Annals of Coloproctology

Review

How to Achieve a Higher Pathologic Complete Response in Patients With Locally Advanced Rectal Cancer Who Receive Preoperative Chemoradiation Therapy: Suk-Hwan Lee; Ann Coloproctol. 2019;35(1):3-8. Published online February 28, 2019; DOI: https://doi.org/10.3393/ac.2019.02.17

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The current standard of care for treating patients with locally advanced rectal cancer includes preoperative chemoradiation therapy (PCRT) followed by a total mesorectal excision and postoperative adjuvant chemotherapy. A subset of these patients has achieved a pathologic complete response (pCR) and they have shown improved disease-free and overall survival compared to non-pCR patients. Thus, many efforts have been made to achieve a higher pCR through PCRT. In this review, results from various ongoing and recently completed clinical trials that are being or have been conducted with an aim to improve tumor response by modifying therapy will be discussed.

Citations

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Predictors of Pathologic Response After Total Neoadjuvant Therapy in Patients With Rectal Adenocarcinoma: A National Cancer Database Analysis
David M McDermott, Sarah A Singh, Paul B Renz, Shaakir Hasan, Josh Weir
Cureus.2021;[Epub] CrossRef
Can Pretreatment Blood Biomarkers Predict Pathological Response to Neoadjuvant Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer?
Marina Morais, Telma Fonseca, Raquel Machado-Neves, Mrinalini Honavar, Ana Rita Coelho, Joanne Lopes, Elisabete Barbosa, Emanuel Guerreiro, Silvestre Carneiro
Future Oncology.2021; 17(35): 4947. CrossRef
Pretreatment Blood Biomarkers Predict Pathologic Responses to Neo-Crt in Patients with Locally Advanced Rectal Cancer
Aijie Li, Kewen He, Dong Guo, Chao Liu, Duoying Wang, Xiangkui Mu, Jinming Yu
Future Oncology.2019; 15(28): 3233. CrossRef

Original Articles

Efficacy of Dose-Escalated Radiotherapy for Recurrent Colorectal Cancer: Sunmi Jo, Yunseon Choi, Sung-Kwang Park, Jin-Young Kim, Hyun Jung Kim, Yun-Han Lee, Won Yong Oh, Heunglae Cho, Ki Jung Ahn; Ann Coloproctol. 2016;32(2):66-72. Published online April 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.2.66

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Abstract PDF

Purpose

This study aimed to evaluate the effects of radiotherapy (RT) on progression-free survival (PFS) for patients with recurrent colorectal cancer.

Methods

We reviewed the records of 22 patients with recurrent colorectal cancer treated with RT between 2008 and 2014. The median radiation dose for recurrent disease was 57.6 Gy (range, 45–75.6 Gy). Patients were divided into 2 groups according to the type of RT: patients underwent RT without previous history of irradiation (n = 14) and those treated with secondary RT (reirradiation: n = 8) at the time of recurrence.

Results

The median follow-up period was 24.9 months (range, 4.5–66.6 months). Progression was observed in 14 patients (including 8 with loco-regional failure and 9 with distant metastases). Distant metastases were related to the RT dose (<70 Gy, P = 0.031). The 2-year loco-regional control (LRC), PFS, and overall survival (OS) rates were 74.6%, 45.1%, and 82.0%, respectively. The LRC rate was not different between the patients treated with RT for the first time and those treated with reirradiation (P = 0.101, 2-year LRC 79.5% vs. 41.7%). However, reirradiation was related to poor PFS (P = 0.022) and OS (P = 0.002). An escalated RT dose (≥70 Gy) was associated with a higher PFS (P = 0.014, 2-year PFS 63.5% vs. 20.8%).

Conclusion

Salvage RT for locally recurrent colorectal cancer can be offered when surgery is impossible. Dose-escalated RT shows a possible benefit in reducing the risk of progression.

