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Journal articles on the topic 'NEOADJUVANT RADIOTHERAPY'

Author: Grafiati

Published: 20 February 2023

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1

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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Skuja, Elina, Arturs Sorubalko, Gunta Purkalne, and Edvins Miklasevics. "Neoadjuvant Chemoradiation in Patient with Localy Advanced Rectal Cancer." Acta Chirurgica Latviensis 13, no. 2 (December 1, 2013): 9–13. http://dx.doi.org/10.2478/chilat-2014-0002.

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Abstract Introduction. Neoadjuvant (preoperative) concomitant chemoradiotherapy (CRT) has become a standard treatment of locally advanced rectal adenocarcinoma. Aim of the study is to analyze efficacy of neoadjuvant CRT and survival rates in patients with locally advanced rectal cancer. Materials and methods. Retrospective study of 60 locally advanced rectal cancer patients who underwent neoadjuvant radiotherapy with or without addition of neoadjuvant chemotherapy in Clinic of Oncology of Pauls Stradiņš Clinical University Hospital from 2007 to 2012 was done. Results. Long-course radiotherapy (45-50.4 Gy) received 52 patients. Median time from diagnosis to radiotherapy was 35.8 days. Median time to surgery was 47.7 days. Pathological complete remission (pCR) of the primary rectal cancer was not observed. Distribution by pathologic staging was as follows: 28.8% Stage I (7.7% T1N0M0), 32.7% Stage II and 38.5% Stage III. Downstaging occurred in 93.7% in concomitant chemoradiation with Ftorafur, 61.9% in combination with 5FU/LV, and 53.3% in radiation without chemotherapy. Median PFS and OS were not met. In median follow up of 22.6 month overall survival was 90.3%, and PFS - 88%. Conclusions. Addition of chemotherapy to neoadjuvant radiotherapy is increasing tumor downstaging rate. Ftorafur in concomitant neoadjuvant chemoradiation showed increased downstaging compared to standard 5FU therapy. Response to preoperative therapy improves survival in patient with locally advanced rectal cancer.

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Feeney, Gerard, Rishabh Sehgal, Margaret Sheehan, Aisling Hogan, Mark Regan, Myles Joyce, and Michael Kerin. "Neoadjuvant radiotherapy for rectal cancer management." World Journal of Gastroenterology 25, no. 33 (September 7, 2019): 4850–69. http://dx.doi.org/10.3748/wjg.v25.i33.4850.

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Osborne, Tamsin. "Neoadjuvant androgen deprivation delays curative radiotherapy." Nature Clinical Practice Urology 2, no. 10 (October 2005): 464–65. http://dx.doi.org/10.1038/ncpuro0280.

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&NA;. "Neoadjuvant chemo ?? radiotherapy in oesophageal cancer." Inpharma Weekly &NA;, no. 1584 (April 2007): 18. http://dx.doi.org/10.2165/00128413-200715840-00050.

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Zheng, Yan, Xianben Liu, Ruixiang Zhang, Zongfei Wang, Haibo Sun, Jianjun Qin, Shilei Liu, and Yin Li. "Neoadjuvant chemotherapy with or without neoadjuvant radiotherapy compared with neoadjuvant chemoradiotherapy for esophageal cancer." Journal of Thoracic Disease 10, no. 8 (August 2018): 4715–23. http://dx.doi.org/10.21037/jtd.2018.07.124.

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Goff, Peter H., Laura Riolobos, Bonnie J. LaFleur, Matthew B. Spraker, Y. David Seo, Kimberly S. Smythe, Jean S. Campbell, et al. "Neoadjuvant Therapy Induces a Potent Immune Response to Sarcoma, Dominated by Myeloid and B Cells." Clinical Cancer Research 28, no. 8 (February 2, 2022): 1701–11. http://dx.doi.org/10.1158/1078-0432.ccr-21-4239.

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Abstract Purpose: To characterize changes in the soft-tissue sarcoma (STS) tumor immune microenvironment induced by standard neoadjuvant therapy with the goal of informing neoadjuvant immunotherapy trial design. Experimental Design: Paired pre- and postneoadjuvant therapy specimens were retrospectively identified for 32 patients with STSs and analyzed by three modalities: multiplexed IHC, NanoString, and RNA sequencing with ImmunoPrism analysis. Results: All 32 patients, representing a variety of STS histologic subtypes, received neoadjuvant radiotherapy and 21 (66%) received chemotherapy prior to radiotherapy. The most prevalent immune cells in the tumor before neoadjuvant therapy were myeloid cells (45% of all immune cells) and B cells (37%), with T (13%) and natural killer (NK) cells (5%) also present. Neoadjuvant therapy significantly increased the total immune cells infiltrating the tumors across all histologic subtypes for patients receiving neoadjuvant radiotherapy with or without chemotherapy. An increase in the percentage of monocytes and macrophages, particularly M2 macrophages, B cells, and CD4+ T cells was observed postneoadjuvant therapy. Upregulation of genes and cytokines associated with antigen presentation was also observed, and a favorable pathologic response (≥90% necrosis postneoadjuvant therapy) was associated with an increase in monocytic infiltrate. Upregulation of the T-cell checkpoint TIM3 and downregulation of OX40 were observed posttreatment. Conclusions: Standard neoadjuvant therapy induces both immunostimulatory and immunosuppressive effects within a complex sarcoma microenvironment dominated by myeloid and B cells. This work informs ongoing efforts to incorporate immune checkpoint inhibitors and novel immunotherapies into the neoadjuvant setting for STSs.

