#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Treatment of locally advanced rectal cancer – is it time for a change?


Authors: R. Soumarová 1,2,3;  M. Škrovina 4
Authors place of work: Oddělení radioterapie a onkologie, Komplexní onkologické centrum Nový Jičín, Nemocnice Nový Jičín, a. s. vedoucí centra: doc. MUDr. R. Soumarová, Ph. D., MBA 1;  Katedra interních oborů LF Ostravské univerzity vedoucí katedry: MUDr. I. Valkovský, Ph. D. 2;  Onkologické oddělení, Vzdělávací a výzkumný institut Agel, o. p. s. – pobočka Nový Jičín, Nemocnice Nový Jičín, a. s. primář: doc. MUDr. R. Soumarová, Ph. D., MBA 3;  Oddělení chirurgie, Komplexní onkologické centrum Nový Jičín, Nemocnice Nový Jičín, a. s. primář: MUDr. M. Škrovina, Ph. D. 4
Published in the journal: Rozhl. Chir., 2017, roč. 96, č. 10, s. 415-420.
Category: Review

Summary

Treatment of locally advanced rectal cancer remains a very topical issue. The method of choice is surgery withpre- or postoperative chemoradiotherapy. Benefits of neoadjuvant chemoradiotherapy have been demonstrated in a number of randomized studies, including its advantages over postoperative treatment.Recently, however, there have been cases ofneoadjuvant chemoradiotherapy beingreplaced bychemotherapy alone. Although very controversial, another possible strategy for treating locally advanced rectal cancer is performing no operation in patients after neoadjuvant chemoradiotherapy who achieved complete remission. The necessity of using adjuvant chemotherapy after radical surgery and neoadjuvant chemoradiotherapy is also widely discussed. All these topicsareaddressed, albeit not exhaustively, in our paper. We are going to try to answer the question whether it is time for changes in the therapeutic strategy for advanced colorectal cancer.

Key words:
locally advanced rectal cancer − neoadjuvant chemoradiotherapy − induction chemotherapy


Zdroje

1. Janout V, Kollárová H. Epidemiology of colorectal cancer. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2001;145:5–10.

2. Camma C, Giunta M, Fiorica F, et al. Preoperative radiotherapy for resectable rectal cancer: A meta–analysis. JAMA 2000;284:1008–15.

3. Glimelius B, Isacsson U, Jung B, et al. Radiotherapy in addition to radical surgery in rectal cancer: Evidence for a dose–response effect favoring preoperative treatment. Int J Radiat Oncol Biol Phys 1997;37:281–7.

4. Rödel C, Grabenbauer GG, Schick C, et al. Preoperative radiation with concurrent 5–fluorouracil for locally advanced T4–primary rectal cancer. Strahlenther Onkol 2000;176:161–7.

5. Bosset JF, Calais G, Daban A, et al. Preoperative chemoradiotherapy versus preoperative radiotherapy in rectal cancer patients: assessment of acute toxicity and treatment compliance. Report of the 22921 randomised trial conducted by the EORTC Radiotherapy Group. Eur J Cancer 2004;40:219–24.

6. Bosset JF, Calais G, Mineur L, et al. Enhanced tumorocidal effect of chemotherapy with preoperative radiotherapy for rectal cancer: preliminary results–EORTC 22921. J Clin Oncol 2005;23:5620–7.

7. Sauer R, Becker H, Hohenberger W, et al. German Rectal Cancer Study Group. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 2004;351:1731–40.

8. Soumarova R, Skrovina M, Machala S, et al. Intraoperative radiotherapy in multimodality treatment of locally advanced rectal carcinoma. Rozhl Chir 2010;89:685−8.

9. Skrovina M, Soumarova R, Duda M, et al. Laparoscopic abdominoperineal resection with intraoperative radiotherapy for locally advanced low rectal cancer. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014;158:447−50.

10. Bosset JF, Pavy JJ, Hamers HP, et al. Determination of the optimal dose of 5-fluorouracil when combined with low dose D, Lleucovorin and irradiation in rectal cancer: results of three consecutive phase II studies. EORTC Radiotherapy Group. Eur J Cancer 1993;29:1406–10.

11. Ng AK, Recht A, Busse PM. Sphincter preservation therapy for distal rectal carcinoma: a review. Cancer 1997;79:671–83.

12. Rich TA, Skibber JM, Ajani JA, et al. Preoperative infusional chemoradiation therapy for stage T3 rectal cancer. Int J Radiat Oncol Biol Phys 1995;32:1025–29.

13. Grann A, Minsky BD, Cohen AM, et al. Preliminary results of pre-operative 5-Fluorouracil (5–FU), low dose leucovorin, and concurrent radiation therapy for resectable T3 rectal cancer. Dis Colon Rectum 1997;40:515–22.