Citations

Citations to this article as recorded by

Carbon-ion Radiotherapy for Colorectal Cancer
Shigeru Yamada, Hirotoshi Takiyama, Yuka Isozaki, Makoto Shinoto, Hirokazu Makishima, Naoyoshi Yamamoto, Hiroshi Tsuji
Journal of the Anus, Rectum and Colon.2021; 5(2): 113. CrossRef
LncRNA TTN‐AS1/miR‐134‐5p/PAK3 axis regulates the radiosensitivity of human large intestine cancer cells through the P21 pathway and AKT/GSK‐3β/β‐catenin pathway
Zhenkui Zuo, Shuling Ji, Lulu He, Yage Zhang, Zining Peng, Jiarui Han
Cell Biology International.2020; 44(11): 2284. CrossRef
A Review on the Special Radiotherapy Techniques of Colorectal Cancer
Shing Yau Tam, Vincent W. C. Wu
Frontiers in Oncology.2019;[Epub] CrossRef
Comparison of overall survival and quality of life between patients undergoing anal reconstruction and patients undergoing traditional lower abdominal stoma after radical resection
P. Du, S.-Y. Wang, P.-F. Zheng, J. Mao, H. Hu, Z.-B. Cheng
Clinical and Translational Oncology.2019; 21(10): 1390. CrossRef
Prospective Observational Study of High-Dose Carbon-Ion Radiotherapy for Pelvic Recurrence of Rectal Cancer (GUNMA 0801)
Shintaro Shiba, Masahiko Okamoto, Hiroki Kiyohara, Tatsuya Ohno, Takuya Kaminuma, Takayuki Asao, Hitoshi Ojima, Ken Shirabe, Hiroyuki Kuwano, Takashi Nakano
Frontiers in Oncology.2019;[Epub] CrossRef
Effects of varying radiation dosages on MMP1 expression, and MMP1 knockdown on the viability and migration of SW620 cells
Fang Ju, Na Li, Wenming Wang, Haicheng Yuan
Molecular Medicine Reports.2019;[Epub] CrossRef
Dose-Escalated Radiotherapy for the Treatment of Patients With Recurrent Colorectal Cancer
Hyung Jin Kim, Seong Taek Oh
Annals of Coloproctology.2016; 32(2): 47. CrossRef

Oncologic Outcome after Cessation or Dose Reduction of Capecitabine in Patients with Colon Cancer: Jung-A Yun, Hee Cheol Kim, Hyun-Sook Son, Hyoung Ran Kim, Hae Ran Yun, Yong Beom Cho, Seong Hyeon Yun, Woo Yong Lee, Ho-Kyung Chun; J Korean Soc Coloproctol. 2010;26(4):287-292. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.287

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Abstract PDF

Purpose

Oral capecitabine has been used as adjuvant therapy for colorectal cancer patients since the 1990s. Patient-initiated cessation or reduced use of capecitabine occurs widely for various reasons, yet the consequences of these actions are unclear. The present study sought to clarify treatment outcomes in such patients.

Methods

The study included 173 patients who had been diagnosed with stage II or III colon cancer according to the pathologic report after radical surgery at Samsung Medical Center from May 2005 to June 2007 and who had received capecitabine as adjuvant therapy. The patients were divided into groups according to whether the dose was reduced (I, dose maintenance; II, dose reduction) or stopped (A, cycle completion; B, cycle cessation). Recurrence and disease-free survival rates between the two groups each were analyzed.

Results

Of the 173 patients, 128 (74.6%) experienced complications, most frequently hand-foot syndrome (n = 114). Reduction (n = 35) or cessation (n = 18) of medication was most commonly due to complications. Concerning reduced dosage, both groups displayed no statistically significant differences in recurrence rate and 3-year disease-free survival rate. Concerning discontinued medication use, the cycle completion group showed an improved recurrence rate (P = 0.048) and 3-year disease-free survival rate (P = 0.028).

