Relevant bibliographies by topics / NEOADJUVANT RADIOTHERAPY

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  5. Conference papers

Academic literature on the topic 'NEOADJUVANT RADIOTHERAPY'

Author: Grafiati
Published: 20 February 2023

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Journal articles on the topic "NEOADJUVANT RADIOTHERAPY"

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ANDREOLLO, Nelson Adami, Valdir TERCIOTI Jr., Luiz Roberto LOPES, and João de Souza COELHO-NETO. "NEOADJUVANT CHEMORADIOTHERAPY AND SURGERY COMPARED WITH SURGERY ALONE IN SQUAMOUS CELL CARCINOMA OF THE ESOPHAGUS." Arquivos de Gastroenterologia 50, no. 2 (April 2013): 101–6. http://dx.doi.org/10.1590/s0004-28032013000200016.

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Context Despite progress in recent years in methods of diagnosis and surgical treatment of esophageal cancer, there is still controversy about the benefits from neoadjuvant chemoradiotherapy. Objective To analise the survival of patients submitted to esophagectomy for squamous cell carcinoma of the esophagus with or without neoadjuvant chemoradiotherapy. Method A retrospective, non-randomized study conducted using the medical charts of patients operated for squamous cell carcinoma of the esophagus at the School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil between 1979 and 2006. The Kaplan-Meier analysis was used to calculate survival curves and the log-rank test to compare data in each group. The significance level was settled as 5%. Results A total of 123 patients were evaluated in this study, divided into three groups: I - 26 (21.2%) patients submitted to esophagectomy alone; II - 81 (65.8%) patients submitted to neoadjuvant radiotherapy plus esophagectomy and III - 16 (13%) patients submitted to neoadjuvant chemoradiotherapy plus esophagectomy. A statistically significant survival was recorded between the groups (log rank = 6.007; P = 0.05), survival being greatest in the group submitted to neoadjuvant chemoradiotherapy, followed by the group submitted to neoadjuvant radiotherapy compared to the group submitted to esophagectomy alone as the initial treatment of choice. Conclusion Radiotherapy and chemotherapy neoadjuvants in patients with squamous cell carcinoma of the esophagus offers benefits and increases survival.
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Untch, Michael, Bruce G. Haffty, Felix Sedlmayer, and Frederik Wenz. "Radiotherapy after Neoadjuvant Chemotherapy." Breast Care 9, no. 6 (2014): 435–36. http://dx.doi.org/10.1159/000370019.

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Fitzgerald, Timothy Louis, Jason Brinkley, Emmanuel E. Zervos, and Jan H. Wong. "Assimilation of evidence-based medicine into clinical practice: Adjuvant radiotherapy in the multidisciplinary treatment of rectal cancer." Journal of Clinical Oncology 30, no. 4_suppl (February 1, 2012): 552. http://dx.doi.org/10.1200/jco.2012.30.4_suppl.552.

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552 Background: Implementation of evidence based standards is recognized to be problematic. Level 1 evidence supports the superiority of neoadjuvant therapy for stage II/III rectal cancer. The purpose of this study was to determine to what extent evidence based medicine has impacted clinical practice. Methods: Stage II/III rectal cancer patients undergoing surgery from 1998-2007 were identified in the SEER tumor registry using SEER*Stat 6.2. Variables were extracted and analyzed in SPSS; trends were evaluated with regression models and survival with log rank test. Results: A total of 25,129 patients were identified, 15,769 (63%) were treated with adjuvant radiotherapy. A majority were > 60 years old (56%), white (82.8%), male (60.9%), had stage III cancers (59.2%) and treated with neoadjuvant radiotherapy (54.5%). Significant changes in timing of adjuvant radiotherapy were noted over the study period. In 1998 28.1% of patients were treated neoadjuvantly, this increased to 74% in 2007, a 263% increase. Scatter plot best fit lines intersect in approximately year 2002, p value of trend <0.001. On univarate analysis race (p=0.018), sex (p<0.001), year of diagnosis (p<0.001), age (p<0.001), and stage (p<0.001) were associated increased likelihood of neoadjuvant radiotherapy. Logistic regression found male sex (OR 1.14, p<0.001), year (OR 1.223, p<0.001) and stage II (OR 1.39, p<0.001) were predictors of neoadjuvant therapy. Significant increases in preoperative radiotherapy were observed for all races and cancer stages (p<0.001). There was a significant survival advantage for those treated with adjuvant radiotherapy, median survival 39 vs. 93 months p<0.0001. There, however, was no survival advantage to neoadjuvant vs. postoperative radiotherapy, median survival 94 vs. 93 months, p=0.749. Conclusions: When adjuvant radiotherapy is utilized, there has been rapid adoption of evidence based standards for Stage II/III rectal cancer. However, substantial numbers of patients are not receiving care recognized to improve outcomes.
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Hutschemaekers, Stefan AJ, and Corrie AM Marijnen. "Neoadjuvant radiotherapy in rectal cancer." Colorectal Cancer 3, no. 6 (December 2014): 469–79. http://dx.doi.org/10.2217/crc.14.40.

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Gourd, Elizabeth. "Neoadjuvant radiotherapy improves hepatectomy survival." Lancet Oncology 20, no. 8 (August 2019): e403. http://dx.doi.org/10.1016/s1470-2045(19)30457-7.

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Mak, K. S., and J. R. Harris. "Radiotherapy Issues After Neoadjuvant Chemotherapy." JNCI Monographs 2015, no. 51 (May 1, 2015): 87–89. http://dx.doi.org/10.1093/jncimonographs/lgv003.

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Le, M. N., B. A. Mailey, W. Lee, M. P. Duldulao, J. Garcia-Aguilar, and J. Kim. "The extent of lymphadenectomy and overall survival depend on the timing of radiotherapy for rectal cancer." Journal of Clinical Oncology 29, no. 4_suppl (February 1, 2011): 540. http://dx.doi.org/10.1200/jco.2011.29.4_suppl.540.

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540 Background: Accurate staging and local disease control depend on the extent of lymphadenectomy (LAD) in rectal cancer. Previous studies suggest that lymph node (LN) number varies with neoadjuvant therapies. Our objectives were to measure the impact of timing of radiotherapy on extent of LAD and to determine the prognostic role of LN number in rectal cancer. Methods: Patients undergoing curative-intent surgery for rectal adenocarcinoma (1988-2006) in Los Angeles County were identified from the Cancer Surveillance Program. Patients were grouped according to radiotherapy timing (neoadjuvant, adjuvant, or none). To measure prognostic significance, an optimal cutoff was assessed for patients with N0 disease by dichotomizing LN numbers from 3-7. Results: Query of the registry identified 6,358 patients. Of these, 20% (n = 1,280), 25% (n = 1,573), and 55% (n = 3,545) received neoadjuvant, adjuvant, and no radiotherapy, respectively. There was no difference in LN number in patients with and without radiotherapy (7 vs. 8 LNs, p = NS). However, within the radiotherapy cohort, there was significantly lower LNs in the neoadjuvant group (5 vs. 9 LNs, respectively; p < 0.001). Survival differences favored the groups with higher LN number. The optimal LN cutoff with no survival difference was 7 in the adjuvant radiotherapy group; there was no optimal cutoff for neoadjuvant therapy patients. Conclusions: From our population-based cohort, we observed that patients receiving neoadjuvant radiotherapy had decreased LN retrieval and that LN number was non-prognostic. In contrast, the extent of LAD is a prognostic factor for overall survival in patients receiving adjuvant radiotherapy. [Table: see text] No significant financial relationships to disclose.
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McGivern, U., D. M. Mitchell, J. O'Hare, G. Corey, and J. M. O'Sullivan. "How does neoadjuvant bicalutamide 150 mg monotherapy compare to lutenising hormone-releasing hormone agonist (LHRHa) therapy in localized prostate cancer treated with radical radiotherapy? A case-matched comparison of PSA kinetics and biochemical outcome." Journal of Clinical Oncology 29, no. 7_suppl (March 1, 2011): 146. http://dx.doi.org/10.1200/jco.2011.29.7_suppl.146.

