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01.01.2018 | Gastrointestinal Cancers (J Meyer, Section Editor)

Role of Chemotherapy in the Neoadjuvant/Adjuvant Setting for Patients With Rectal Adenocarcinoma Undergoing Chemoradiotherapy and Surgery or Radiotherapy and Surgery

verfasst von: Shahab Ahmed, Cathy Eng

Erschienen in: Current Oncology Reports | Ausgabe 1/2018

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Abstract

Rectal cancer has been successfully managed in the last couple of decades. In the USA, as the initial approach, neoadjuvant concurrent chemoradiation has been associated not only with decrease in tumor size and recurrence but also with higher resection rate with minimal side effects. Data support that addition of chemotherapy to radiotherapy is superior to radiotherapy alone in the neoadjuvant setting. Recent debates have addressed the question of administration of adjuvant chemotherapy following surgery. In this article, we discuss the role of chemotherapy in both the neoadjuvant and the adjuvant settings for locally advanced rectal cancer.

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•• Fernandez-Martos, C., et al. Chemoradiation (CRT) followed by surgery and adjuvant capecitabine plus oxaliplatin (CAPOX) compared with induction CAPOX followed by concomitant CRT and surgery for locally advanced rectal cancer: results of the Spanish GCR-3 randomized phase II trial after a median follow-up of 5 years, in 2014 Gastrointestinal Cancers Symposium. 2014, ASCO: San Fransisco, CA. The study compared different neoadjuvant options for locally advanced rectal cancer. This study may open the door for next step in the management of rectal cancer.

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Calvo FA, Serrano FJ, Diaz-González JA, Gomez-Espi M, Lozano E, Garcia R, et al. Improved incidence of pT0 downstaged surgical specimens in locally advanced rectal cancer (LARC) treated with induction oxaliplatin plus 5-fluorouracil and preoperative chemoradiation. Ann Oncol. 2006;17(7):1103–10. https://doi.org/10.1093/annonc/mdl085.CrossRefPubMed

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Marechal R, Vos B, Polus M, Delaunoit T, Peeters M, Demetter P, et al. Short course chemotherapy followed by concomitant chemoradiotherapy and surgery in locally advanced rectal cancer: a randomized multicentric phase II study. Ann Oncol. 2012;23(6):1525–30. https://doi.org/10.1093/annonc/mdr473.CrossRefPubMed

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Schou JV, Larsen FO, Rasch L, Linnemann D, Langhoff J, Høgdall E, et al. Induction chemotherapy with capecitabine and oxaliplatin followed by chemoradiotherapy before total mesorectal excision in patients with locally advanced rectal cancer. Ann Oncol. 2012;23(10):2627–33. https://doi.org/10.1093/annonc/mds056.CrossRefPubMed

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20.

Sainato A, Cernusco Luna Nunzia V, Valentini V, de Paoli A, Maurizi ER, Lupattelli M, et al. No benefit of adjuvant fluorouracil leucovorin chemotherapy after neoadjuvant chemoradiotherapy in locally advanced cancer of the rectum (LARC): long term results of a randomized trial (I-CNR-RT). Radiother Oncol. 2014;113(2):223–9. https://doi.org/10.1016/j.radonc.2014.10.006.CrossRefPubMed

Titel: Role of Chemotherapy in the Neoadjuvant/Adjuvant Setting for Patients With Rectal Adenocarcinoma Undergoing Chemoradiotherapy and Surgery or Radiotherapy and Surgery
verfasst von: Shahab Ahmed
Cathy Eng
Publikationsdatum: 01.01.2018
Verlag: Springer US
Erschienen in: Current Oncology Reports / Ausgabe 1/2018
Print ISSN: 1523-3790
Elektronische ISSN: 1534-6269
DOI: https://doi.org/10.1007/s11912-018-0652-7

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Role of Chemotherapy in the Neoadjuvant/Adjuvant Setting for Patients With Rectal Adenocarcinoma Undergoing Chemoradiotherapy and Surgery or Radiotherapy and Surgery

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