دورية أكاديمية
Improved Outcomes for Responders After Treatment with Induction Chemotherapy and Chemo(re)irradiation for Locally Recurrent Rectal Cancer.
| العنوان: | Improved Outcomes for Responders After Treatment with Induction Chemotherapy and Chemo(re)irradiation for Locally Recurrent Rectal Cancer. |
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| المؤلفون: | Voogt ELK; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands. eva.voogt@catharinaziekenhuis.nl., van Zoggel DMGI; Department of Surgery, Isala, Zwolle, The Netherlands., Kusters M; Department of Surgery, Amsterdam University Medical Centres, Location VUmc, Amsterdam, The Netherlands., Nieuwenhuijzen GAP; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands., Bloemen JG; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands., Peulen HMU; Department of Radiotherapy, Catharina Hospital, Eindhoven, The Netherlands., Creemers GJM; Department of Medical Oncology, Catharina Hospital, Eindhoven, The Netherlands., van Lijnschoten G; Pathology Department, PAMM Laboratory for Pathology and Medical Microbiology, Eindhoven, The Netherlands., Nederend J; Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands., Roef MJ; Department of Nuclear Medicine, Catharina Hospital, Eindhoven, The Netherlands., Burger JWA; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands., Rutten HJT; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.; GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands. |
| المصدر: | Annals of surgical oncology [Ann Surg Oncol] 2020 Sep; Vol. 27 (9), pp. 3503-3513. Date of Electronic Publication: 2020 Mar 19. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Original Publication: New York, NY : Raven Press, c1994- |
| مواضيع طبية MeSH: | Induction Chemotherapy*/methods , Neoadjuvant Therapy*/methods , Neoplasm Recurrence, Local*/drug therapy , Neoplasm Recurrence, Local*/mortality , Neoplasm Recurrence, Local*/radiotherapy , Neoplasm Recurrence, Local*/surgery , Rectal Neoplasms*/drug therapy , Rectal Neoplasms*/mortality , Rectal Neoplasms*/radiotherapy , Rectal Neoplasms*/surgery, Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Capecitabine/administration & dosage ; Combined Modality Therapy ; Female ; Fluorouracil/administration & dosage ; Humans ; Leucovorin/administration & dosage ; Male ; Margins of Excision ; Middle Aged ; Organoplatinum Compounds/administration & dosage ; Oxaliplatin/administration & dosage ; Proctectomy/methods ; Reoperation ; Retrospective Studies ; Survival Analysis ; Treatment Outcome |
| مستخلص: | Background: Despite improvements in the multimodality treatment for patients with locally recurrent rectal cancer (LRRC), oncological outcomes remain poor. This study evaluated the effect of induction chemotherapy and subsequent chemo(re)irradiation on the pathologic response and the rate of resections with clear margins (R0 resection) in relation to long-term oncological outcomes. Methods: All consecutive patients with LRRC treated in the Catharina Hospital Eindhoven who underwent a resection after treatment with induction chemotherapy and subsequent chemo(re)irradiation between January 2010 and December 2018 were retrospectively reviewed. Induction chemotherapy consisted of CAPOX/FOLFOX. Endpoints were pathologic response, resection margin and overall survival (OS), disease free survival (DFS), local recurrence free survival (LRFS), and metastasis free survival (MFS). Results: A pathologic complete response was observed in 22 patients (17%), a "good" response (Mandard 2-3) in 74 patients (56%), and a "poor" response (Mandard 4-5) in 36 patients (27%). An R0 resection was obtained in 83 patients (63%). The degree of pathologic response was linearly correlated with the R0 resection rate (p = 0.026). In patients without synchronous metastases, pathologic response was an independent predictor for LRFS, MFS, and DFS (p = 0.004, p = 0.003, and p = 0.024, respectively), whereas R0 resection was an independent predictor for LRFS and OS (p = 0.020 and p = 0.028, respectively). Conclusions: Induction chemotherapy in addition to neoadjuvant chemo(re)irradiation is a promising treatment strategy for patients with LRRC with high pathologic response rates that translate into improved oncological outcomes, especially when an R0 resection has been achieved. |
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| المشرفين على المادة: | 0 (Organoplatinum Compounds) 04ZR38536J (Oxaliplatin) 6804DJ8Z9U (Capecitabine) Q573I9DVLP (Leucovorin) U3P01618RT (Fluorouracil) |
| SCR Protocol: | Folfox protocol |
| تواريخ الأحداث: | Date Created: 20200321 Date Completed: 20210405 Latest Revision: 20211101 |
| رمز التحديث: | 20240513 |
| DOI: | 10.1245/s10434-020-08362-4 |
| PMID: | 32193717 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1534-4681 |
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| DOI: | 10.1245/s10434-020-08362-4 |