Conclusion

The results demonstrate that maintaining compliance with capecitabine as an adjuvant treatment for colon cancer to preventing complications positively affects patient prognosis.

Citations

Citations to this article as recorded by

Medication Perceptions Mediate the Association between Illness Perceptions and Adherence to Oral Anticancer Agents among Patients with Gastrointestinal Tract Cancer: A Cross-sectional Study
Yongfeng Chen, Marques Shek Nam Ng, Xulian Wei, LiYuan Zhang, Kai Chow Choi, Yan Ma, Fang Wang, Carmen Wing Han Chan
European Journal of Oncology Nursing.2024; : 102720. CrossRef
The Value of Pharmacogenetics to Reduce Drug-Related Toxicity in Cancer Patients
Doreen Z. Mhandire, Andrew K. L. Goey
Molecular Diagnosis & Therapy.2022; 26(2): 137. CrossRef
Global Cancer Burden and Natural Disasters: A Focus on Asia’s Vulnerability, Resilience Building, and Impact on Cancer Care
Roselle De Guzman, Monica Malik
Journal of Global Oncology.2019; (5): 1. CrossRef
Association Between Adjuvant Chemotherapy Duration and Survival Among Patients With Stage II and III Colon Cancer
Devon J. Boyne, Colleen A. Cuthbert, Dylan E. O’Sullivan, Tolulope T. Sajobi, Robert J. Hilsden, Christine M. Friedenreich, Winson Y. Cheung, Darren R. Brenner
JAMA Network Open.2019; 2(5): e194154. CrossRef
5-fluorouracil Toxicity Mechanism Determination in Human Keratinocytes: in vitro Study on HaCaT Cell Line
Jan Hartinger, Pavel Veselý, Martin Šíma, Irena Netíková, Eva Matoušková, Luboš Petruželka
Prague Medical Report.2017; 118(4): 128. CrossRef
An exploratory study to identify risk factors for the development of capecitabine‐induced Palmar Plantar Erythrodysesthesia (PPE)
Annie Law, Sue Dyson, Denis Anthony
Journal of Advanced Nursing.2015; 71(8): 1825. CrossRef

The Influence of DNA Ploidy, Index and Lymph Node Status on Disease Free Survival in Patients with Colorectal Cancer.: Choi, Sun Keun , Jeong, Joo Hwan , Bae, Sun Young , Kwon, Young Sik , Hong, Kee Chun , Shin, Seok Hwan , Woo, Ze Hong; J Korean Soc Coloproctol. 2000;16(3):186-192.

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Abstract PDF: The DNA flow cytometric analysis in colorectal cancer has been studied for more than 10 years as an independent prognostic factor or a factor correlated with other preexistent prognostic factors, such as the depth of invasion, lymph node status, histologic differentiation, etc. To clarify the influence of DNA contents (DNA ploidy, DNA index) and lymph node status on disease free survival in colorectal cancer, we investigated the relationship between them, retrospectively.
METHODS
This study included 198 patients with curatively resected Dukes' stage A, B, and C colorectal cancer who had taken DNA flow cytometric analysis from June of 1996 to March of 1999 at Department of Surgery, Inha University Hospital.
RESULTS
In over all twelve-month disease free survival, there were 92.5% in DNA diploid and 74.3% in DNA aneuploid tumors. And so forth, there were 78.0% in positive and 91.9% in negative lymph node tumors. In the event of a DNA index greater and lesser than 1.15, the twelve-month disease free survival was 72.9% and 92.7%, respectively. These results were statistically significant (p<0.05). Therefore, patients with a negative lymph node, diploid colorectal cancer or DNA index lesser than 1.15 had a longer disease free survival than those with a positive lymph node, aneuploid one or DNA index greater than 1.15.
CONCLUSIONS
In conclusion, there seems to be a significant relationship between DNA contents and lymph node status on disease free survival. Thus, these factors are considered to be valuable in predicting the recurrence of colorectal cancer.

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