scholarly journals 449 Role of neoadjuvant chemotherapy on local control in locally advanced vulvar carcinoma: a single institution experience

2020 ◽  
Author(s):  
M Adorni ◽  
S Negri ◽  
L Bazzurini ◽  
F Vecchione ◽  
A Lissoni ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Local Control ◽  
Locally Advanced ◽  
Vulvar Carcinoma ◽  
Single Institution

scholarly journals Use of FOLFIRINOX or Nab-Paclitaxel Plus Gemcitabine for the Treatment of Locally Advanced Pancreatic Adenocarcinoma: A Single Institution Observational Study

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4939
Author(s):  
Alberto Servetto ◽  
Antonio Santaniello ◽  
Fabiana Napolitano ◽  
Francesca Foschini ◽  
Roberta Marciano ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Locally Advanced ◽  
Distant Metastases ◽  
Ductal Adenocarcinoma ◽  
Controlled Clinical Trials ◽  
Single Institution ◽  
Locally Advanced Pancreatic Adenocarcinoma ◽  
Grade 3 ◽  
Advanced Pancreatic Adenocarcinoma

Patients with locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) do not present distant metastases but are not eligible for surgery upfront. Chemotherapy regimens, such as FOLFIRINOX (FFN) or nab-paclitaxel plus gemcitabine (GemNab) in combination with loco-regional treatments are generally used in this setting. However, the best treatment choice is unknown. We retrospectively analyzed the information of 225 patients with stage II–III PDAC treated at our institution between October 2011 and December 2020. A total of 94 patients with LA PDAC who are non-eligible for surgery upfront received neoadjuvant FFN or GemNab. Of the 67 patients receiving FFN, 28 (41.8%) underwent surgery after neoadjuvant therapy. Of the 27 patients treated with GemNab, 6 (22.2%) became eligible for resection. The median overall survival (OS) was 85.1 weeks and 54.3 weeks in the FFN and GemNab groups, respectively (HR = 0.54, p = 0.0109). The median OS was 189.7 weeks and 76.4 weeks in the resected and unresected cohorts, respectively (HR = 0.25, p < 0.0001). Neutropenia (37.3%), anemia (6.0%), and diarrhea (6.0%) in the FFN group and neutropenia (22.2%) and thrombocytopenia (18.5%) in the GemNab groups were the most frequent grade 3–4 side effects. Higher rates of thrombocytosis (p < 0.0001) and peripheral edema (p < 0.0001) were observed in the GemNab group. Our results suggest that the use of FFN is associated with more favorable clinical outcomes than GemNab for patients with LA PDAC. Future randomized and controlled clinical trials are needed to further elucidate the role of these regimens and loco-regional treatments in this setting.

Neoadjuvant Chemotherapy Plus Cystectomy Compared With Cystectomy Alone for Locally Advanced Bladder Cancer

2021 ◽  
pp. 141-146
Author(s):  
Vikram M. Narayan
Keyword(s):  
Adverse Effect ◽  
Overall Survival ◽  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Randomized Study ◽  
Locally Advanced ◽  
Common Adverse Effect ◽  
Advanced Bladder Cancer ◽  
Muscle Invasive

This study summarizes a landmark study on the role of neoadjuvant chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) in patients with muscle-invasive bladder cancer. This randomized study of M-VAC plus cystectomy versus cystectomy alone suggested improved overall survival in patients receiving neoadjuvant therapy. Severe granulocytopenia was a common adverse effect in the chemotherapy group, but no deaths were attributed to chemotherapy.

Neoadjuvant Chemotherapy to Radiation and Concurrent Chemoradiation for Locally Advanced Squamous Cell Carcinoma of the Cervix: A Review of the Recent Literature

1998 ◽  
Vol 84 (2) ◽  
pp. 229-237 ◽  
Author(s):  
Alessandro Colombo ◽  
Fabio Landoni ◽  
Andrea Maneo ◽  
Gerardo Zanetta ◽  
Simonetta Nava ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Local Control ◽  
Randomized Trials ◽  
Recent Literature ◽  
Combined Treatment ◽  
Locally Advanced ◽  
Distant Metastases ◽  
Integrated Treatment ◽  
Concurrent Chemoradiation ◽  
Late Morbidity

Radiotherapy is the standard treatment for locally advanced cervical cancer; nevertheless it fails to control disease progression within the irradiation fields in more than 40% of cases, particularly in patients with bulky tumor. Distant metastases are not infrequent in more advanced cases. Chemotherapy has been integrated with radiotherapy to improve local control and treat distant subclinical metastases. Schedules of combined treatment more frequently represented by neoadjuvant chemotherapy followed by radiation (NACT) and by concomitant chemotherapy and radiation (CT-RT). A review of the recent literature is presented. The role of NACT is controversial: high response rates are reported but doubtful advantages in terms of survival or local control have been shown. In randomized trials, hydroxyurea concomitant to radiation improves local control and survival, particularly in stage IIIB and IVA. Several randomized trials of concurrent chemoradiation with 5FU, cisplatin and mitomycin C are underway, but few have been published: no significative differences are reported in term of local control or survival. Acute toxicity is higher than in radiation alone, but usually manageable. For the analysis of late morbidity a longer follow-up is required. Large randomized trials of adequate radiotherapy versus concomitant chemoradiation are necessary to refine our understanding of the benefits of this integrated treatment.

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