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146 Background: In patients treated with neoadjuvant lutenising hormone-releasing hormone agonist (LHRHa) therapy prior to radical prostate radiotherapy the PSA nadir in the first week of radiotherapy has been correlated with subsequent biochemical failure free survival (BFFS). Bicalutamide monotherapy (BC) is increasingly being used as a neoadjuvant therapy in place of LHRHa. We wished to compare the initial PSA response to neoadjuvant BC or LHRHa in this setting as well as examining subsequent biochemical failure rates. Methods: We retrospectively reviewed the case notes of consecutive men with prostate cancer treated with BC monotherapy prior to radical prostate radiotherapy from April 2004 to December 2008 and case-matched them to men treated with neoadjuvant LHRHa. PSA levels and kinetics prior to radiotherapy and subsequent BFFS were analysed. Results: Eighty nine men treated with BC with a median follow-up of 42 months were case matched to 89 men treated with LHRHa. There were no significant differences in age, initial PSA, Gleason, or T stage. The median nadir PSA on day 1 of radiotherapy was 2.2ng/mL (0.1-11.2) for BC patients and 0.9ng/mL (0.1-11.2) for LHRHa patients (p=0.0007). There were no significant differences in PSA velocity or doubling time during the neoadjuvant period. A PSA of <1.0ng/mL on day 1 of radiotherapy was seen in 29 (32%) and 47 (52%) of BC and LHRHa patients respectively. Biochemical failure was seen in 10 (11.2%) and 2 (2.2%) of BC and LHRHa patients respectively. PSA kinetics did not predict for subsequent BFFS at this duration of FU for men receiving neoadjuvant BC. Conclusions: In this case-matched study, neoadjuvant BC therapy does not provide the same level of pre-radiotherapy PSA suppression when compared to neoadjuvant LHRHa. Higher biochemical failure rates are seen in patients treated with BC than LHRHa however this may be a result of prolonged castration. No significant financial relationships to disclose.
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Sun, Zhifei, Mohamed A. Adam, Jina Kim, Shiao-Wen D. Hsu, Manisha Palta, Brian G. Czito, John Migaly, and Christopher Mantyh. "Effect of combined neoadjuvant chemoradiation on overall survival for patients with locally advanced rectal cancer." Journal of Clinical Oncology 34, no. 4_suppl (February 1, 2016): 657. http://dx.doi.org/10.1200/jco.2016.34.4_suppl.657.

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657 Background: Prospective randomized trials have demonstrated that neoadjuvant chemoradiation improves local control and results in a higher rate of sphincter-sparing surgery for patients with locally advanced rectal cancer. However, neoadjuvant therapy utilization and population-based outcomes are not well defined. Methods: Adults with stage II/III rectal adenocarcinoma within the National Cancer Data Base undergoing surgery between 2006-2012 were analyzed. Patients were grouped by type of neoadjuvant therapy received: no therapy, chemotherapy only, radiotherapy only, or concomitant chemoradiation. Multivariable modeling was used to compare perioperative outcomes and overall survival between groups. Results: Among 32,978 patients included, 9,714 (29.5%) received no neoadjuvant therapy, 890 (2.7%) chemotherapy only, 1,170 (3.5%) radiotherapy only, and 21,204 (64.3%) concomitant chemoradiation. 5-year overall survival among groups was 62%, 69%, 71%, and 74%, respectively. Compared to no therapy, chemotherapy or radiotherapy alone was not associated with any differences in perioperative or oncologic outcomes (all p > 0.05). With adjustment for patient and disease characteristics, neoadjuvant chemoradiation was associated with a lower likelihood of margin positivity (OR 0.74, p < 0.001), need for permanent colostomy (OR 0.77, 95% CI 0.70-0.85, p < 0.001), 30-day mortality (OR 0.67, p = 0.003), and overall survival (HR 0.69, p < 0.001). When compared to chemotherapy or radiotherapy alone, neoadjuvant chemoradiation was still associated with improved overall survival (vs. chemotherapy: HR 0.83, p = 0.04; vs. radiotherapy: HR 0.75, p < 0.001). Conclusions: Neoadjuvant chemoradiation, not chemotherapy or radiotherapy alone, is important for sphincter-preservation and survival for patients with locally advanced rectal cancer. Despite this finding, one third of patients with locally advanced rectal cancer are failing to receive this therapy in the United States.
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Liu, Fang, Maohui Yan, Boning Cai, Baolin Qu, Wei Yu, Yanrong Luo, Qianqian Wang, Yao Wang, Lanqing Liang, and Mingyue Zeng. "Neoadjuvant chemoradiotherapy combined with surgery in the treatment of potentially operable thoracic squamous cell carcinoma of the esophagus(ChiCTR-OIC-17011648): A phase II single center clinical study." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e15543-e15543. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e15543.

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e15543 Background: To investigate the efficacy and safety of neoadjuvant radiotherapy and chemotherapy combined with surgery in the treatment of potentially operable thoracic esophageal squamous cell carcinoma. Methods: Nineteen patients with advanced thoracic esophageal squamous cell carcinoma hospitalized in our hospital from July 2016 to June 2018 were prospectively studied. All patients received neoadjuvant concurrent radiotherapy and chemotherapy: intensity modulated conformal radiotherapy (40 ∽ 44Gy/20 ∽22f, 2 Gy/f), chemotherapy (paclitaxel 150 ∽ 175 mg/m2 d1, 22+lobaplatin 25-30 mg/m2 d2, 23, 2 cycles). After radiotherapy and chemotherapy, the efficacy and safety of the operation were observed. Results: Two case (10.5%) was completely remitted after neoadjuvant radiotherapy and chemotherapy, 17 cases (89.5%) were partially remitted, and the objective effective rate was 100%. All patients underwent radical surgery successfully, the R0 resection rate was 100% and the pCR rate was 52.6%. The main adverse reactions of neoadjuvant radiotherapy and chemotherapy were granulocytopenia and grade III-IV granulocytopenia. The rate of survival was 16.7%, and anastomotic leakage occurred in 1 patients after operation. Conclusions: Neoadjuvant chemoradiotherapy for thoracic esophageal squamous cell carcinoma can effectively reduce the volume of the tumor, significantly reduce the pathological grade, improve the resection rate, and have less adverse reactions, which is worthy of clinical application. Clinical trial information: ChiCTR-OIC-17011648.
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Dissertations / Theses on the topic "NEOADJUVANT RADIOTHERAPY"

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Bhangu, Aneel. "Epithelial mesenchymal transition and resistance to neoadjuvant radiotherapy in locally advanced rectal cancer." Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/24734.

