotherapy compared with ... In locally advanced pancreatic cancer, the role of chemoradiotherapy is controversial and the efficacy of erlotinib is unknown ...
and safety of weekly cisplatin / liposome paclitaxel concurrent chemoradiotherapy and. radiotherapy alone in the treatment of ...
Cisplatin-tethered gold nanospheres for multimodal chemo-radiotherapy of glioblastoma S. Setua, M. Ouberai, S. G. Piccirillo, C ... We report the first successful chemo-radiotherapy on patient derived treatment resistant GBM cells using a cisplatin-tethered ...
  • citation needed] His scientific career in neuro- and thoracic oncology started in 1988 and was marked by a zealous focus on evidence-based medicine through clinical and translational research, including a variety of areas such as endobronchial brachytherapy, radioimmunotherapy, stereotactic radiosurgery, fractionated stereotactic radiotherapy, image-guided and intensity-modulated radiotherapy, radioprotectors, radiosensitizers, altered fractionation, combination chemoradiotherapy as well as combining targeted agents with radiotherapy. (wikipedia.org)
  • Proton chemoradiotherapy was associated with a significantly lower relative risk of 90-day side effects of at least grade 3, 90-day side effects of at least grade 2 and decline in performance status during treatment. (curetoday.com)
  • 100 and decreased NRI category during chemoradiotherapy did not significantly affect OS. (dovepress.com)
  • Using both molecular and radiological findings, the investigators want to predict pathological response after chemoradiotherapy and to select patients who may benefit from treatment adjustments during chemoradiotherapy. (bioportfolio.com)
  • For patients achieving an objective response after chemoradiotherapy, two additional cycles of chemotherapy were administered. (nih.gov)
  • This single institutional retrospective study included patients who underwent chemoradiotherapy for clinical T1N0M0 ESCC using serum albumin concentrations and body weights evaluated pre- and post-chemoradiotherapy from January 2005 to December 2016. (dovepress.com)
  • Twenty-nine percent of patients who underwent resection after chemoradiotherapy achieved a pathological complete response. (empr.com)
  • Among the 492 patients with ESCC who underwent chemoradiotherapy, 44 were included in this study. (dovepress.com)