No abstract available.
Chemoradiotherapy* ; Drug Therapy* ; Humans ; Rectal Neoplasms*

The current conventional treatment for locally advanced rectal cancer with stage II or III is surgery following or followed by chemoradiotherapy (CRT), which improved local control and overall survival when compared with surgery alone. Recently, a prospective randomized study with a large sample size and long-term follow-up reported that preoperative CRT resulted in improved local control and sphincter preservation, reduced toxicities, and comparative overall survival when compared with postoperative CRT. However, diagnostic imaging for accurate stage should be applied. In addition, chemotherapeutic regimen, schedule for radiation therapy, and timing of surgery should be also optimized in order to maximize the effect of preoperative CRT.
Combined Modality Therapy ; Humans ; Rectal Neoplasms/*drug therapy

Children's rectal cancer is a very rare condition and its reported incidence is below 0.5%. The prognosis is very poor due to the advanced stage at diagnosis and a higher malignant potential. Recently some authors treated rectal cancer of children with surgery and they have had a better prognosis. We experienced a case of rectal cancer in a 12 year old boy treated with surgery and chemotherapy and reviewed related literature.
Child* ; Diagnosis ; Drug Therapy ; Humans ; Incidence ; Male* ; Prognosis ; Rectal Neoplasms*

Until mid-1990s, fluorouracil was the only chemotherapeutic agent available for the treatment of colorectal cancer. The treatment of advanced colorectal cancer has evolved considerably over the last decade. Considerable improvements in survival as well as quality of life have been achieved with the application of oxaliplatin and irinotecan with fluoropyrimidine as a first and subsequent line therapy for colorectal cancer. Development of oral fluoropyrimidines as an alternative to intravenous administration provides an additional option for combination cytotoxic therapy, which is currently being assessed in phase III trials in advanced settings. The appearance of biologic agents in mid-2000s, namely cetuximab and bevacizumab, and their integration with conventional cytotoxic therapy for the treatment of colorectal cancer has additionally expanded the options for the treatment. Their dramatic success has led to further clinical studies of targeted therapy in colorectal cancer, making it one of the most promising areas of cancer research. Although considerable improvement was achieved by incorporating oxaliplatin in adjuvant chemotherapy for the treatment of colon cancer, there has been no phase III trial incorporating new agents in adjuvant setting for rectal cancer. However, many phase II trials on the efficacy of new agents in the setting of concurrent chemoradiation are in progress. Based on their results, randomized phase III clinical trials evaluating new agents in preoperative or postoperative setting will be carried out.
Antineoplastic Agents/therapeutic use ; Colorectal Neoplasms/drug therapy ; Humans ; Rectal Neoplasms/*drug therapy

A 30-yr-old man was referred for suspicious rectal cancer because of ulcerated lesions in the rectum and a palpable mass in left inguinal area. Sigmoidoscopy showed two indurated masses and histologic evaluation of biopsy revealed obliterative endarteritis with heavy plasma cell infiltration. Both venereal disease research laboratories (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS) tests were positive. After injection of penicillin G benzathine for 3 weeks, the rectal chancre and the palpable mass disappeared.
Adult ; Diagnosis, Differential ; Humans ; Male ; Rectal Diseases/*complications/drug therapy/*pathology ; Rectal Neoplasms/pathology ; Syphilis/*complications/drug therapy/*pathology

PURPOSE: We studied the effectiveness and toxicities of 5-fluorouracil+leucovorin, combination chemotherapy in advanced or recurred colo-rectal cancer patients, who didn't have previous chemotherapy and enrolled from August 1993 to July 1998. MATERIALS AND METHODS: All patients were treated with leucovorin followed by 5-fluorouracil for 5 consecutive days every 4 weeks. Among 43 patients who were enrolled, 40 patients received treatment at least 2 courses, and they were evaluable. Male to female ratio was 21 to 19. In serum CEA level, 27 patients were greater than 5 ng/ml and 13 were less than 5 ng/ml. And primary site was colon in 21 patients and rectum in 19 patients. RESULTS: The complete response rate was 7,5% and the partial response rate was 25%. The median survival duration was 14.7 months, the median response duration was 16.0 months, and median time to progression was 7.3 months. In the analysis of response, survival duration, time to progression according to various characteristics of patients, serum CEA level and liver involvement were revealed significant difference in survival duration, time to progression (p=0.0122, 00350 & 0.0202, 0.0123) on univariate analysis, but no significant difference on multivariates. Hematologic and non-hematologic toxicities were mild and tolerable. CONCLUSION: This study indicates that the combination of 5-fluorouracil (370 mg/m) and leucovorin (20 mg/m) is effective and tolerable regimen in advanced or recurred colo-rectal cancer patients without previous chemotherapy.
Colon ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Fluorouracil* ; Humans ; Leucovorin* ; Liver ; Male ; Rectal Neoplasms* ; Rectum