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Background: Non-response to neoadjuvant therapy is a significant challenge for clinicians managing solid cancers. This thesis aimed to determine whether Epithelial Mesenchymal Transition (EMT) was associated with non-response to neoadjuvant therapy in patients with locally advanced rectal cancer. Methods: Representative tissue specimens from the tumour invasive front of consecutive patients undergoing resection of rectal cancer from 2009-2011 were used. Patients with marked regression to neoadjuvant therapy were classified as responders with the remainder as non-responders. Markers of EMT included: reduced immunohistochemical expression of membranous E-cadherin, increased nuclear beta-catenin expression and tumour budding. In-situ-hybridisation was used to assess the expression of microRNA-200c (mir200c), an upstream master-regulator of EMT. Real-time polymerase chain reaction was used to quantitate expression of the gene for E-cadherin. Results: From 103 patients undergoing resection of rectal cancer, 69 received neoadjuvant chemoradiotherapy; 65% of these were non-responders. Reduced mir200c expression was significantly associated with higher T grade. Reduced membranous E-cadherin, increased nuclear beta-catenin and tumour budding individually predicted the presence of extra-mural vascular invasion. Reduced E-cadherin, nucleic beta-catenin, reduced mir200c and tumour budding were all significantly associated with non-response to neoadjuvant therapy (all p<0.001). Reduced E-cadherin and mir200c expression were both associated with reduced cancer specific survival (log-rank p-value 0.036 and 0.009 respectively). E-cadherin gene expression was not related to radiotherapy response or tumour budding. Conclusion: Targeted biomarkers of EMT were associated with non-response to neoadjuvant therapy and reduced survival in advanced rectal cancer. EMT may provide a practical clinical biomarker and novel therapeutic target, to improve the proportion of patients who respond to neoadjuvant therapy.
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Ansari, Nabila. "Understanding surgeon decision making in the use of radiotherapy as neoadjuvant treatment in rectal cancer." Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/28508.

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Substantial evidence supports the use of neoadjuvant radiotherapy in the management of resectable rectal cancer to improve local control. Decision making however, is complex, with multiple available treatment choices, varying influence of both clinical and non-clinical factors and, ever changing evidence resulting in uncertainty. There is a paucity of research investigating clinician decision making in rectal cancer. This research aimed to determine the effect of clinical and non-clinical factors on decision making by colorectal surgeons in patients with rectal cancer. Two factorial surveys comprising clinical vignettes of alternating short (4) and long (12) cues identified previously as important in rectal cancer treatment decision making, were randomly assigned to all members of the Colorectal Surgical Society of Australia and New Zealand. Respondents chose from three possible treatments: long course chemoradiotherapy (LC), short course radiotherapy (SC), or surgery alone to investigate the effects on surgeon decision and confidence in decisions. Choice data were analysed using multinomial logistic regression models. The response rate was 64% (106/165). LC was the preferred treatment choice in 73% of vignettes. Surgeons were more likely to recommend LC over SC (OR 1.79) or surgery alone (OR 1.99) when presented with shorter, four-cue scenarios. There was no significant difference in confidence in the decision made when surgeons were presented with long-cue vignettes (p = 0.57). Significant factors affecting choice between LC, SC and surgery alone were tumour stage (p < 0.001), nodal status (p < 0.001), tumour position in the rectum (p < 0.001) and the circumferential location of the tumour (p < 0.001). A T4 tumour was the factor most likely associated with a recommendation against surgery alone (OR 335.96) or SC (OR 61.73). These results demonstrate that clinical factors exert the most significant influence on Australian and New Zealand surgeon decision making. Therapy is primarily determined by tumour stage, position, circumferential location and nodal stage. LC is the preferred treatment of choice. Surgeon decision making appears to follow a ‘fast and frugal’ heuristic decision making model.
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Cheung, Henry. "Neoadjuvant radiotherapy and outcomes of rectal cancer – comparison of rectal cancer management and outcomes in the setting of standard intraoperative anatomic dissection of the rectum. Single centre study." Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/25675.

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Background: Neoadjuvant radiotherapy (NRT) has become an integral part of the multidisciplinary management of locally advanced rectal cancer. Whilst there is an abundance of literature on its effect in reducing local recurrence and improving cancer-specific survival, the standard use of Kaplan-Meier and Cox-regression analyses does not account for non-cancer related deaths as a competing risk. This cohort study aimed to use competing risks statistical method to examine the association between NRT and recurrence and cancer-specific death after potentially curative rectal cancer resection. Methods: A hospital database of prospectively collected data on clinical, operative, pathology and follow-up information of at least 5 years for all surviving patients were examined. The data were analysed by competing risks methods and multivariable regression models. Results: Six hundred and sixty-two patients between January 1995 and December 2014 met the inclusion criteria of the study. Following examination of the resection specimen, 594 patients underwent potentially curative resections, of which 151 received NRT. There were no statistically significant bivariate association between NRT and overall survival (HR 1.21, CI 0.95-1.53, p = 0.120), disease-free survival (HR 1.18, CI 0.94-1.53, p = 0.202) or local-only recurrence (HR 1.07, CI 0.46-2.50, p = 0.868). Competing risk methods found significant association between NRT and cancer-specific deaths (HR 1.72, CI 1.21-2.45, p = 0.003) as well as tumour recurrence at any site (HR 1.61, CI 1.16-2.25, p = 0.005). However, their significant association was diminished in multivariable models. Multivariable models found tumour with direct spread beyond muscular propria and presence of nodal metastases may have independent effect on survival and recurrence outcomes. Conclusions: Competing risks findings in this study showed significant association between NRT and cancer-specific deaths as well as tumour recurrence at any site.
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Tercioti, Junior Valdir 1975. "Estudo retrospectivo do impacto da terapêutica neo-adjuvante do carcinoma de esôfago na sobrevida dos pacientes operados na Faculdade de Ciências Médicas da Unicamp." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311396.