14. Hofheinz RD, Wenz F, Post S, et al. Chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer: a randomised, multicentre, non-inferiority, phase 3 trial. Lancet Oncol 2012;13:579–88.

15. O‘Connell MJ, Colangelo LH, Beart RW, et al. Capecitabine and oxaliplatin in the preoperative multimodality treatment of rectal cancer: surgical end points from National Surgical Adjuvant Breast and Bowel Project trial R-04. J Clin Oncol 2014;32:1927−34.

16. Gérard JP, Azria D, Gourgou-Bourgade S, et al. Comparison of two neoadjuvant chemoradiotherapy regimens for locally advanced rectal cancer: results of the phase III trial ACCORD 12/0405-Prodige 2. J Clin Oncol 2010;28:1638–4.

17. Roh MS, Yothers GA, O’Connell MJ, et al. The impact of capecitabine and oxaliplatin in the preoperative multimodality treatment in patients with carcinoma of the rectum: NSABP R-04, abstract 3503, J Clin Oncol 2011, suppl. 29.

18. Rödel C, Liersch T, Becker H, et al. Preoperative chemoradiotherapy and postoperative chemotherapy with fluorouracil and oxaliplatin versus fluorouracil alone in locally advanced rectal cancer: initial results of the German CAO/ARO/AIO-04 randomised phase 3 trial. Lancet Oncol 2012;13:679−87.

19. van Gijn W, Marijnen CA, Nagtegaal ID, et al. Dutch Colorectal Cancer Group. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011;12:575−82.

20. Bujko K, Nowacki MP, Nasierowska-Guttmejer A, et al. Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg 2006;93:1215−23.

21. Bujko K, Wyrwicz L, Rutkowski A, et al. Polish Colorectal Study Group. Long-course oxaliplatin-based preoperative chemoradiation versus 5×5 Gy and consolidation chemotherapy for cT4 or fixed cT3 rectal cancer: results of a randomized phase III study. Ann Oncol 2016;27:834−42.

22. Ngan SY, Burmeister B, Fisher RJ, et al. Randomized trial of short course radiotherapy versus long course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer: Trans-Tasman Radiation Oncology Group trial 01.04. J Clin Oncol2012;30:3827.

23. Tang Y, Jin J, Li S, et al. The initial results for a phase III study of short-term versus long-term chemoradiotherapy in locally advanced rectal cancer (STELLAR trial). ASTRO presentation 2016

24. Zhou ZR, Liu SX, Zhang TS, et al. Short-course preoperative radiotherapy with immediate surgery versus long-course chemoradiation with delayed surgery in the treatment of rectal cancer: a systematic review and meta-analysis. Surg Oncol 2014;23:211−21.

25. Loos M, Quentmeier P, Schuster T, et al. Effect of preoperative radio(chemo)therapy on long-term functional outcome in rectal cancer patients: a systematic review and meta-analysis. Ann Surg Oncol 2013;20:1816−28.

26. Guillem JG, Díaz-González JA, Minsky BD, et al. cT3N0 rectal cancer: potential overtreatment with preoperative chemoradiotherapy is warranted. J Clin Oncol 2008;26:368−73.

27. NCCN Clinical Practice Guidelines in Oncology, Rectal Cancer 2/2017. Available from: www.nccn.org.

28. Fernández-Martos C, Pericay C, Aparicio J, et al. Phase II, randomized study of concomitant chemoradiotherapy followed by surgery and adjuvant capecitabine plus oxaliplatin (CAPOX) compared with induction CAPOX followed by concomitant chemoradiotherapy and surgery in magnetic resonance imaging-defined, locally advanced rectal cancer: Grupo cancer de recto 3 study. J Clin Oncol 2010;28:859−65.

29. Maréchal R, Vos B, Polus M, et al. Short course chemotherapy followed by concomitant chemoradiotherapy and surgery in locally advanced rectal cancer: a randomized multicentric phase II study. Ann Oncol 2012;23:1525−30.

30. Helbling D, Bodoky G, Gautschi O, et al. Neoadjuvant chemoradiotherapy with or without panitumumab in patients with wild-type KRAS, locally advanced rectal cancer (LARC): a randomized, multicenter, phase II trial SAKK 41/07. Ann Oncol 2013;24:718−25.

31. Spigel DR, Bendell JC, McCleod M, et al. Phase II study of bevacizumab and chemoradiation in the preoperative or adjuvant treatment of patients with stage II/III rectal cancer. Clin Colorectal Cancer 2012;11:45−52.