PURPOSE: Colorectal cancers have been known to be refractory to chemotherapy in the past decades. Recently, novel agents have been developed and various data have shown an improved response rate and a survival benefit. However, considerable heterogeneity exists between cancers of the same tissue type, including colorectal cancer. Thus, Individualized chemotherapy that is tailored specifically to the characteristics of the tumor is necessary for an improved clinical outcome. RESULTS: We evaluate the chemosensitivity of colorectal cancer to standard drugs (5-FU, oxaliplatin, and irinotecan) and to drugs used for other cancers (mitomycin, paclitaxel, and gemcitabine) by using Adenosine-triphosphate-based chemotherapy response assay (ATP-CRA). RESULTS: The degree of in-vitro response to a single anticancer medication was highest for 5-FU. According to stages, 5-FU is the most sensitive chemotherapeutic agent in Duke's B, irinotecan in Duke's C, and 5-FU in Duke's D patients. With tumor location, irinotecan is most sensitive in colon cancers and 5-FU in rectal cancers. The effect of treatment is superior in the test-guided therapy group in Duke's D colorectal cancer patients. CONCLUSIONS: Chemosensitivity tests may be useful in selecting optimum drugs for patient who require chemotherapy. However, the results of this study do not strongly support the usefulness of this assay; further studies with a sufficient number of cases and an extended observation period are ongoing.
Colonic Neoplasms ; Colorectal Neoplasms* ; Drug Therapy ; Fluorouracil ; Humans ; Paclitaxel ; Population Characteristics ; Rectal Neoplasms

PURPOSE: Despite advances in rectal cancer treatment over the last decade, local control and risk of late side effects due to external beam radiation therapy (EBRT) remain as concerns. The present study aimed to investigate the efficacy and the safety of low-dose-rate endorectal brachytherapy (LDRBT) as a boost to neoadjuvant chemoradiation for use in treating locally advanced distal rectal adenocarcinomas. METHODS: This phase-II clinical trial included 34 patients (as the study arm) with newly diagnosed, locally advanced (clinical T3-T4 and/or N1/N2, M0) lower rectal cancer. For comparative analysis, 102 matched patients (as the historical control arm) with rectal cancer were also selected. All the patients were treated with LDRBT (15 Gy in 3 fractions) and concurrent chemoradiation (45-50.4 Gy). Concurrent chemotherapy consisted of oxaliplatin 130 mg/m2 intravenously on day 1 plus oral capecitabine 825 mg/m2 twice daily during LDRBT and EBRT. RESULTS: The study results revealed a significant differences between the study arm and the control arm in terms in the pathologic tumor size (2.1 cm vs. 3.6 cm, P = 0.001), the pathologic tumor stage (35% T3-4 vs. 65% T3-4, P = 0.003), and the pathologic complete response (29.4% vs. 11.7%, P < 0.028). Moreover, a significantly higher dose of EBRT (P = 0.041) was found in the control arm, and a longer time to surgery was observed in the study arm (P < 0.001). The higher rate of treatment-related toxicities, such as mild proctitis and anemia, in the study arm was tolerable and easily manageable. CONCLUSION: A boost of LDRBT can optimize the pathologic complete response, with acceptable toxicities, in patients with distal rectal cancer.
Adenocarcinoma ; Anemia ; Arm ; Brachytherapy* ; Drug Therapy ; Humans ; Neoadjuvant Therapy ; Proctitis ; Rectal Neoplasms* ; Capecitabine

PURPOSE: The aim of this study is to evaluate the efficacy and the safety of additional 4-week chemotherapy with capecitabine during the resting periods after a 6-week neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer. METHODS: Radiotherapy was delivered to the whole pelvis at a total dose of 50.4 Gy for 6 weeks. Oral capecitabine was administered at a dose of 825 mg/m2 twice daily for 10 weeks. Surgery was performed 2-4 weeks following the completion of chemotherapy. RESULTS: Between January 2010 and September 2011, 44 patients were enrolled. Forty-three patients underwent surgery, and 41 patients completed the scheduled treatment. Pathologic complete remission (pCR) was noted in 9 patients (20.9%). T down-staging and N down-staging were observed in 32 patients (74.4%) and 33 patients (76.7%), respectively. Grade 3 to 5 toxicity was noted in 5 patients (11.4%). The pCR rate was similar with the pCR rates obtained after conventional NCRT at our institute and at other institutes. CONCLUSION: This study showed that additional 4-week chemotherapy with capecitabine during the resting periods after 6-week NCRT was safe, but it was no more effective than conventional NCRT.
Chemoradiotherapy* ; Deoxycytidine ; Drug Therapy* ; Fluorouracil ; Humans ; Neoadjuvant Therapy ; Pelvis ; Polymerase Chain Reaction ; Rectal Neoplasms* ; Capecitabine

PURPOSE: The aim of this study is to evaluate the efficacy and the safety of additional 4-week chemotherapy with capecitabine during the resting periods after a 6-week neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer. METHODS: Radiotherapy was delivered to the whole pelvis at a total dose of 50.4 Gy for 6 weeks. Oral capecitabine was administered at a dose of 825 mg/m2 twice daily for 10 weeks. Surgery was performed 2-4 weeks following the completion of chemotherapy. RESULTS: Between January 2010 and September 2011, 44 patients were enrolled. Forty-three patients underwent surgery, and 41 patients completed the scheduled treatment. Pathologic complete remission (pCR) was noted in 9 patients (20.9%). T down-staging and N down-staging were observed in 32 patients (74.4%) and 33 patients (76.7%), respectively. Grade 3 to 5 toxicity was noted in 5 patients (11.4%). The pCR rate was similar with the pCR rates obtained after conventional NCRT at our institute and at other institutes. CONCLUSION: This study showed that additional 4-week chemotherapy with capecitabine during the resting periods after 6-week NCRT was safe, but it was no more effective than conventional NCRT.
Chemoradiotherapy* ; Deoxycytidine ; Drug Therapy* ; Fluorouracil ; Humans ; Neoadjuvant Therapy ; Pelvis ; Polymerase Chain Reaction ; Rectal Neoplasms* ; Capecitabine