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Orientadores: Nelson Adami Andreollo, Luiz Roberto Lopes
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-16T06:07:19Z (GMT). No. of bitstreams: 1 TerciotiJunior_Valdir_M.pdf: 3600998 bytes, checksum: 6867e524b51d1a71d777c2132d9f2244 (MD5) Previous issue date: 2010
Resumo: A neoplasia de esôfago é a oitava neoplasia mais incidente no Brasil, mantendo alta letalidade a despeito da melhora do tratamento cirúrgico nas últimas décadas. Os tratamentos utilizados dividem-se em: I) paliativos (sondas para nutrição enteral, próteses endoscópicas, gastrostomia, jejunostomia, derivação esôfago-gástrica, quimioterapia, radioterapia) e; II) curativos (esofagectomias isoladas, terapias neo-adjuvantes e terapias adjuvantes). Sendo assim, estratégias de tratamento neo-adjuvante tornam-se objeto de estudo. O objetivo do trabalho é avaliar em estudo retrospectivo não-randomizado a morbidade, a mortalidade e a sobrevida dos pacientes operados na Faculdade de Ciências Médicas da UNICAMP no período de 1979 a 2006, divididos em três grupos: I) esofagectomia; II) radioterapia neo-adjuvante seguido de esofagectomia; e III) radioterapia-quimioterapia neo-adjuvante seguido de esofagectomia. Na análise dos resultados, os grupos não diferem significativamente quanto ao sexo, cor, idade, alguns sintomas pré-operatórios (pirose, tabagismo), complicações pós-operatórias, mortalidade, N patológico, grau de diferenciação histológica e estadiamento; os grupos diferem significativamente em relação a outros sintomas (disfagia, dor retroesternal, etilismo), localização tumoral, T patológico e resposta tumoral. As conclusões mostram diferenças de sobrevida entre os grupos após a exclusão dos óbitos peri-operatórios, com benefício estatisticamente significativo para a terapêutica neo-adjuvante
Abstract: Neoplasm of esophagus cancer is the eighth highest incidence in Brazil, maintaining a high mortality rate despite the improvement of surgical treatment in recent decades. Treatments are divided into: I) palliative (nasogastric tube for enteral nutrition, prosthetics, endoscopic gastrostomy, jejunostomy, esophageal-gastric bypass, chemotherapy, radiotherapy) and; II) radical (esophagectomy isolated, neo-adjuvant therapy and adjuvant therapy) . Thus, neoadjuvant treatment strategies become the object of study. The objective is to evaluate with a non-randomized retrospective study morbidity, mortality and survival of patients operated in the Faculty of Medical Sciences of Campinas in the period 1979-2006, divided into three groups: I) esophagectomy; II) neoadjuvant radiotherapy followed by esophagectomy, and III) neoadjuvant radiotherapy and chemotherapy followed by esophagectomy. Results show that groups did not differ significantly regarding gender, race, age, some preoperative symptoms (heartburn, smoking), postoperative complications, mortality, N pathological, histological grade and stage; groups differ significantly for other symptoms (dysphagia, retrosternal pain, alcoholism), tumor location, T and pathological tumor response. Findings show differences in survival between groups after the exclusion of perioperative deaths, with statistically significant benefit for neoadjuvant therapy
Mestrado
Cirurgia
Mestre em Cirurgia
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Filitto, Giuseppe. "Implementation of an automated pipeline to predict the response to neoadjuvant chemo-radiotherapy of patients affected by colorectal cancer." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2021. http://amslaurea.unibo.it/24832/.

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Colorectal cancer is a malignant neoplasm of the large intestine resulting from the uncontrolled proliferation of one of the cells making up the colorectal tract. In order to get information about diagnosis, therapy evaluation on colorectal cancer, analysis on radiological images can be performed through the application of dedicated algorithms. Up to now, this process is performed using manual or semi-automatic techniques, which are time-consuming and highly operator dependent. The aim of this project is to develop and apply an automated pipeline to predict the response to neoadjuvant chemo-radiotherapy of patients affected by colorectal cancer. Here, we propose an approach based on automatic segmentation and radiomic features extraction. The segmentation process exploits a Convolutional Neural Network like U-Net, trained with medical annotations to perform the segmentation of the tumor areas. Then, from the segmented regions, radiomic features are extracted and analyzed to obtain the prediction of response, based on the Tumor Regression Grade (TRG). We tested and developed our pipeline on MRI scans provided by the IRCCS Sant’Orsola-Malpighi Polyclinic. The performance of the pipeline was measured for the segmentation purpose and for the prediction of response. The results of these preliminary tests show that the pipeline is able to achieve a segmentation consistent with the medical annotations and a Dice Similarity Coefficient (DSC) coherent with literature. Even for the prediction of response, the results show that the pipeline is able to correctly classify most of the cases.
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Monteiro, Francisco Coracy Carneiro. "Acurracy of three-dimensional anorectal ultrasonography in assessment tumor into the mid or distal third of the rectum of pacients submitted neoadjuvant chemotherapy and radiotherapy." Universidade Federal do CearÃ, 2009. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=5484.

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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior
O ultrassom anorretal tridimensional (US 3D) proporciona informaÃÃes acuradas do tamanho do tumor e sua relaÃÃo com os mÃsculos do esfÃncter anal. O objetivo deste estudo foi avaliar a acurÃcia do US 3D em predizer a resposta do cÃncer retal à quimioterapia e radioterapia, confrontando as imagens do US 3D com os achados histopatolÃgicos. Trinta e dois pacientes (idade mÃdia de 59 anos), estadiados em T2 (n=3), T3 (n=23) e T4 (n=6), com metÃstase em linfonodos perirretais em 22 casos, foram submetidos à quimioterapia e radioterapia neoadjuvantes, seguidas de uma segunda avaliaÃÃo com US 3D sete semanas depois. Os pacientes foram agrupados conforme a distÃncia (cm) entre a borda distal do tumor e a borda proximal do esfÃncter anal interno (EAI) (Grupo I, apresentando invasÃo do canal anal; Grupo II ≤ 2,0cm; Grupo III > 2,0 cm). Todos os pacientes foram operados e os achados histopatolÃgicos foram confrontados com os resultados do US 3D pÃs-neoadjuvÃncia. Cinco pacientes (16%) apresentaram regressÃo completa do tumor. Dezenove pacientes (59%) apresentaram regressÃo parcial do tumor. A distÃncia ao EAI foi > 2,0cm em 11 pacientes (34%). Os 7 (22%) pacientes restantes nÃo apresentaram regressÃo. O US 3D e os achados histopatolÃgicos foram concordantes em 31 (97%) pacientes, com apenas um caso (3%) inconclusivo do US 3D pÃs-neoadjuvÃncia. Comparando as imagens do US 3D com os achados histopatolÃgicos de acordo com a distÃncia entre a borda distal do tumor e a borda proximal do EAI, houve concordÃncia em 100% dos pacientes. A regressÃo tumoral tornou possÃvel a cirurgia com preservaÃÃo do esfÃncter em 16 pacientes (50%) (onze do Grupo III e cinco com regressÃo completa do tumor). O exame histopatolÃgico revelou margens livres em todos os casos. O Ãndice de concordÃncia entre as metÃstases em linfonodos ao US 3D pÃs-neoadjuvÃncia e as peÃas cirÃrgicas foi substancial (87,5%). Concluiu-se que o US 3D pode auxiliar significativamente na seleÃÃo da abordagem cirÃrgica apÃs quimioterapia e radioterapia. Entretanto, uma maior amostra de pacientes à necessÃria para estabelecer parÃmetros ultrassonogrÃficos suficientemente acurados apÃs quimioterapia e radioterapia
O ultrassom anorretal tridimensional (US 3D) proporciona informaÃÃes acuradas do tamanho do tumor e sua relaÃÃo com os mÃsculos do esfÃncter anal. O objetivo deste estudo foi avaliar a acurÃcia do US 3D em predizer a resposta do cÃncer retal à quimioterapia e radioterapia, confrontando as imagens do US 3D com os achados histopatolÃgicos. Trinta e dois pacientes (idade mÃdia de 59 anos), estadiados em T2 (n=3), T3 (n=23) e T4 (n=6), com metÃstase em linfonodos perirretais em 22 casos, foram submetidos à quimioterapia e radioterapia neoadjuvantes, seguidas de uma segunda avaliaÃÃo com US 3D sete semanas depois. Os pacientes foram agrupados conforme a distÃncia (cm) entre a borda distal do tumor e a borda proximal do esfÃncter anal interno (EAI) (Grupo I, apresentando invasÃo do canal anal; Grupo II ≤ 2,0cm; Grupo III > 2,0 cm). Todos os pacientes foram operados e os achados histopatolÃgicos foram confrontados com os resultados do US 3D pÃs-neoadjuvÃncia. Cinco pacientes (16%) apresentaram regressÃo completa do tumor. Dezenove pacientes (59%) apresentaram regressÃo parcial do tumor. A Three-dimensional anorectal ultrasound (3-DAUS) scanning provides accurate informationes on tumor size and its relation to the anal muscles. The purpose of this study was to evaluate the ability of 3-DAUS to assess response to radiochemotherapy (RCT) for rectal cancer by comparing 3-DAUS images to pathological findings. Thirty two patients (mean age 59 years), staged as T2 (n = 3), T3 (n = 23) or T4 (n = 6), with lymph node metastases in 22 cases, were submitted to neoadjuvant RCT, followed by a second 3-DAUS scan 7 weeks later. The patients were grouped according to the distance (cm) between the distal tumor edge and the proximal border of the internal anal sphincter (IAS) (Group I, presenting anal canal invasion; Group II ≤ 2.0 cm; Group III > 2.0 cm). All patients were operated on and the pathological findings were compared to post-RCT 3-DAUS scanning results. Five (16%) patients experienced complete tumor regression. Nineteen (59%) tumors regressed partially. Distance to the IAS was >2.0 cm in eleven (34%) patients. The remaining seven (22%) patients experienced no regression. 3-DAUS and pathological findings were concordant in 31 (97%) patients, with only one (3%) nonconclusive post-RCT 3-DAUS result. Comparing 3-DAUS images to pathological findings according to the distance between the distal tumor edge and the proximal border of IAS, there was agreement in 100% of the pacients. Tumor regression made sphincter-saving surgery possible in 16 patients (50%) (eleven in group III and five complete tumor regression). Pathological examination revealed free distal margins in all cases. The index of agreement between lymph node metastases on post-RCT 3-DAUS and surgical specimens was substantial (87,5%). It may be concluded that 3-DAUS can aid significantly in the choice of surgical approach following RCT. However, a greater sample of patients is required to establish sufficiently accurate post-RCT 3-DAUS parameters. Keywords: Ultrasonography. Colorectal cancer. Radiology
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Rahmani, Samir. "The pathophysiological effects of adjuvant preoperative chemotherapy and/or radiotherapy on patients with advanced rectal cancer : 'neoadjuvant treatment is a two edged sword in patients with advanced colorectal cancer'." Thesis, University of Leeds, 2013. http://etheses.whiterose.ac.uk/5001/.