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Prakash, Kuppa, Vindhya Vasini, and M. Vijay Kumar. "A comparative study of neoadjuvant chronomodulated folfox and radiotherapy vs. Conventional folfox and radiotherapy in locally advanced carcinoma rectum." Asian Pacific Journal of Health Sciences 3, no. 3 (July 2016): 307–14. http://dx.doi.org/10.21276/apjhs.2016.3.3.46.

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Koo, Kendrick, Rachel Ward, Ryan L. Smith, Jeremy Ruben, Peter W. G. Carne, and Hany Elsaleh. "Temporal determinants of tumour response to neoadjuvant rectal radiotherapy." PLOS ONE 16, no. 6 (June 30, 2021): e0254018. http://dx.doi.org/10.1371/journal.pone.0254018.

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Introduction In locally advanced rectal cancer, longer delay to surgery after neoadjuvant radiotherapy increases the likelihood of histopathological tumour response. Chronomodulated radiotherapy in rectal cancer has recently been reported as a factor increasing tumour response to neoadjuvant treatment in patients having earlier surgery, with patients receiving a larger proportion of afternoon treatments showing improved response. This paper aims to replicate this work by exploring the impact of these two temporal factors, independently and in combination, on histopathological tumour response in rectal cancer patients. Methods A retrospective review of all patients with rectal adenocarcinoma who received long course (≥24 fractions) neoadjuvant radiotherapy with or without chemotherapy at a tertiary referral centre was conducted. Delay to surgery and radiotherapy treatment time were correlated to clinicopathologic characteristics with a particular focus on tumour regression grade. A review of the literature and meta-analysis were also conducted to ascertain the impact of time to surgery from preoperative radiotherapy on tumour regression. Results From a cohort of 367 patients, 197 patients met the inclusion criteria. Complete pathologic response (AJCC regression grade 0) was seen in 46 (23%) patients with a further 44 patients (22%) having at most small groups of residual cells (AJCC regression grade 1). Median time to surgery was 63 days, and no statistically significant difference was seen in tumour regression between patients having early or late surgery. There was a non-significant trend towards a larger proportion of morning treatments in patients with grade 0 or 1 regression (p = 0.077). There was no difference in tumour regression when composite groups of the two temporal variables were analysed. Visualisation of data from 39 reviewed papers (describing 27379 patients) demonstrated a plateau of response to neoadjuvant radiotherapy after approximately 60 days, and a meta-analysis found improved complete pathologic response in patients having later surgery. Conclusions There was no observed benefit of chronomodulated radiotherapy in our cohort of rectal cancer patients. Review of the literature and meta-analysis confirms the benefit of delayed surgery, with a plateau in complete response rates at approximately 60-days between completion of radiotherapy and surgery. In our cohort, time to surgery for the majority of our patients lay along this plateau and this may be a more dominant factor in determining response to neoadjuvant therapy, obscuring any effects of chronomodulation on tumour response. We would recommend surgery be performed between 8 and 11 weeks after completion of neoadjuvant radiotherapy in patients with locally advanced rectal cancer.

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Groenewold, M. D., C. G. Olthof, and D. J. Bosch. "Anaesthesia after neoadjuvant chemotherapy, immunotherapy or radiotherapy." BJA Education 22, no. 1 (January 2022): 12–19. http://dx.doi.org/10.1016/j.bjae.2021.08.002.

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Dimery, Isaiah W., Alan M. Kramer, Asit J. Choksi, and Waun K. Hong. "Neoadjuvant Chemotherapy and Radiotherapy in Larynx Preservation." American Journal of Clinical Oncology 12, no. 2 (April 1989): 173–77. http://dx.doi.org/10.1097/00000421-198904000-00017.

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Yeh, Rudy, Lee Na Chong, and T. Michael Hughes. "Malignant phyllodes: excellent response to neoadjuvant radiotherapy." ANZ Journal of Surgery 89, no. 12 (September 12, 2018): 1668–70. http://dx.doi.org/10.1111/ans.14807.

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Kirova, Y. "SP-0557 Neoadjuvant radiotherapy in breast cancer." Radiotherapy and Oncology 133 (April 2019): S292. http://dx.doi.org/10.1016/s0167-8140(19)30977-6.

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Zhan, Tiancheng, Jin Gu, Ming Li, and Changzheng Du. "Intermediate-Fraction Neoadjuvant Radiotherapy for Rectal Cancer." Diseases of the Colon & Rectum 56, no. 4 (April 2013): 422–32. http://dx.doi.org/10.1097/dcr.0b013e31828576c6.

