1.Neo-adjuvant therapy for locally advanced low rectal cancer.
Xiao DU ; Zhong CHENG ; Zong-guang ZHOU
Chinese Journal of Gastrointestinal Surgery 2012;15(10):1095-1098
Rectal cancer is one of the most malignant tumors in gastrointestinal tract, while low rectal cancer with locally advanced stage is the most common type in China. The concept of neo-adjuvant therapy has challenged the traditional treatment strategy for rectal cancer, and has showed encouraging effects in local relapse control, radical resection and sphincter preservation. However, some important issues still remain controversial, including course and dose of radiotherapy, choice of chemotherapy regimen, long-term benefits. This article aims to review and discuss related issues of neo-adjuvant therapy.
China
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Humans
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Neoadjuvant Therapy
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Neoplasm Recurrence, Local
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Rectal Neoplasms
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therapy
2.Application of biotherapy in recurrent or metastatic gastric cancer.
Chinese Journal of Gastrointestinal Surgery 2011;14(8):569-572
Post-operative recurrence and metastasis remain the leading causes of death for patients with gastric cancer. The major determinants of recurrence and metastasis are the biological characteristics of cancer cells and the immunological status of the patients. In recent years, due to the target-specificity, biotherapy has yielded efficacious responses in diverse clinical applications for cancer treatment, partially for the treatment of recurrence and metastasis of gastric cancer. However, because of the high diversities in clinical manifestations, patients' condition, and tumor's characteristics, there is no ideal strategy of biotherapy established for the prevention and treatment of recurrence and metastasis in gastric cancer. Therefore, a lot of work need to be done in basic research and clinical trial to make the biotherapy effective in treatment of gastric cancer recurrence.
Biological Therapy
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Humans
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Neoplasm Metastasis
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Neoplasm Recurrence, Local
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Stomach Neoplasms
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pathology
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therapy
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Treatment Outcome
4.A review on treatment of high-risk neuroblastoma.
Chinese Journal of Contemporary Pediatrics 2014;16(2):103-107
So far treatment of advanced neuroblastoma is still difficult, due to its high malignancy. Currently comprehensive therapies, including high-dose multi-drug chemotherapy, surgery, stem cell transplantation, radiation, biological therapy and immune therapy as well as target therapy dominant the treatment of this disease, and we hereby introduce the latest development of treatment protocols for this disease.
Combined Modality Therapy
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Female
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Humans
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Male
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Neoplasm Recurrence, Local
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therapy
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Neuroblastoma
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therapy
5.Advances and challenges in neoadjuvant treatment for colorectal cancer liver metastasis.
Chinese Journal of Gastrointestinal Surgery 2021;24(10):919-924
Liver metastasis is the leading cause of death in patients with colorectal cancer. Since surgical resection alone has a high postoperative recurrence rate, neoadjuvant therapy as an important means is widely applied in order to reduce recurrence and improve survival. Progress has been achieved in many aspects of neoadjuvant therapy in colorectal cancer liver metastasis, such as eligible patients selection, optimal regimens and courses of chemotherapy. However, controversies still remain regarding the standards of resectability of lesions and the application of targeted drugs. Individualized treatments could be developed based on multidisciplinary teamwork to achieve the goal of 'resources integration and treatment stratification'.
Chemotherapy, Adjuvant
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Colorectal Neoplasms/drug therapy*
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Humans
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Liver Neoplasms/drug therapy*
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Neoadjuvant Therapy
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Neoplasm Recurrence, Local
6.Correlation between pelvic relapses of rectal cancer after radical and R0 resection: A regression model-based analysis.
Peng GUO ; Liang TAO ; Chang WANG ; Hao Run LYU ; Yi YANG ; Hao HU ; Guang Xue LI ; Fan LIU ; Yu Xi LI ; Ying Jiang YE ; Shan WANG
Chinese Journal of Gastrointestinal Surgery 2023;26(3):277-282
Objective: To propose a new staging system for presacral recurrence of rectal cancer and explore the factors influencing radical resection of such recurrences based on this staging system. Methods: In this retrospective observational study, clinical data of 51 patients with presacral recurrence of rectal cancer who had undergone surgical treatment in the Department of Gastrointestinal Surgery, Peking University People's Hospital between January 2008 and September 2022 were collected. Inclusion criteria were as follows: (1) primary rectal cancer without distant metastasis that had been radically resected; (2) pre-sacral recurrence of rectal cancer confirmed by multi-disciplinary team assessment based on CT, MRI, positron emission tomography, physical examination, surgical exploration, and pathological examination of biopsy tissue in some cases; and (3) complete inpatient, outpatient and follow-up data. The patients were allocated to radical resection and non-radical resection groups according to postoperative pathological findings. The study included: (1) classification of pre-sacral recurrence of rectal cancer according to its anatomical characteristics as follows: Type I: no involvement of the sacrum; Type II: involvement of the low sacrum, but no other sites; Type III: involvement of the high sacrum, but no other sites; and Type IV: involvement of the sacrum and other sites. (2) Assessment of postoperative presacral recurrence, overall survival from surgery to recurrence, and duration of disease-free survival. (3) Analysis of factors affecting radical resection of pre-sacral recurrence of rectal cancer. Non-normally distributed measures are expressed as median (range). The Mann-Whitney U test was used for comparison between groups. Results: The median follow-up was 25 (2-96) months with a 100% follow-up rate. The rate of metachronic distant metastasis was significantly lower in the radical resection than in the non-radical resection group (24.1% [7/29] vs. 54.5% [12/22], χ2=8.333, P=0.026). Postoperative disease-free survival was longer in the radical resection group (32.7 months [3.0-63.0] vs. 16.1 [1.0-41.0], Z=8.907, P=0.005). Overall survival was longer in the radical resection group (39.2 [3.0-66.0] months vs. 28.1 [1.0-52.0] months, Z=1.042, P=0.354). According to univariate analysis, age, sex, distance between the tumor and anal verge, primary tumor pT stage, and primary tumor grading were not associated with achieving R0 resection of presacral recurrences of rectal cancer (all P>0.05), whereas primary tumor pN stage, anatomic staging of presacral recurrence, and procedure for managing presacral recurrence were associated with rate of R0 resection (all P<0.05). According to multifactorial analysis, the pathological stage of the primary tumor pN1-2 (OR=3.506, 95% CI: 1.089-11.291, P=0.035), type of procedure (transabdominal resection: OR=29.250, 95% CI: 2.789 - 306.811, P=0.005; combined abdominal perineal resection: OR=26.000, 95% CI: 2.219-304.702, P=0.009), and anatomical stage of presacral recurrence (Type III: OR=16.000, 95% CI: 1.542 - 166.305, P = 0.020; type IV: OR= 36.667, 95% CI: 3.261 - 412.258, P = 0.004) were all independent risk factors for achieving radical resection of anterior sacral recurrence after rectal cancer surgery. Conclusion: Stage of presacral recurrences of rectal cancer is an independent predictor of achieving R0 resection. It is possible to predict whether radical resection can be achieved on the basis of the patient's medical history.