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Introduction The modern treatment of colorectal cancer consists of surgery, with or without adjuvant pre-operative radiotherapy, chemotherapy or chemoradiotherapy (APT) for selected cases. In the United Kingdom, therapy may be given prior to surgery in an attempt to facilitate surgical excision and improve survival. However, there is some evidence that APT in other cancers may adversely affect the patient’s health and increase the risk of operative morbidity. The association between functional capacity, represented by the maximum oxygen consumption per unit time (VO2max) as measured by cardiopulmonary exercise testing (CPEX), and the perioperative outcome is well established. A reduction in cardiopulmonary reserve may increase the perioperative mortality and morbidity; however, sufficient data to demonstrate this are not available yet. This study examined the affect of APT on the cardiopulmonary status, body composition, cytokines assay, nutritional status and quality of life in patients with colorectal cancer. Methods This is a pilot observational study performed on two groups of patients, no intervention was used at this stage. Group one received combined ChemoRadiotherapy and Group two received only pelvic radiotherapy. Cardiopulmonary function was measured with exercise bicycle to achieve Anaerobic Threshold (AT) and Maximum Oxygen consumption (VO2max) using CPEX testing. Anthropometric parameters such as mid-arm circumference (MAC), Triceps skin fold (TSF), grip strength measurements (GS), Body weight, height and body mass index as well as extracellular water (ECW), intracellular water (ICW), total body water (TBW) and fat free mass (FFM) were measured using a Bio-electrical impedance analyser. 9 cytokines were measured using a Luminex assay in addition to CRP and albumin assessment. Nutritional status and quality of life were evaluated using two validated questionnaires (EORTC QLQ-C30 and PG-SGA). These assessments were made before and within two weeks after the administration of APT. Wilcoxon rank sum test represented in median and interquartile range was used to compare results before and after the exposure to APT. Results Between January 2010 and January 2011, a total of 36 patients with rectal cancer were recruited, 24 patients in group 1 had combined chemoradiotherapy (mean age 59.4, 18 males and 6 females) and 12 patient in group 2 had radiotherapy only (mean age 71.8, 10 males and 2 females). Group 1 had a significant decline in VO2max with p=0.005, an increase in the ventilatory equivalent ratio for CO2 (VE/VCO2) with p= 0.001, a reduction in TSF, MAC, GS and TBW with p- values of 0.007, 0.006, 0.010 and 0.000 respectively after APT exposure. Group 2 had no significant changes in their CPEX data, however, they showed a marked decline in TSF, MAC, GS, TBW and FFM with p- values of 0.013, 0.013, 0.002 and 0.034 respectively after APT exposure. Both groups showed a highly significant overall reduction in the health related quality of life data with no significant changes in their plasma cytokines, CRP and albumin post APT. Conclusions These data suggest that APT has a significant effect upon the cardiopulmonary capacity with reduced VO2max as well as an increased VE/VCO2. There were also signs of fluid depletion and reduced muscle bulk represented by a significant reduction in TBW, FFM, MAC and TSF. Therefore, these important physiological changes could be deleterious and affect the peri and post-operative recovery and increase the morbidity of surgery in colorectal cancer patients. In view of this, a period of optimisation following APT and prior to surgery may serve to minimise the risk of such complications.
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Köpple, Rebecca [Verfasser], and Claus [Akademischer Betreuer] Belka. "Neoadjuvante Radiotherapie beim Ösophaguskarzinom : retrospektive Analyse der Ergebnisse unter besonderer Berücksichtigung der Toxizität / Rebecca Köpple ; Betreuer: Claus Belka." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2020. http://d-nb.info/1221061976/34.

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Junior, Samuel Aguiar. "Análise do perfil de expressão gênica de sarcomas de partes moles de extremidades de adultos submetidos a quimioterapia neoadjuvante com doxorrubicina e ifosfamida." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/5/5155/tde-25032009-161906/.