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Nardone, Valerio, Luca Boldrini, Roberta Grassi, Davide Franceschini, Ilaria Morelli, Carlotta Becherini, Mauro Loi, Daniela Greto, and Isacco Desideri. "Radiomics in the Setting of Neoadjuvant Radiotherapy: A New Approach for Tailored Treatment." Cancers 13, no. 14 (July 17, 2021): 3590. http://dx.doi.org/10.3390/cancers13143590.

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Introduction: Neoadjuvant radiotherapy is currently used mainly in locally advanced rectal cancer and sarcoma and in a subset of non-small cell lung cancer and esophageal cancer, whereas in other diseases it is under investigation. The evaluation of the efficacy of the induction strategy is made possible by performing imaging investigations before and after the neoadjuvant therapy and is usually challenging. In the last decade, texture analysis (TA) has been developed to help the radiologist to quantify and identify the parameters related to tumor heterogeneity, which cannot be appreciated by the naked eye. The aim of this narrative is to review the impact of TA on the prediction of response to neoadjuvant radiotherapy and or chemoradiotherapy. Materials and Methods: Key references were derived from a PubMed query. Hand searching and ClinicalTrials.gov were also used. Results: This paper contains a narrative report and a critical discussion of radiomics approaches in different fields of neoadjuvant radiotherapy, including esophageal cancer, lung cancer, sarcoma, and rectal cancer. Conclusions: Radiomics can shed a light on the setting of neoadjuvant therapies that can be used to tailor subsequent approaches or even to avoid surgery in the future. At the same, these results need to be validated in prospective and multicenter trials.

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H.G, Vinay, and Vybhav R. "The Outcome of Neoadjuvant Chemo Radiotherapy and Surgery in Carcinoma Rectum: Our Experience." New Indian Journal of Surgery 9, no. 1 (2018): 97–102. http://dx.doi.org/10.21088/nijs.0976.4747.9118.19.

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Hussain, Syed A., Emma Hall, Nuria Porta, Malcolm Crundwell, Peter Jenkins, Christine Lisa Rawlings, Jean Tremlett, et al. "Outcome of BC2001 patients (CRUK/01/004) who received neoadjuvant chemotherapy prior to randomization to chemo-radiotherapy (cRT) versus radiotherapy (RT)." Journal of Clinical Oncology 35, no. 6_suppl (February 20, 2017): 298. http://dx.doi.org/10.1200/jco.2017.35.6_suppl.298.

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298 Background: Neoadjuvant chemotherapy is considered standard of care for patients with muscle invasive bladder cancer (MIBC). Gemcitabine plus cisplatin or carboplatin (GC) has been adopted as a standard neoadjuvant regimen for MIBC. BC2001 showed that adding chemotherapy (5FU+MMC) to radiotherapy (55Gy/20f or 64Gy/32f) significantly improved rates of muscle invasive bladder cancer (MIBC) locoregional control (LRC) [James 2012]. We report outcome of patients (pts) receiving neoadjuvant chemotherapy prior to starting BC2001 trial treatment (cRT or RT alone). Methods: Between August 2001 and April 2008, 360 pts were randomised to RT (178) or cRT (182); 117 (32.5%) received neoadjuvant chemotherapy (61 RT, 56 cRT). Primary endpoint was LRC, secondary endpoints included toxicity, overall survival (OS) and metastasis free survival (MFS). Cox models adjusted by known prognostic factors were used to estimate randomised treatment effect in this subgroup of pts. Toxicities were compared by Chi squared tests. Results: Median age of the 117 pts was 66 (interquartile range: 60-73) years, 86% were male, 73% had baseline 0 WHO performance status. 81% had T2 and 87% G3 tumours. Neoadjuvant treatment received was GC (73.5%), MVAC (13.6%), CMV (11.1%) or other (<2%). 92.3% cRT and 91.8% RT pts completed radiotherapy as planned. Grade 3 or above adverse events during treatment occurred in 27.4% pts (32.2% cRT vs 22.9 RT, p-value(p)=0.27), and in 9.5% during follow-up (13.4% cRT vs 5.3% RT, p=0.21). There was a trend for improved LRC in the cRT group (hazard ratio HR=0.64, 95CI% 0.33-1.23, p=0.18), while no differences in OS (HR=0.95, 95CI% 0.57-1.57, p=0.83) or MFS (HR=0.93, 95CI% 0.52-1.65, p=0.80) were observed. Median OS was 46.7 months ,cRT: 50.4 months vs RT: 46.7 months. MFS: Median: 68.5 months, cRT: 118.5 months vs RT: 54.2 months. Conclusions: The benefit in improved LRC of synchronous chemotherapy with 5FU/MMC was also found in the subgroup of BC2001 pts receiving neoadjuvant chemotherapy, with no significant increase in late toxicity. Neoadjuvant chemotherapy did not compromise the delivery of radical curative treatment with RT or cRT. Clinical trial information: ISRCTN68324339.

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Horwich, Alan, David Paul Dearnaley, Aslam Sohaib, Kjell Pennert, and Robert Anthony Huddart. "Neoadjuvant carboplatin in stage IIa and IIb seminoma." Journal of Clinical Oncology 31, no. 6_suppl (February 20, 2013): 321. http://dx.doi.org/10.1200/jco.2013.31.6_suppl.321.

