Carcinomas of the Rectum and Anus


Phase II trials

N.

Design

RT dose

CR

Median F/U

3 yr DFS

3 yr CFS

OS

RTOG-0529 phase II completed accrual March 2008

63

5FU 1000 mg/m2 days 1–4 ad 29–33 2 doses of MMC 10 mg/m2 days 1, 29 Total dose = 20mg/m2

IMRT dose acc to T stage 50,4 Gy/28# T2NO 54Gy/30# for T3/T4NO 54 Gy/30# for T3/T4NO

34/61 67% at 8 weeks

No data

No data

No data

No data

ECOG E320510

62

NACT cisplat/5FUx2 induction, then 5FU/cisplat/cetuximab during RT in immunocompetent

54 Gy/30# for T3/T4NO

Study suspended 11/3/20018

No data

No data

No data

No data

AMC045

47

5FU 1000 mg/m2 days 1–4, cisplatin day 1, 29 cetuximabduring RT in HIV+

54 Gy/30# for T3/T4NO

Study ongoing

No data

No data

No data

No data

NCT0032444

15

FNCLCC

77

Cisplatin and 5FU with cetuximab

65 Gy

Study ongoing

No data

No data

No data

No data

NCT009551

40

Total

245
       

N number, RT radiotherapy, CR complete clinical response, DFS disease free survival, CFS colostomy free survival, OS overall survival, IMRT intensity modulated radiotherapy, 5FU 5-fluorouracil, cisplat cisplatinum, MMC mitomycin C, F/U follow-up, NACT neoadjuvant chemotherapy, HIV human immunodeficiency virus.









References



1.

Peeters KC, Marijnen CA, Nagtegaal ID et al (2007) Dutch Colorectal Cancer Group the TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma. Ann Surg 246: 693–701PubMedCrossRef


2.

Valentini V, Aristei C, Glimelius B et al (2009) Multidisciplinary Rectal Cancer Management: 2nd European Rectal Cancer Consensus Conference (EURECA-CC2). Radiother Oncol 92: 148–163PubMedCrossRef


3.

Fazio VW, Zutshi M, Remzi FH et al (2007) A randomized multicentric trial to compare long-term functional outcome, quality of life, and complications of surgical procedures for low rectal cancers. Ann Surg 246: 481–488PubMedCrossRef


4.

den Dulk M, Putter H, Collette L et al (2009) The abdominoperineal resection itself is associated with an adverse outcome: the European experience based on a pooled analysis of five European randomised clinical trials on rectal cancer. Eur J Cancer 45: 1175–1183CrossRef


5.

Stelzner S, Koehler C, Stelzer J et al (2011) Extended abdominoperineal excision vs. standard abdominoperineal excision in rectal cancer-a systematic overview. Int J Colorectal Dis 26: 1227–1240PubMedCrossRef


6.

van Gijn W, Marijnen CA, Nagtegaal ID et al (2011) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 12: 575–582PubMedCrossRef


7.

Peng J, Chen W, Sheng W et al (2011) Oncological outcome of T1 rectal cancer undergoing standard resection and local excision. Colorectal Dis 13: 14–19CrossRef


8.

Moore JS, Cataldo PA, Osier T et al (2008) Transanal endoscopic microsurgery is more effective than traditional transanal excision for resection of rectal masses. Dis Colon Rectum 51: 1026–1030PubMedCrossRef


9.

Hahnloser D, Wolff BG, Larson DW et al (2005) Immediate radical resection after local excision of rectal cancer: an oncologic compromise? Dis Colon Rectum 48: 429–437PubMedCrossRef


10.

Piessen G, Gabral C, Benoist S et al (2012) Previous transanal full-thickness excision increases the morbidity of radical resection for rectal cancer. Colorectal Dis 14: 445–452PubMedCrossRef


11.

Doornebosh PG, Ferenschild FT, de Wilt JH et al (2010) Treatment of recurrence after transanal endoscopic microsurgery (TEM) for T1 rectal cancer. Dis Colon Rectum 53: 1234–1239CrossRef


12.

Sebag-Montefiore D, Stephens RJ, Steele R et al (2009) Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet 373: 811–820PubMedCrossRef


13.

Roedel C, Becker H, Fietkau R et al (2011) Preoperative chemoradiotherapy and postoperative chemotherapy with 5-fluorouracil and oxaliplatin versus 5-fluorouracil alone in locally advanced rectal cancer: First results of the German CAO/ARO/AIO-04 randomized phase III trial. J Clin Oncol 29(suppl):abs 3505


14.

Bujko K, Nowacki MP, Nasierowska-Guttmejer A et al (2006) Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg 93: 1215–1223PubMedCrossRef


15.

MERCURY study group (2007) Extramural depth of tumor invasion at thin-section MR in patients with rectal cancer: results of the MERCURY study. Radiology 243: 132–139CrossRef


16.

Peeters KC, van den Velde CJ, Leer JW et al (2005) Late side effects of short-course preoperative radiotherapy combined with total mesorectal excision for rectal cancer: increased bowel dysfunction in irradiated patients-a Dutch colorectal cancer group study. J Clin Oncol 23: 6199–6206PubMedCrossRef


17.

Schmoll HJ, Van Cutsem E, Stein A et al (2012) ESMO Consensus Guidelines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making. Ann Oncol 23: 2479–2516PubMedCrossRef

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Feb 18, 2017 | Posted by in ONCOLOGY | Comments Off on Carcinomas of the Rectum and Anus

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