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INTRODUÇÃO: A cirurgia associada à radioterapia proporciona altas taxas de preservação de membros e de controle local em sarcomas de partes moles de extremidade de adultos, mas ainda apresenta elevadas taxas de complicações locais e de metástases à distância. O valor da quimioterapia adjuvante ou neoadjuvante ainda é controverso e objeto de investigações clínicas. A identificação de fatores moleculares preditivos de resposta à quimioterapia pode selecionar pacientes que se beneficiem ou não da sua aplicação. OBJETIVOS: identificar perfis de expressão gênica capazes de diferenciar tumores respondedores e não respondedores a quimioterapia neoadjuvante em sarcomas de partes moles. Analisar os resultados preliminares relativos à efetividade de um esquema de quimioterapia neoadjuvante em sarcomas de partes moles. MÉTODOS: amostras foram coletadas a partir de um ensaio clínico fase II não controlado que testa um esquema de quimioterapia neoadjuvante com doxorrubicina e ifosfamida em sarcomas de alto grau histológico, localizados em extremidades de pacientes adultos. O perfil de expressão gênica foi determinado pela análise de cDNA microarrays. RESULTADOS: 14 pacientes foram incluídos no estudo clínico e 6 amostras foram utilizadas para análise molecular. 222 seqüências diferentemente expressas entre respondedores e não respondedores foram identificadas. Entre os genes com maior diferença de expressão, foram observados genes envolvidos com via de sinalização de TGF, genes envolvidos com angiogênese, com degradação de matriz extracelular e com desenvolvimento. A taxa de resposta objetiva à quimioterapia neoadjuvante foi de 28,6%, a taxa de amputação foi de 7,1% e taxa de complicações relacionadas à ferida operatória foi de 23%. Complicações graus 3 e 4 ocorreram em 50% dos pacientes e nenhum deles faleceu ou teve a proposta cirúrgica suspensa em decorrência de complicações da quimioterapia. CONCLUSÕES: tumores respondedores a quimioterapia neoadjuvante com doxorrubicina e ifosfamida apresentaram um perfil de expressão gênica diferente dos não respondedores, particularmente em genes envolvidos na via de sinalização de TGF. O esquema terapêutico testado mostrou-se efetivo e seguro para ser investigado em um estudo fase III
INTRODUCTION: Surgery combined with adjuvant radiotherapy provides high rates of limb sparing and local control for adult extremity soft tissue sarcomas, but is still associated with high rates of local morbidity and distant recurrences. The role of adjuvant or neoadjuvant chemotherapy is still controversy and target of clinical investigations. The identification of molecular predictive factors of response to chemotherapy could select patients who have benefits or not with its use. OBJECTIVES: to identify gene expression profiles that discriminate tumors with respect to response to neoadjuvant chemotherapy. Analyze the preliminary results of a protocol of neoadjuvant chemotherapy in soft tissue sarcomas. METHODS: samples were collected from subjects of a single-arm prospective clinical trial that investigates the effectiveness of a neoadjuvant doxorubicin and ifosphamide-based chemotherapy regimen in high grade extremity soft tissue sarcomas in adults. Gene expression profiles were determined by the analysis of cDNA microarrays. RESULTS: 14 patients were included in the clinical trial and six samples were used in the molecular study. 222 sequences differentially expressed between responders and non responders were identified. Among the genes with higher differences in expression, we have identified genes involved with TGF signaling pathway, angiogenesis, extracelular matrix degradation and development. The objective response rate to neoadjuvant chemotherapy was 28,6%, the amputation rate was 7,1%, and the wound complication rate was 23%. Grades 3 and 4 complications have occurred in 50 % of the cases, but no deaths or modifications on surgical intent related to chemotherapy complications have occurred. CONCLUSIONS: tumors considered responders to neoadjuvant chemotherapy showed a gene expression profile significantly different from non responders, especially with respect to the TGF signaling pathway. The neoadjuvant regimen tested has showed to be effective and safe to be considering for a phase III clinical trial
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Ferreira, Susana Filipe. "Optimization of Neoadjuvant Radiotherapy for zebrafish-avatars – towards personalized medicine." Master's thesis, 2018. http://hdl.handle.net/10362/63681.

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Recently, Fior and colleagues developed zebrafish Patient-derived Xenografts (zPDX) for personalized medicine to quickly screen the recommended Adjuvant Chemotherapies for colorectal cancer (CRC). Now the Lab goal is to test if zPDX can also be used to screen patients for Neoadjuvant Radiotherapy (RT). In rectal cancer the Neoadjuvant RT comprises a short Fractionated RT regimen of 5x5Gy (FRT), used to shrink tumor before surgery. Preliminary results from the Lab showed to be possible to distinguish radiosensitive from radioresistant CRC zebrafish xenografts, using an adapted RT protocol Single-High Dose RT (SHD-RT, 1x25Gy). However this SHD-RT protocol was different from the one given in the clinic (FRT, 5x5Gy), raising the question whether this adaptation is a good proxy of tumor response. Thus, the main goal of this thesis was to compare both RT protocols and test if SHD-RT is suitable to determine tumor radiosensitivity/radioresistance. To address this aim, radiosensitive CRC zebrafish xenografts were generated and distributed into the different experimental conditions: Control (non-irradiated); FRT; and SHD-RT. Our results revealed that SHD-RT induces similar tumor responses to FRT, in 6 days, i.e. both protocols lead to a significant induction of apoptosis and reduction of tumor size, suggesting that SHD-RT is enough for a quick and feasible assay. However, we also investigated further the cumulative effect of radiation and whether “time matters” for the radiobiology of the tumors in this short assay. Indeed, our results showed that cumulative damage and time are crucial factors to reduce the overall tumor size. However, given the similar results in the 6dpi assay, the adapted SHD-RT protocol seemed a practical option for the zPDX assay. Nevertheless this study needs further confirmation with a radioresistant tumor. Moreover, CRC zebrafish avatars were tested for RT and its combination with Chemotherapy, suggesting an increase of apoptotic cells upon the treatment combination.
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Books on the topic "NEOADJUVANT RADIOTHERAPY"

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Lower gastrointestinal malignancies. New York: Demos Medical, 2010.

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Howard, Silberman, and Silberman Allan W, eds. Surgical oncology: Multidisciplinary approach to difficult problems. London: Arnold, 2002.

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Dubose, Arielle C., Benjamin D. Lee, and SreyRam Kuy. Improved Survival with Preoperative Radiotherapy in Resectable Rectal Cancer. Edited by SreyRam Kuy and Miguel A. Burch. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199384075.003.0009.

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The landmark Swedish Rectal Cancer Trial examined whether preoperative radiation given to patients <80 years of age with resectable rectal cancer impacted rate of local recurrence and survival compared with immediate surgical resection. This trial demonstrated that neoadjuvant radiation therapy decreased rates of local and distant recurrence and improved survival. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.
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Ben-Josef, Edgar. Lower Gastrointestinal Malignancies. Springer Publishing Company, Incorporated, 2010.

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Koong, Albert, Edgar Ben-Josef, and Thomas Charles R. Jr. Lower Gastrointestinal Malignancies. Springer Publishing Company, Incorporated, 2011.

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Silberman, Allan W., and Howard Silberman. Surgical Oncology: Multidisciplinary Approach to Difficult Problems. A Hodder Arnold Publication, 2002.

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Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, Gareth Morris-Stiff, and Amen Sibtain. Colorectal cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0015_update_001.