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321 Background: Approaches to managing stages IIa and IIb seminoma post-orchidectomy range from combination chemotherapy (typically 3 cycles of BEP) to extended field radiotherapy (typically 36 Gy to para-aortic and ipsilateral pelvic lymph nodes. Survival rates are very good, which highlights the need to minimise toxicity risks. We report on the role of a single cycle of neoadjuvant carboplatin prior to limited field radiotherapy. Methods: In a single arm study fifty one patients were treated between May 1996 and November 2011 with a single cycle of carboplatin at an AUC of 7 mg.mins/ml followed by radiotherapy. The radiation field was reduced to just the para-aortic region and the dose to 30Gy in 39 patients. Results: After a median follow-up of 55 months (range 8-151 months) with 38 (74%) of the patients having been followed for more than 2 years, there have to date been no relapses (95% confidence limits of 5 year relapse free survival of 93-100%). Toxicity has been low with grade 3 toxicity limited to 4 patients with grade 3 haematological toxicity (with no clinical sequelae) and 1 patient with grade 3 nausea (during radiotherapy). No patients experienced grade 4 toxicity. Conclusions: The results of this pilot study suggest that a single cycle of neoadjuvant carboplatin prior to radiotherapy may reduce recurrence risk and permit a smaller radiation field, and this approach is proposed for further investigation.

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Palmeri, M., J. M. Pipas, G. H. Ripple, M. McGowan, K. D. Smith, and B. I. Zaki. "Neoadjuvant intensity-modulated radiotherapy (IMRT) in pancreatic adenocarcinoma: The Dartmouth experience." Journal of Clinical Oncology 29, no. 4_suppl (February 1, 2011): 274. http://dx.doi.org/10.1200/jco.2011.29.4_suppl.274.

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274 Background: Neoadjuvant chemoradiation may play a role in improving the resectability and overall survival (OS) of patients with pancreatic adenocarcinoma. IMRT allows higher radiation doses to regions within a tumor while minimizing the dose to surrounding normal structures. Methods: Eighty-one patients with pancreatic adenocarcinoma completed neoadjuvant IMRT from 2003-2008. All were staged by CT scan, endoscopic ultrasound and laparoscopy. Based on defined resectability criteria, 14 were resectable (R), 38 considered borderline resectable (B) and 29 unresectable (U). Patients were categorized into 3 groups based on their neoadjuvant treatment. All patients received concurrent IMRT with gemcitabine (50mg/m2) twice weekly for 12 doses. IMRT prescription dose was 54 Gy in 28 fractions with a biologically effective dose of 64.47Gy10. All resected patients received intra-operative radiation (mean dose 14 Gy). Group 1 received neoadjuvant chemotherapy involving gemcitabine and docetaxel on days 1, 15, and 29 followed by IMRT. Group 2 received concurrent weekly cetuximab in addition to bi-weekly gemcitabine and IMRT. Group 3 received only concurrent gemcitabine twice weekly and IMRT. Four weeks after treatment completion, patients were evaluated with a CT scan in preparation for surgery. Results: Median OS for all patients was 22 months. The overall resectability rate after neoadjuvant IMRT was 63%. 78% of B and 39% of U patients underwent resection. 80% of all patients had an R0 resection. Median OS was 23 months for R, 28 months for B and 14 months for U patients (P = 0.002). Median OS was 18 months, 27 months and 18 months respectively for patients receiving gemcitabine-IMRT, gemcitabine-cetuximab and neoadjuvant gemcitabine/docetaxel plus concurrent gemcitabine-IMRT (P = 0.20). Median OS for R0 resections were 28 months compared to 24.3 months for patients with positive margins and 11.7 months for unresectable patients (P < 0.001). Conclusions: IMRT as part of a neoadjuvant treatment strategy for pancreatic adenocarcinoma is feasible and well tolerated. Neoadjuvant IMRT rendered a significant percentage of B patients resectable with an OS comparable to patients who were R at presentation. [Table: see text]

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Capdevila, Laia, Sara Cros, Nuria Pardo, Jose Luis Cuadra, Olatz Etxaniz, Salvador Villà, and Carmen Balana. "Analysis of two consecutive series of unresectable high-grade glioma (HGG) patients (pts) treated with or without neoadjuvant chemotherapy before estandar radiochemotherapy (CRT) and adjuvant temozolamide (TMZ)." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e12504-e12504. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e12504.

