Short-term outcomes of preoperative chemotherapy in patients with upper ampullary rectal cancer

The purpose of the study: to analyze short-term efficacy and tolerability of preoperative chemotherapy in patients with upper ampullary rectal carcinoma. Material and methods. A prospective study conducted at the cancer research institute (tomsk, russia) between 2018 and 2020 included 47 patients with operable cancer of the upper ampullary part of the rectum with mrt3n0m0 (mesorectal fascia involvement (crm+) or low-grade cancer), mrt4аn0m0 and mrt3–4аn1m0. All patients were divided into two groups. Group i comprised 22 patients, who received 3 cycles of chemotherapy with folfox-4 followed by surgery. Group ii consisted of 25 patients, who underwent surgery alone. All patients underwent arterior resection of the rectum. Results. Group i patients completed all three cycles of preoperative chemotherapy. Downstaging after chemotherapy was observed in 16 (72.7 %) patients. No severe side effects of chemotherapy were found. The frequency of radical surgeries (r0) was 100 %. No significant differences in the rate of postoperative complications between the treatment groups were observed (18.2 % and 16 %, respectively, p>0.05). There were no cases of postoperative mortality. Conclusion. Compared with surgery alone, preoperative chemotherapy followed by surgery demonstrates a high short-term efficacy, does not adversely affect the course of the perioperative period.

Evaluation Short-term Efficacy of Cervical Cancer Under Radiotherapy by Shear Wave Elastography: a Preliminary Study

Background To find a reliable, safe, convenient and low-cost imaging technology in evaluation of the short-term clinical efficacy of cervical cancer. Here, we performed a preliminary examination of the value of shear wave elastography (SWE) in assessing short-term efficacy of radiotherapy in cervical cancer. Methods In this study, we used SWE to measure the elastic modulus of cervical masses and healthy paracervical tissues and record the maximum elastic modulus (Emax) and the mean elastic modulus (Emean) in 46 patients with cervical cancer. The 46 patients who were naive to treatment were monitored at 5 time points. We divided those into sensitive and non-sensitive groups based on MRI in combination with RECIST1.1. The relative changes in the elastic modulus of the mass before and after radiotherapy were calculated in all patients. MRI was also combined with gynecological examinations to determine if any residual masses remained. Results In this study, 25 patients completed all 5 time points examinations showing the elastic modulus of the cervix decreased while healthy paracervical tissues first increased and then decreased. Then, all 46 patients underwent SWE at 3 time points: prior to radiotherapy, the 15th radiotherapy session, and at completed radiotherapy. The results revealed that the relative changes in cervical masses in the sensitive group were larger than that in the non-sensitive group (P < 0.05). We further discovered the Emax and the Emean of cervical tissues in the residual group were higher than that in the non-residual group (135.69 ± 35.18, 128.25 ± 35.55 vs 104.13 ± 20.19, 98.14 ± 18.9, respectively; P < 0.05), and the area under the curve (AUCs) of the receiver operating characteristic (ROC)were 0.770 and 0.767, respectively (P < 0.05). Conclusions SWE can be used to monitor changes in cervix and paracervical stiffness, and to assist in assessments of the efficacy of radiotherapy in cervical cancer.