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Breast cancer reviews the epidemiology and aetiology of this malignancy, with particular attention to the genetics underlying familial breast cancer, its pathology along with its receptors, oestrogen receptor (ER), the growth factor receptor HER2, and epidermal growth factor receptor (EGFR), and the bearing these have on treatment and prognosis. The benefits of breast cancer screening in the population and families at higher risk are discussed. Presenting symptoms and signs are followed by investigation including examination, bilateral mammography, and core biopsy of suspicious lesions. Management of non-invasive in situ disease is considered. Invasive breast cancer is staged according to TNM guidelines. Early breast cancer is defined, managed frequently by breast conserving surgery and sentinel node biopsy from the axilla. A positive sentinel node biopsy requires clearance of the axilla. Larger lesions may require mastectomy. Breast radiotherapy is indicated after breast conserving surgery. Following surgery, the risk of systemic micrometastatic disease is estimated from the primary size, lymph node spread, and tumour grade. Adjuvant chemotherapy improves treatment outcome in all but very good prognosis premenopausal breast cancer, and intermediate or poor prognosis postmenopausal breast cancer. This is combined with trastuzumab in HER2 positive disease. Adjuvant endocrine therapy is recommended for all ER positive breast cancer, tamoxifen in premenopausal, aromatase inhibitors in postmenopausal women. Neoadjuvant chemotherapy may be used in large operable breast cancers to facilitate breast conserving surgery. Locally advanced breast cancer is defined, its high risk of metastatic disease requiring full staging before treatment. Systemic therapy is often best first treatment, according to receptor profile. Metastatic breast cancer although incurable can be controlled for years using endocrine therapy, chemotherapy, trastuzumab, palliative radiotherapy, and bisphosphonates as appropriate. Male breast cancer is uncommon, but management similar.
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Book chapters on the topic "NEOADJUVANT RADIOTHERAPY"

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Vuong, Te, and Aurelie Garant. "Neoadjuvant Radiotherapy." In Surgical Techniques in Rectal Cancer, 65–76. Tokyo: Springer Japan, 2017. http://dx.doi.org/10.1007/978-4-431-55579-7_4.

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Choi, Gi Hong. "Neoadjuvant Radiotherapy Converting to Curative Resection." In Radiotherapy of Liver Cancer, 209–14. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-16-1815-4_15.

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Chen, K. Y., C. K. Law, K. H. Chi, J. J. Chao, J. S. Jan, Y. P. Wu, C. Z. Lin, P. Chang, C. Y. Shiau, and W. K. Chan. "Neoadjuvant Chemotherapy Plus Radiotherapy Versus Radiotherapy Alone in Nasopharyngeal Cancer." In Epstein-Barr Virus and Human Disease • 1990, 421–25. Totowa, NJ: Humana Press, 1991. http://dx.doi.org/10.1007/978-1-4612-0405-3_60.

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Ng, Sylvia S. W., Albert C. Koong, and Natalie G. Coburn. "Neoadjuvant and Adjuvant Radiotherapy in Operable Pancreatic Cancer." In Textbook of Pancreatic Cancer, 713–28. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-53786-9_46.

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Ohri, Nisha, and Alice Ho. "Radiotherapy Following Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer." In Personalized Treatment of Breast Cancer, 171–86. Tokyo: Springer Japan, 2016. http://dx.doi.org/10.1007/978-4-431-55552-0_12.

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Bujko, Krzysztof, Maciej Partycki, and Lucyna Pietrzak. "Neoadjuvant Radiotherapy (5 × 5 Gy): Immediate Versus Delayed Surgery." In Early Gastrointestinal Cancers II: Rectal Cancer, 171–87. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-08060-4_12.

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Tanaka, Fumihiro, and Kazue Yoneda. "Surgery and Adjuvant or Neoadjuvant Setting of Radiotherapy: What Is the Role of Radiotherapy in Combination with Lung-Sparing Surgery?" In Malignant Pleural Mesothelioma, 333–44. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-15-9158-7_28.

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von Weyhern, Claus Hann, and Björn L. D. M. Brücher. "Application of Laser Microdissection and Quantitative PCR to Assess the Response of Esophageal Cancer to Neoadjuvant Chemo-Radiotherapy." In Methods in Molecular Biology, 197–202. Totowa, NJ: Humana Press, 2011. http://dx.doi.org/10.1007/978-1-61779-163-5_16.

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Glynne-Jones, Rob. "Neoadjuvant Treatment in Rectal Cancer: Do We Always Need Radiotherapy–or Can We Risk Assess Locally Advanced Rectal Cancer Better?" In Early Gastrointestinal Cancers, 21–36. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-31629-6_2.

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PAhlman, L. "Neoadjuvante Radiotherapie des Rektumkarzinoms." In Rektumkarzinom: Das Konzept der totalen mesorektalen Exzision, 268–84. Basel: KARGER, 1998. http://dx.doi.org/10.1159/000058621.

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Conference papers on the topic "NEOADJUVANT RADIOTHERAPY"

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Lee, S., and K. Shin. "Locoregional Recurrence with Breast Conservation Surgery and Radiotherapy after Neoadjuvant Chemotherapy." In Abstracts: Thirty-Second Annual CTRC‐AACR San Antonio Breast Cancer Symposium‐‐ Dec 10‐13, 2009; San Antonio, TX. American Association for Cancer Research, 2009. http://dx.doi.org/10.1158/0008-5472.sabcs-09-4120.

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Bgatova, Nataliya, Nikita Skudin, Alexey Lomakin, Maxim Ryaguzov, Vadim Zakharov, and Maxim Korolev. "Comparative Study of the Colon Adenocarcinoma Stroma Before and after Neoadjuvant Radiotherapy." In 2022 IEEE International Multi-Conference on Engineering, Computer and Information Sciences (SIBIRCON). IEEE, 2022. http://dx.doi.org/10.1109/sibircon56155.2022.10017010.

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Sousa, Paulo Roberto Moura de, Mauricio de Aquino Resende, Ailton Joioso, Raimundo Jovita Araujo Bonfim, and Carlos Eduardo Witoslawski Breda. "FAT GRAFTING AFTER RADIOTHERAPY AND BREAST IMPLANT." In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2095.

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This is a case report of reconstruction of the right breast and aesthetic improvement of the left breast, in a 52-year-old smoker woman, with bilateral breast cancer, neoadjuvant chemotherapy, modified radical mastectomy on the right, quadrantectomy with left, lymphadenectomy, and radiotherapy (RT). She sought the Amaral Carvalho Hospital for reconstructive surgery after 6 years of treatment. She underwent fat grafting (FG) with 237 mL on the right breast and 90 mL on the left breast and correction of the left areola. After 6 months, a retromuscular tissue expander was placed on the right, and remodeling of the breast and correction of the surgical scar are done on the left. After 8 months of achieving expansion with 350 mL of saline solution, the tissue expander was replaced by a wide base anatomical prosthesis with 485 mL and a 225 mL nonanatomical round prosthesis additive to the left. RT makes breast reconstruction difficult, as it gives better results with myocutaneous flaps. FG has a regenerative effect on irradiated tissues. Historically, reconstruction with autologous tissue is preferable to reconstruction with implantation in patients irradiated after mastectomy, as it presents less reoperation (16.6% vs. 37.0%, p<0.0001), total complications (30.9% vs. 41.3%, p <0.0001), and reconstructive failure (1.6% vs. 16.8%, p<0.0001). Radiodermite affects more than 90% of patients treated with RT. The dermis is affected with an increase in fibrosis, reduction in the number of capillaries, and irregular distribution. FG is able to reverse these changes. FG improves the characteristics of irradiated tissue, restores elasticity, and allows breast reconstruction with an implant without a myocutaneous flap.
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Koyama, Fernanda C., Camila Ramos, Angelita Habr-Gama, Venâncio Avancini Ferreira Alves, Rodrigo O. Perez, and Anamaria Aranha Camargo. "Abstract 391: Implications of Akt inhibition for neoadjuvant radiotherapy: improving the rectal cancer treatment." In Proceedings: AACR 107th Annual Meeting 2016; April 16-20, 2016; New Orleans, LA. American Association for Cancer Research, 2016. http://dx.doi.org/10.1158/1538-7445.am2016-391.

