OC-0452 DOSE-RESPONSE OF TUMOUR REGRESSION AFTER PRE-OPERATIVE CHEMORADIOTHERAPY FOR LOCALLY ADVANCED RECTAL CANCER

2012 ◽  
Vol 103 ◽  
pp. S180-S181
Author(s):  
A.L. Appelt ◽  
J. Ploen ◽  
I.R. Vogelius ◽  
S.M. Bentzen ◽  
A. Jakobsen
Keyword(s):  
Rectal Cancer ◽  
Dose Response ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Tumour Regression

Polymorphisms of thymidylate synthase as prognostic factor in rectal cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 433-433
Author(s):  
V. Arrazubi ◽  
J. Suarez ◽  
D. Guerrero ◽  
K. Cambra ◽  
M. L. Gomez Dorronsoro ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Thymidylate Synthase ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Tumour Regression ◽  
The Difference

433 Background: Neoadjuvant fluoropyrimidine-based chemotherapy (ChT) plus radiotherapy (Rt) is a standard approach for locally advanced rectal cancer. Polymorphisms of thymidylate synthase (TS), the target for fluoropyrimidines, are recognized prognostic factors in colon cancer. The aim of this study was to evaluate the prognostic value of the polymorphisms of TS in rectal cancer after neoadjuvant ChT plus Rt. Methods: We studied one-hundred consecutive patients with stage II/III rectal cancer between November 2001 and March 2009. Patients underwent surgery 6-8 weeks after neoadjuvant Rt (5,040 cGy) plus fluoropyrimidine-based ChT. DNA was extracted from paraffin embedded biopsies. TS1494del6 and 5′-28bp repeat +G/C SNP polymorphisms were determined. Results: Sixty-seven percent were men and median age was 67 years. ypT stage was: T0 9%, T1 2%, T2 27%, T3 60% and T4 2%; 32% had locoregional adenopathies. The median follow-up was 45 months and relapse occurred in 20% of patients. Polimorphisms could be determined in 98% of pt: -6bp/-6bp 10%, - 6bp/+6bp 39%, +6bp/+6bp 51% and 2R/2R 72%, 2R/3R 21%, 3R/3R 6%. The grade of pathological tumour regression was not associated with polymorphisms. Relapses occurred in 40% of patients -6bp/-6bp, 22% of patients -6bp/+6bp and 21% of patients +6bp/+6bp. The difference in disease- free survival (DFS) between the first and the third groups was stadistically significative (p=0.049). No relation between 5′-28bp repeat +G/C SNP polymorphism and DFS was found. Conclusions: Our data suggest that the TS1494del6 polimorphism may be an important prognosis factor in rectal cancer receiving neoadjuvant chemoradiotherapy. No significant financial relationships to disclose.

338. Correlation Between Lymph Node Status and Tumour Regression After Neoadyuvant Chemoradiation in Locally Advanced Rectal Cancer

2012 ◽  
Vol 38 (9) ◽  
pp. 836-837
Author(s):  
A. Frunza ◽  
L.J. García Flórez ◽  
M.M. Camaces ◽  
G. Gómez Álvarez ◽  
C. Martínez Alonso ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Lymph Node Status ◽  
Tumour Regression ◽  
Node Status

scholarly journals Analysis of patients with complete histopathological tumour regression after neoadjuvant chemoradiotherapy for locally advanced rectal cancer

2010 ◽  
Vol 18 (1-2) ◽  
pp. 3-7
Author(s):  
Tomislav Petrovic ◽  
Zoran Radovanovic ◽  
Bojana Bokorov ◽  
Ivan Nikolic ◽  
Slavica Knezevic-Usaj ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Neoadjuvant Chemoradiation ◽  
Preoperative Chemoradiation ◽  
Chemoradiation Therapy ◽  
Tumour Regression ◽  
Neoadjuvant Chemoradiation Therapy ◽  
Preoperative Chemoradiation Therapy