Humans
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Neoplasm Recurrence, Local/diagnosis*
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Rectal Neoplasms/therapy*
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Retrospective Studies
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Pelvis/pathology*
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Recurrence
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Treatment Outcome
8.Outcomes of oesophageal cancer treated with neoadjuvant compared with definitive chemoradiotherapy.
Caryn WUJANTO ; Jeremy TEY ; Balamurugan VELLAYAPPAN ; Jimmy SO ; Wei Peng YONG ; Asim SHABBIR ; Michelle TSENG ; Yu Yang SOON ; Francis HO
Annals of the Academy of Medicine, Singapore 2021;50(7):536-547
INTRODUCTION:
We report outcomes of patients with oesophageal cancer treated with neoadjuvant chemoradiotherapy (NACRT) plus surgery or definitive chemoradiotherapy (chemoRT) at our institution.
METHODS:
We retrospectively reviewed patients who underwent chemoRT from 2005 to 2017. The primary outcome was overall survival (OS). Secondary outcomes were disease-free survival (DFS) and toxicities.
RESULTS:
We identified 96 patients with median age of 64 years and squamous cell carcinoma in 82.3%. Twenty-nine patients (30.2%) received NACRT plus surgery, 67 patients (69.8%) received definitive chemoRT. Median follow-up was 13.5 months. The 3/5-year OS were 26.4%/13.4%, and 59.6%/51.6% in the definitive chemoRT and NACRT plus surgery groups, respectively. The 3/5-year DFS were 19.3%/12.3%, and 55.7%/37.2% in the definitive chemoRT and NACRT plus surgery groups, respectively. NACRT plus surgery significantly improved OS (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.22-0.72,
CONCLUSION
NACRT plus surgery improved OS and DFS. However, in view of treatment-related complications, careful selection of patients is warranted. With the predominant histology of our cohort being squamous cell carcinoma (SCC), our results may be more relevant for those with SCC.
Chemoradiotherapy
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Esophageal Neoplasms/pathology*
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Humans
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Middle Aged
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Neoadjuvant Therapy
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Neoplasm Recurrence, Local
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Neoplasm Staging
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Retrospective Studies
9.The anti-tumor efficacy of nanosecond pulsed electric fields on the mouse with melanoma xenograft in vivo.
Qiao PENG ; Shoulong DONG ; Fei GUO ; Chenguo YAO ; Junying TANG
Journal of Biomedical Engineering 2013;30(6):1302-1308
This study was conducted to investigate the anti-tumor efficacy of nanosecond pulsed electric fields (nsPEFs) on the mouse with A375-GFP melanoma xenograft in vivo. In vivo fluorescence image analysis system was used in this study to evaluate the effects of nsPEFs on human melanoma A375 cell xenograft. On the Day 90 af ter pulse delivery, the skin that had contained A375 cell xenograft was surgically excised and pathologically evalua ted. The changes of scar were recorded by digital camera. The experiment revealed that significant changes in fluorescence value trend and amplitude were found in the treated group from those in the control group. The fluorescence of tumor in the treated group decreased mostly 48 h after the treatment and completely disappeared 10 d after the treatment, while that in control group was increased gradually. Surgical excision of the area confirmed a complete pathologic response. Within a few days after the nsPEFs treatment, a hard scab formed at the treatment region. The scab fell off by the end of the second week. As time went on, the scar gradually became faded and all xenograft tumors were disappeared without recurrence. From the experiment, we learn that nsPEFs can bring good therapeutic effect. It may provide a new approach for the clinical treatment of superficial tumors.
Animals
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Electric Stimulation Therapy
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methods
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Heterografts
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Humans
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Melanoma
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therapy
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Mice
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Neoplasm Recurrence, Local
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Skin
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pathology
10.Standard treatment for colorectal cancer.
Chinese Journal of Surgery 2007;45(7):433-435