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e12504 Background: Standard treatment of HGG is based in CRT with TMZ. Neoadjuvant treatment before radiotherapy has been studied in small series. Methods: We retrospectively analyzed 2 consecutive series of non-resectable HGG pts treated with neoadjuvant chemotherapy (TMZ & cisplatin) before the 2005 with those treated with TMZ and concurrent and adjuvant TMZ & radiotherapy (after 2005). Results: 46pts diagnosed between August 2003 and October 2010 were selected. 23 received neoadjuvant therapy with TMZ (200mg/m2/d x 5d) and cisplatin (75mg/m2) followed by radiotherapy -60Gy 6w- (NA group), and the remaining 23pts received standard treatment with concomitant TMZ and radiotherapy -60Gy 6w- and adjuvant TMZ (CRT group). In the NA group, 87% of pts were ≥50 years, 43.5% were men, 65.2% had performance status (PS) <2, 38.4% Barthel index <70. Histology: 78.3% were glioblastoma (GB). 30.4% of pts had multifocal lesions and 43.5% had seizures at the diagnosis. 95.7% of pts required dexamethasone. In the CRT group, 91.3% of pts were ≥50 years, 78.3% were men, PS was <2 in 60.9% and Barthel index <70 in 21.7% of cases. Histology: 69.6% were GB, 26.1% pts had multifocal lesions and 26.1% had seizures at diagnosis. 87% of pts required dexamethasone. All factors were uniformly distributed in the two groups. 82.6% of pts completed scheduled radiotherapy in NA group in front 91.3% in the CRT group (P= 0.66). PFS was 2.9 months (m) (CI 95%: 0.5 – 5.5) in NA group versus 5.1m (CI 95%: 3.1 – 7.1) in the CRT group (p=0.62), OS was 8.5m (CI 95%: 4.0 – 12.9) vs 8.2m (CI 95%: 1.2 – 15.2) respectively (p=0.45). Conclusions: No differences were found in either PFS or OS between the two treatment groups. The administration of neoadjuvant therapy does no have a negative impact on the ability to receive radiotherapy. These results provide a basis to justify clinical trials in this setting with promising drugs before radiotherapy treatment.

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Lin, Huapeng, Xiaocheng Li, Ye Liu, and Yingchun Hu. "Neoadjuvant radiotherapy provided survival benefit compared to adjuvant radiotherapy for hepatocellular carcinoma." ANZ Journal of Surgery 88, no. 10 (February 5, 2018): E718—E724. http://dx.doi.org/10.1111/ans.14387.

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Qu, Chenghao, Rongyang Li, Jingyi Han, Weiming Yue, and Hui Tian. "Effects of Neoadjuvant Radiotherapy on Survival in Patients with Stage IIIA-N2 Non-Small-Cell Lung Cancer Following Pneumonectomy." Journal of Clinical Medicine 11, no. 23 (December 2, 2022): 7188. http://dx.doi.org/10.3390/jcm11237188.

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Background: Pneumonectomy is a drastic but sometimes inevitable treatment option for patients with non-small-cell lung cancer (NSCLC) to improve their chances for long-term survival. However, the optimal adjuvant radiotherapy used for patients with N2 NSCLC following pneumonectomy remains unclear in the literature. Methods: T1-4N0-2M0 NSCLC patients registered in the Surveillance, Epidemiology, and End Results database were retrospectively analyzed. Propensity score matching was applied to balance the assignment of patients. Cox proportional hazards models and Kaplan–Meier analyses were used to identify the factors related to overall survival rates. Restricted cubic splines were used to detect the possible nonlinear dependency of the relationship between the risk of survival and age. Results: A total of 4308 NSCLC patients were enrolled in this study. In N2 patients, the long-term outcome of the chemotherapy and postoperative radiotherapy groups was the worst (p = 0.014). Subgroup analyses showed that the influence of age on survival outcome was confined to patients who received chemotherapy and neoadjuvant radiotherapy (p = 0.004). Meanwhile, patients >65 years of age who received chemotherapy and neoadjuvant radiotherapy had significantly worse prognoses than those in the chemotherapy group (p = 0.005). Conclusions: Our results show that neoadjuvant radiotherapy may have potential benefits in patients aged ≤ 65 years who are scheduled for pneumonectomy, but not in elderly patients.

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Li, Jia-yi, Xuan-zhang Huang, Peng Gao, Xiao-wan Chen, Yong-xi Song, Xing-er Lv, Yv Fu, Qiong Xiao, and Zhen-ning Wang. "Postoperative Adjuvant Treatment Strategy for Locally Advanced Rectal Cancer after Neoadjuvant Treatment." BioMed Research International 2021 (March 27, 2021): 1–21. http://dx.doi.org/10.1155/2021/8852699.