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Laseca Modrego, M., O. Arencibia Sanchez, D. González García-Cano, AF Rave Ramirez, and A. Martín Martínez. "441 Neoadjuvant radiotherapy followed by Simple Hysterectomy in locally advanced Endometrial Cancer, Stage II." In ESGO 2021 Congress. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/ijgc-2021-esgo.147.

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Koyama, Fernanda C., Camila M. Lopes Ramos, Jennifer M. Fernandes, Fernanda C. Ledesma, Venancio A. F. Alves, Fernanda C. Vailati, Angelita Habr-Gama, Rodrigo O. Perez, and Anamaria A. Camargo. "Abstract A53: Akt inhibitior MK2206 combination to neoadjuvant radiotherapy: Improving the rectal cancer treatment." In Abstracts: AACR International Conference held in cooperation with the Latin American Cooperative Oncology Group (LACOG) on Translational Cancer Medicine; May 4-6, 2017; São Paulo, Brazil. American Association for Cancer Research, 2018. http://dx.doi.org/10.1158/1557-3265.tcm17-a53.

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Daveau, C., A. Savignoni, S. Abrous-Anane, J. Pierga, F. Reyal, C. Gautier, Y. Kirova, et al. "Is Exclusive Radiotherapy an Option for Early Breast Cancers with Complete Clinical Response after Neoadjuvant Chemotherapy?" In Abstracts: Thirty-Second Annual CTRC‐AACR San Antonio Breast Cancer Symposium‐‐ Dec 10‐13, 2009; San Antonio, TX. American Association for Cancer Research, 2009. http://dx.doi.org/10.1158/0008-5472.sabcs-09-4108.

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Thiruchelvam, P., D. Hadjiminas, S. Cleator, S. Wood, D. Leff, N. Jallali, S. James, and F. MacNeill. "Abstract P3-14-07: Neoadjuvant radiotherapy in mastectomy and immediate autologous free flap reconstruction. Findings from the primary radiotherapy and DIEP flap (PRADA) pilot study." In Abstracts: 2016 San Antonio Breast Cancer Symposium; December 6-10, 2016; San Antonio, Texas. American Association for Cancer Research, 2017. http://dx.doi.org/10.1158/1538-7445.sabcs16-p3-14-07.

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Nunes, Mirella Laranjeira, Carlos Eduardo Caiado Anunciação, Vidianna Barbosa Sampaio, Rossano Robério Fernandes Araújo, Cinthya Roberta Santos de Jesus, Ana Leide Guerra dos Santos, Bruno Pacheco Pereira, and João Esberard de Vasconcelos Beltrão Neto. "OCCULT PRIMARY BREAST CARCINOMA: A CASE REPORT." In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2049.

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Abstract:
Introduction: Occult breast carcinoma (OBC) is the histologically proven axillary lymph node (LN) metastasis, consistent with primary breast cancer, with no identifiable primary site. It is most commonly found in women above 60 years. Owing to the absence of protocols, management is challenging. According to the National Comprehensive Cancer Network (NCCN), the therapeutic options are mastectomy plus lymphadenectomy with or without radiotherapy, or lymphadenectomy with breast irradiation with or without axillary irradiation. Mastectomy is often used, but advances in neoadjuvant chemotherapy have made the survival between mastectomy and conservative breast management same. The prognosis is controversial, with lymph node (LN) involvement being the main factor. Case Report: A 45-year-old female presents with suspicious palpable right axillary lesion at level 1 topography of 2.5 cm size on the physical examination. No breast mass was palpable. Mammography was BIRADS classification 1. Breast and axillar ultrasound done 2 months before showed benign findings on the left side and axillary LN of 2.3 cm and breast nodule of 1.1 cm × 0.9 cm on the right side. Core-needle biopsy showed fibroadenoma in the right-sided breast nodule and metastatic carcinoma in the axillary LN. Immunohistochemistry expression of the markers was consistent with breast origin and was progesterone and estrogen receptors positive and HER-2 negative. Magnetic resonance imaging (MRI) showed this atypical LN with 1.5 cm. Clinical staging is T0N1M0. Neoadjuvant chemotherapy was performed with Adriamycin, cyclophosphamide, and paclitaxel. There was tumor remission with another MRI and ultrasonography showing the node metastasis with 1 cm. Right radical mastectomy was performed. Anatomopathology showed cytoarchitectural changes due to chemotherapy, complete pathological response in the LN, and immunohistochemistry unchanged. In addition, tumorectomy were performed in the left-sided nodule, with anatomopathology showing ductal ectasia and histiocitary abscess. Radiotherapy at the supraclavicular area and tangents was performed, and tamoxifen was prescribed. The patient remained cancer free for 2 years after surgery.
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Jacome, Anna Carolina Pereira, Ingrid Bernucci Neto, Patrícia Aguiar Bellini, Luciana Carvalho Horta, and Bruno Henrique Jacome Alvarenga. "OCCULT PRIMARY TRIPLE NEGATIVE BREAST CANCER IN AN ELDERLY PATIENT: CASE REPORT." In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1003.

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Introduction: Occult primary breast cancer is very rare, accounting for less than 1% of all cases of breast cancer, generally associated with a poor prognosis. It is defined as a clinically recognizable metastatic carcinoma derived from an undetectable primary breast tumor, with metastasis to the axillary and cervical lymph nodes. Clinical and radiological examinations represent the first steps in the diagnosis, followed by a histological and immunohistochemistry (IHC) analysis, as well as a multidisciplinary team evaluation and therapy - essential for diagnosis and treatment. The most common phenotype is a positive hormone-receptor adenocarcinoma for which there is no clear consensus about optimal management, however a standard approach is axillary lymph node (ALN) dissection. Ipsilateral mastectomy, neoadjuvant chemotherapy and radiotherapy are controversial but may be acceptable in selected cases. Case report: A 72-year-old woman with a history of colon adenocarcinoma surgically treated, presented with an axillary mass of rapid growth. Uponn physical examination, a 5 cm mass in the left axilla and a palpable ipsilateral supraclavicular lymph node (SCLN) were identified, without any evidence of a breast lesion. imaging analysis with bilateral mammography, ultrasonography and breast magnetic ressonance imaging showed suspicious axillary and SC adenopathy, both on the left side; no abnormal breast findings. She was submitted to core biopsy and IHC analysis, andan invasive triple negative metastatic breast cancer was diagnosed. The patient underwent neoadjuvant chemotherapy with cyclophosphamide / doxorubicin, evolving with disease progression, so the regimen was modified to carboplatin. There was no response to treatment, with persistent growing of the lesion. Neoadjuvant chemotherapy was interrupted and surgery was performed to resect the ALN and the SCLN. It was a difficult surgery due to the extension of the axillary mass, in conjunction with adherence to the subclavian vein. A histologic analysis confirmed the inicial diagnosis of metastatic breast cancer. Surgery was followed by radiotherapy, but disease progression was fast. She manifested a large axillary recurrence and progressed to death 4 months after the beginning of treatment. This case report describes how challeging occult breast cancer can be, specially when associated with an unusual presentation such as a triple negative phenotype and SC adenopathy. At first, the hypothesis of colon metastasis was proposed due to the poor reponse to chemotherapy. Despite being submited to the standard approach proposed and supported by literature, the aggressive and rapid progression to death represents an obvious need to discuss other treatment options for occult breast carcinoma with unusual presentations, such as negative hormone-receptor.
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