Background: Our aim was to present the effect of the neoadjuvant chemoradiation therapy on the development of the complete histopathological tumour regression in patients with locally advanced rectal cancer and its influence on a five-year survival of these patients. Methods: In total, 223 patients were included in the analysis; 109 patients had the locally advanced rectal cancer; 75 patients received the neoadjuvant chemoradiation therapy, which was later followed by surgery; 34 patients were treated with the surgery alone. The surgical procedure was done 6 to 8 weeks after the chemoradiation therapy and it was preceded by haematology and biochemical analyses. In addition, patients were examined by ultrasound and MRI imaging of liver to evaluate the effects of neoadjuvant chemoradiation therapy. Accordingly, we had two patient groups: patients with the complete histopathological tumour regression and patients with the incomplete or no regression. We performed the statistical analysis of all locally advanced rectal cancer patients and determined their survival. Results: The complete histopathological tumour regression was found in 10.7% of 75 patients who were treated with preoperative chemoradiation. The down staging of the tumour appeared in 53.3% of patients. There were no stage changes in 21.3% of patients. The disease progressed into a more severe stage in 9.3% of patients, while the effects of the preoperative chemoradiation therapy could not be determined in 5.3% of patients. The survival of patients with the complete histopathological tumour regression was 70% in a five-year period, while it was 40% in patients with incomplete histopathological regression. Conclusion: The preoperative chemoradiation therapy leads to complete histopathological tumour regression and increases a five-year survival (70%). It also leads to the increase of the number of patients who undergo radical surgery.

scholarly journals The Heterogeneity of Skewness in T2W-Based Radiomics Predicts the Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 795
Author(s):  
Francesca Coppola ◽  
Margherita Mottola ◽  
Silvia Lo Monaco ◽  
Arrigo Cattabriga ◽  
Maria Adriana Cocozza ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Youden Index ◽  
Tumour Regression ◽  
P Value ◽  
Tumour Regression Grade

Our study aimed to investigate whether radiomics on MRI sequences can differentiate responder (R) and non-responder (NR) patients based on the tumour regression grade (TRG) assigned after surgical resection in locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (nCRT). Eighty-five patients undergoing primary staging with MRI were retrospectively evaluated, and 40 patients were finally selected. The ROIs were manually outlined in the tumour site on T2w sequences in the oblique-axial plane. Based on the TRG, patients were grouped as having either a complete or a partial response (TRG = (0,1), n = 15). NR patients had a minimal or poor nCRT response (TRG = (2,3), n = 25). Eighty-four local first-order radiomic features (RFs) were extracted from tumour ROIs. Only single RFs were investigated. Each feature was selected using univariate analysis guided by a one-tailed Wilcoxon rank-sum. ROC curve analysis was performed, using AUC computation and the Youden index (YI) for sensitivity and specificity. The RF measuring the heterogeneity of local skewness of T2w values from tumour ROIs differentiated Rs and NRs with a p-value ≈ 10−5; AUC = 0.90 (95%CI, 0.73–0.96); and YI = 0.68, corresponding to 80% sensitivity and 88% specificity. In conclusion, higher heterogeneity in skewness maps of the baseline tumour correlated with a greater benefit from nCRT.

scholarly journals Vascular calcification and response to neoadjuvant therapy in locally advanced rectal cancer: an exploratory study

2021 ◽  
Author(s):  
Katrina A. Knight ◽  
Ioanna Drami ◽  
Donald C. McMillan ◽  
Paul G. Horgan ◽  
James H. Park ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Poor Response ◽  
Complete Response ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Tumour Regression ◽  
Royal Infirmary

Abstract Purpose Patients with locally advanced rectal cancer (LARC) may experience a clinical complete response (cCR) to neoadjuvant chemoradiotherapy (NACRT) and opt for non-operative management. Pathological factors that relate to NACRT response have been well described. Host factors associated with response, however, are poorly defined. Calcification of the aortoiliac (AC) vessels supplying the rectum may influence treatment response. Methods Patients with LARC having NACRT prior to curative surgery at Glasgow Royal Infirmary (GRI) and St Mark’s hospital (SMH) between 2008 and 2016 were identified. AC was scored on pre-treatment CT imaging. NACRT response was assessed using pathologic complete response (pCR) rates, tumour regression grades (TRGs), the NeoAdjuvant Rectal score and T-/N-downstaging. Associations were assessed using Chi-squared, Mantel–Haenszel and Fisher’s exact tests. Results Of 231 patients from GRI, 79 (34%) underwent NACRT for LARC. Most were male (58%), aged over 65 (51%) with mid- to upper rectal tumours (56%) and clinical T3/4 (95%), node-positive (77%) disease. pCR occurred in 10 patients (13%). Trends were noted between higher clinical T stage and poor response by Royal College of Pathologist’s TRG (p = 0.021) and tumour height > 5 cm and poor response by Mandard TRG (0.068). In the SMH cohort, 49 of 333 (15%) patients underwent NACRT; 8 (16%) developed a pCR. AC was not associated with NACRT response in either cohort. Conclusions AC was not associated with NACRT response in this cohort. Larger contemporary cohorts are required to better assess host determinants of NACRT response and develop predictive models to improve patient selection.

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