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Background. Neoadjuvant (chemo) radiotherapy is used as a standard treatment for locally advanced rectal cancer (LARC), but there is no general consensus on either the efficacy of postoperative adjuvant chemotherapy in patients with LARC after neoadjuvant treatment and surgery, or whether the addition of oxaliplatin to adjuvant chemotherapy provides survival benefits. Methods. We performed a meta-analysis of data from the PubMed and Embase databases. We included patients with LARC who received neoadjuvant (chemo) radiotherapy and curative surgery. Overall survival (OS), disease-free survival (DFS), toxicity, and compliance were analyzed in the oxaliplatin/fluorouracil- (OX/FU-) based group compared with the FU-based group, and in the chemotherapy group compared with the observation group. Results. Twenty studies were included in the analysis. Our results indicated that adjuvant chemotherapy prolonged OS (hazard ratio HR = 0.78 , 95 % CI = 0.67 – 0.91 ) in patients with LARC treated with neoadjuvant (chemo) radiotherapy and surgery compared with those in the observation group. Subgroup analysis showed the same results in both the ypStage II and ypStage III groups. Compared with those in the observation group, patients in the chemotherapy group also showed an increase in DFS ( HR = 0.75 , 95 % CI = 0.60 – 0.93 ). No significant increase was observed in OS ( HR = 1.04 , 95 % CI = 0.87 – 1.24 ) or DFS ( HR = 0.98 , 95 % CI = 0.76 – 1.27 ) when oxaliplatin was added to FU-based adjuvant chemotherapy, as compared with the FU-based treatment, and subgroup analysis also indicated no survival benefits in the clinical stage II, clinical stage III, ypStage II, and ypStage III groups. Conclusions. For patients with LARC who have already received neoadjuvant (chemo) radiotherapy and curative surgery, adjuvant chemotherapy improves OS over that in the observation group. Adding oxaliplatin to FU-based adjuvant chemotherapy does not confer survival benefits beyond those from FU-based adjuvant chemotherapy.

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Ma, Jun, Hai-Qiang Mai, Ming-Huang Hong, Hua-Qing Min, Zhi-Da Mao, Nian-Ji Cui, Tai-Xiang Lu, and Hao-Yuan Mo. "Results of a Prospective Randomized Trial Comparing Neoadjuvant Chemotherapy Plus Radiotherapy With Radiotherapy Alone in Patients With Locoregionally Advanced Nasopharyngeal Carcinoma." Journal of Clinical Oncology 19, no. 5 (March 1, 2001): 1350–57. http://dx.doi.org/10.1200/jco.2001.19.5.1350.

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PURPOSE: A prospective randomized trial was performed to evaluate the contribution of neoadjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma. PATIENTS AND METHODS: Patients with locoregionally advanced nasopharyngeal carcinoma were treated either with radiotherapy alone (RT group) or neoadjuvant chemotherapy plus radiotherapy (CT/RT group). Neoadjuvant chemotherapy consisting of two to three cycles of cisplatin (100 mg/m2, day 1), bleomycin (10 mg/m2, days 1 and 5), and fluorouracil (5-FU; 800 mg/m2, days 1 through 5, continuous infusion) followed by radiotherapy was given to the CT/RT group. All patients were treated in a uniform fashion by definitive-intent radiation therapy in both groups. RESULTS: Between July 1993 and July 1994, 456 patients were entered onto the study, with 228 patients randomized to each treatment arm, and 449 patients (225 in the RT group and 224 in the CT/RT group) were assessable. All 456 patients were included in survival analysis according to the intent-to-treat principle. The 5-year overall survival (OS) rates were 63% for the CT/RT group and 56% for the RT group (P = .11). The median relapse-free survival (RFS) time was 50 months for the RT group and not reached for the CT/RT group. The 5-year RFS rate was 49% for the RT group versus 59% for the CT/RT group (P = .05). The 5-year freedom from local recurrence rate was 82% for the CT/RT group and 74% for the RT group (P = .04). There was no significant difference in freedom from distant metastasis between the two treatment groups (CT/RT group, 79%; RT group, 75%; P = .40). CONCLUSION: This randomized study failed to demonstrate any significant survival benefit with the addition of neoadjuvant chemotherapy for patients with locoregionally advanced nasopharyngeal carcinoma. Therefore, neoadjuvant chemotherapy for nasopharyngeal carcinoma should not be used outside of the context of a clinical trial.

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Zaghloul, Mohamed Saad. "Adjuvant and neoadjuvant radiotherapy for bladder cancer: revisited." Future Oncology 6, no. 7 (July 2010): 1177–91. http://dx.doi.org/10.2217/fon.10.82.

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Ng, Sweet Ping, Samuel Y. Ngan, and Trevor Leong. "Current State of Neoadjuvant Radiotherapy for Rectal Cancer." Clinical Colorectal Cancer 21, no. 1 (March 2022): 63–70. http://dx.doi.org/10.1016/j.clcc.2021.10.008.

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Karapantzos, Ilias, Chrysa Karapantzou, Paul Zarogoulidis, Michail Karanikas, Vasilis Thomaidis, and Charalampos Charalampidis. "Neoadjuvant Chemotherapy Followed by Radiotherapy for Laryngeal Cancer." Journal of Biomedicine 1 (2016): 32–35. http://dx.doi.org/10.7150/jbm.16927.

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Jootun, N., S. Sengupta, C. Cunningham, P. Charlton, M. Betts, A. Weaver, C. Jacobs, R. Hompes, and R. Muirhead. "Neoadjuvant radiotherapy in rectal cancer – less is more?" Colorectal Disease 22, no. 3 (October 20, 2019): 261–68. http://dx.doi.org/10.1111/codi.14863.

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Wachter, Stefan, Natascha Wachter-Gerstner, and Richard Pötter. "Neoadjuvant Hormonal Treatment and Radiotherapy for Prostate Cancer." Oncology 65, no. 1 (2003): 29–33. http://dx.doi.org/10.1159/000072489.