32. Lefevre JH,Mineur L, Kotti S, et al. Effect of interval (7 or 11 weeks) between neoadjuvant radiochemotherapy and surgery on complete pathologic response in rectal cancer: A multicenter, randomized, controlled trial (GRECCAR-6). J Clin Oncol 2016. [Epub ahead of print]

33. Tulchinsky H, Shmueli E, Figer A, et al. An interval >7 weeks between neoadjuvant therapy and surgery improves pathologic complete response and disease-free survival in patients with locally advanced rectal cancer. Ann Surg Oncol 2008;15:2661−7.

34. Pettersson D, Cedermark B, Holm T, et al. Interim analysis of the Stockholm III trial of preoperative radiotherapy regimens for rectal cancer. Br J Surg 2010;97:580−7.

35. Pettersson D, Lörinc E, Holm T, et al. Tumour regression in the randomized Stockholm III Trial of radiotherapy regimens for rectal cancer. Br J Surg2015;102:972−8; discussion 978.

36. Wang XJ, Zheng ZR, Chi P, et al. Effect of interval between neoadjuvant chemoradiotherapy and surgery on oncological outcome for rectal cancer: A systematic review and meta-analysis. Gastroenterol Res Pract 2016. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4829714/.

37. Petrelli F, Sgroi G, Sarti E, et al. Increasing the interval between neoadjuvant chemoradiotherapy and surgery in rectal cancer: A meta-analysis of published studies. Ann Surg 2016;263:458−64.

38. Martens MH, Subhani S, Heijnen LA, et al. Can perfusion MRI predict response to preoperative treatment in rectal cancer? Radiother Oncol 2015;114:218−23.

39. Flanagan L, Lindner AU, de Chaumont C, et al. BCL2 protein signalling determines acute responses to neoadjuvant chemoradiotherapy in rectal cancer. J Mol Med (Berl) 2015;93:315−26.

40. Caramés C, Cristobal I, Moreno V, et al. MicroRNA-31 emerges as a predictive biomarker of pathological response and outcome in locally advanced rectal cancer. Int J Mol Sci2016;17:878.

41. Fokas E, Liersch T, Fietkau R, et al. Tumor regression grading after preoperative chemoradiotherapy for locally advanced rectal carcinoma revisited: updated results of the CAO/ARO/AIO-94 trial. J Clin Oncol 2014;32:1554−62.

42. Collette L, Bosset JF, den Dulk M, et al. European Organisation for Research and Treatment of Cancer Radiation Oncology Group. Patients with curative resection of cT3-4 rectal cancer after preoperative radiotherapy or radiochemotherapy: does anybody benefit from adjuvant fluorouracil-based chemotherapy? A trial of the European Organisation for Research and Treatment of Cancer Radiation Oncology Group. J Clin Oncol 2007;25:4379−86.

43. Park IJ, Kim DY, Kim HC, et al. Role of adjuvant chemotherapy in ypT0-2N0 patients treated with preoperative chemoradiation therapy and radical resection for rectal cancer. Int J Radiat Oncol Biol Phys 2015;92:540−7.

44. Breugom AJ, Swets M, Bosset JF, et al. Adjuvant chemotherapy after preoperative (chemo)radiotherapy and surgery for patients with rectal cancer: a systematic review and meta-analysis of individual patient data. Lancet Oncol 2015;16:200−7.

45. Bujko K, Glimelius B, Valentini V, et al. Postoperative chemotherapy in patients with rectal cancer receiving preoperative radio(chemo)therapy: A meta-analysis of randomized trials comparing surgery ± a fluoropyrimidine and surgery + a fluoropyrimidine ± oxaliplatin. Eur J Surg Oncol 2015;41:713−23.

46. Habr-Gama A, Perez RO, Nadalin W, et al. Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results. Ann Surg 2004;240:711−7; discussion 717−8.

47. Habr-Gama A, Gama-Rodrigues J, São Julião GP, et al. Local recurrence after complete clinical response and watch and wait in rectal cancer after neoadjuvant chemoradiation: impact of salvage therapy on local disease control. Int J Radiat Oncol Biol Phys 2014;88:822−8.

48. ASCO GI, presentation. More patients with rectal cancer are candidates for a watch-and-wait approach. Practice Update Editorial Team 2017.

49. Kong JC, Guerra GR, Warrier SK, et al. Outcome and salvage surgery following „watch and wait“ for rectal cancer after neoadjuvant therapy: A systematic review. Dis Colon Rectum 2017;60:335−45.

50. Renehan AG, Malcomson L, Emsley R, et al. Watch-and-wait approach versus surgical resection after chemoradiotherapy for patients with rectal cancer (the OnCoRe project): a propensity-score matched cohort analysis. Lancet Oncol 2016;17:174−83.

51. Millard T, Kunk PR, Ramsdale E, et al. Current debate in the oncologic management of rectal cancer. World J Gastrointest Oncol 2016;8:715−24.

Štítky
Surgery Orthopaedics Trauma surgery
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#