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Santarelli, M., N. Raffetto, P. Torcia, A. Vitturini, V. Tombolini, and R. Maurizi Enrici. "Neoadjuvant radiotherapy and chemiotherapy for advanced esophageal cancer." European Journal of Cancer 35 (September 1999): S156. http://dx.doi.org/10.1016/s0959-8049(99)81009-0.

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Porhanov, V. A., I. S. Poliakov, S. S. Semendiaev, V. B. Kononenko, A. N. Bocharov, V. N. Bodnia, and M. U. Mamelov. "Neoadjuvant radiotherapy treatment for Stage N2 disease NSCLC." Lung Cancer 29, no. 1 (September 2000): 94. http://dx.doi.org/10.1016/s0169-5002(00)80308-6.

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Haustermans, K. "Neoadjuvant radiotherapy: drugs or rays? Hypo- or hyper-?" European Journal of Cancer 37 (April 2001): S254. http://dx.doi.org/10.1016/s0959-8049(01)81434-9.

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Glynne-Jones, R. "PG 1.03 Neoadjuvant treatment: Do we need radiotherapy?" European Journal of Cancer 48 (March 2012): S1—S2. http://dx.doi.org/10.1016/s0959-8049(12)70004-7.

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Martel, Guillaume, Youssuf Al-Suhaibani, Hartley Stern, and Robin P. Boushey. "Rectal Cancer Perforation After Short-course Neoadjuvant Radiotherapy." Diseases of the Colon & Rectum 50, no. 10 (October 2007): 1724–25. http://dx.doi.org/10.1007/s10350-007-0287-5.

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Lee, Jack. "Rectal Cancer Perforation After Short-course Neoadjuvant Radiotherapy." Diseases of the Colon & Rectum 50, no. 10 (October 2007): 1726. http://dx.doi.org/10.1007/s10350-007-0288-4.

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Cheng, Hao, John T. Miura, Mona Lalehzari, Rahul Rajeev, Amy E. Donahue, Meena Bedi, T. Clark Gamblin, Kiran K. Turaga, and Fabian M. Johnston. "Neoadjuvant radiotherapy for retroperitoneal sarcoma: A systematic review." Journal of Surgical Oncology 113, no. 6 (March 16, 2016): 628–34. http://dx.doi.org/10.1002/jso.24221.

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Spałek, Mateusz Jacek, Katarzyna Kozak, Anna Małgorzata Czarnecka, Ewa Bartnik, Aneta Borkowska, and Piotr Rutkowski. "Neoadjuvant Treatment Options in Soft Tissue Sarcomas." Cancers 12, no. 8 (July 26, 2020): 2061. http://dx.doi.org/10.3390/cancers12082061.

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Due to the heterogeneity of soft tissue sarcomas (STS), the choice of the proper perioperative treatment regimen is challenging. Neoadjuvant therapy has attracted increasing attention due to several advantages, particularly in patients with locally advanced disease. The number of available neoadjuvant modalities is growing continuously. We may consider radiotherapy, chemotherapy, targeted therapy, radiosensitizers, hyperthermia, and their combinations. This review discusses possible neoadjuvant treatment options in STS with an emphasis on available evidence, indications for each treatment type, and related risks. Finally, we summarize current recommendations of the STS neoadjuvant therapy response assessment.

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Allen, Jeffrey C., Jae Ho Kim, and Roger J. Packer. "Neoadjuvant chemotherapy for newly diagnosed germ-cell tumors of the central nervous system." Journal of Neurosurgery 67, no. 1 (July 1987): 65–70. http://dx.doi.org/10.3171/jns.1987.67.1.0065.

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✓ A neoadjuvant (preradiotherapy) chemotherapy regimen consisting of either cyclophosphamide alone (60 to 80 mg/kg) or a modified multidrug regimen (vinblastine, bleomycin, cyclophosphamide, and cisplatin) was administered to 15 newly diagnosed patients with histologically confirmed, fully staged, primary germ-cell tumors (GCT's) of the central nervous system (CNS). There were 11 patients with germinomas and four with non-germinoma malignant GCT's. There were six females and nine males, whose median age was 13 years (range 4 months to 24 years). Seven germinoma patients (64%) had disseminated disease. For the germinoma patients, the subsequent radiotherapy dose was modified based on the response to the neoadjuvant chemotherapy, and craniospinal radiotherapy was given only to those with disseminated CNS disease at diagnosis. Ten of the 11 germinoma patients had complete disappearance of all evaluable disease after two courses of chemotherapy (cyclophosphamide in eight and multidrug in three) and one had a partial response. The planned dose of radiotherapy to the primary tumor was reduced from 5500 to 3000 rads, and the craniospinal dose was lowered from 3600 to 2000 rads. Ten patients remain in continuous disease-free remission 20+ to 89+ months after diagnosis (median follow-up period 47 months). All four patients with non-germinoma GCT's received the multidrug regimen, and two of three patients with evaluable disease had a partial response. High-dose regional and craniospinal radiotherapy was administered thereafter, but only two patients remain in their first remission. Previously untreated germinoma is a highly chemosensitive disease and the neoadjuvant treatment strategy permits the identification of active chemotherapy regimens in newly diagnosed patients. Patients who have complete responses to neoadjuvant chemotherapy tolerate a significant radiotherapy dose reduction without compromising long-term survival, thereby allowing a reduction of some of the late effects of therapeutic radiation. Germinomas tend to disseminate early in the course of the disease and a pre-therapy staging evaluation permits individualized radiotherapy treatment planning.

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Arnold, Christoph Reinhold, Julian Mangesius, Robert Jäger, and Ute Ganswindt. "Neoadjuvant chemoradiotherapy in rectal cancer." memo - Magazine of European Medical Oncology 13, no. 3 (April 15, 2020): 329–33. http://dx.doi.org/10.1007/s12254-020-00594-0.

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Summary Neoadjuvant chemoradiotherapy is a well-established standard treatment for locally advanced rectal cancer and has led to a remarkable improvement in local control. However, distant recurrences still pose a notable threat and local failure, albeit increasingly rare, can lead to unfavorable clinical situations. In this short review, we discuss three promising new strategies to improve rectal cancer treatment: total neoadjuvant therapy, short course radiotherapy, and immune checkpoint inhibitors.

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Huang, Chun-Ming, Ching-Wen Huang, Cheng-Jen Ma, Yung-Sung Yeh, Wei-Chih Su, Tsung-Kun Chang, Hsiang-Lin Tsai, Suh-Hang Juo, Ming-Yii Huang, and Jaw-Yuan Wang. "Predictive Value of FOLFOX-Based Regimen, Long Interval, Hemoglobin Levels and Clinical Negative Nodal Status, and Postchemoradiotherapy CEA Levels for Pathological Complete Response in Patients with Locally Advanced Rectal Cancer after Neoadjuvant Chemoradiotherapy." Journal of Oncology 2020 (January 28, 2020): 1–9. http://dx.doi.org/10.1155/2020/9437684.

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We aimed to identify predictors of a pathological complete response (pCR) in patients with locally advanced rectal cancer (LARC) following a multimodality therapy. We retrospectively reviewed 236 patients with LARC treated with neoadjuvant chemoradiotherapy (CRT) followed by radical resection from January 2011 to December 2017. Patients were administered CRT, which comprised radiotherapy and chemotherapy with an oxaliplatin plus 5-fluorouracil- or fluoropyrimidine-based regimen. Clinical factors were correlated with treatment response. The multivariate logistic regression revealed that a negative nodal stage (odds ratio (OR) = 3.2, P=0.0135), a high hemoglobin level (>10 g/dL) during neoadjuvant CRT (OR = 3.067, P=0.0125), an oxaliplatin-containing neoadjuvant CRT (OR = 5.385, P=0.0044), a long interval (>8 weeks) between radiotherapy and surgery (OR = 1.135, P=0.0469), and a post-CRT CEA ≤2 ng/mL (OR = 2.891, P=0.0233) were the independent predictors of increased pCR rates. The prediction nomogram was developed according to the above independent variables. The concordance index was 0.74, and the calibration curve showed good agreement. In summary, negative nodal stages, high hemoglobin levels during treatment, oxaliplatin-containing neoadjuvant therapy, a long radiotherapy-surgery interval (>8 weeks), and post-CRT CEA levels ≤2 ng/mL were favorable predictors of a pCR. This prediction nomogram might be crucial for patients with LARC undergoing a multimodality therapy.

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Siala, Wicem, Wafa Mnejja, Fatma Elloumi, Abdelmoneem Ghorbel, Jameleddine Mnif, Mounir Frikha, and Jamel Daoud. "Late Toxicities after Conventional Radiotherapy for Nasopharyngeal Carcinoma: Incidence and Risk Factors." Journal of Radiotherapy 2014 (February 10, 2014): 1–8. http://dx.doi.org/10.1155/2014/268340.

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Background. To determine the incidence and analyze the factors affecting late toxicity for nasopharyngeal carcinoma patients treated with conventional radiotherapy. Patients and Methods. Retrospective analysis was performed on 239 NPC patients treated between 1993 and 2004 in our institution. One hundred and fifty-seven patients were treated with conventional fractionation (2 Gy per fraction, 5 fractions per week) and eighty-two patients with hyperfractionated radiotherapy (1.6 Gy per fraction twice a day, 5 days per week). One hundred fifty nine patients underwent neoadjuvant cisplatin based chemotherapy. Late toxicity was evaluated according to the RTOG/EORTC score. Results. Xerostomia was the most common related complication (98.7%). Neoadjuvant chemotherapy and hyperfractionated radiotherapy did not increase late toxicities. Multivariate analyses showed that radiation dose was a significant factor for hearing impairment, younger age for trismus, initial node status for neck fibrosis, and initial dental hygiene for dental complications. Female gender was associated with significantly higher incidence of trismus and hearing impairment. Conclusion. Conventional radiotherapy was associated with a high rate of late toxicities which affect patients’ quality of life. With the development of three-dimensional conformal radiotherapy and intensity modulated radiotherapy, a reduced incidence of radiation related complications could be expected.

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