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Capecitabine as third line therapy in patients with advanced colorectal cancer.

https://arctichealth.org/en/permalink/ahliterature16849
Source
Acta Oncol. 2005;44(3):236-9
Publication Type
Article
Date
2005
Author
Michael Gubanski
Gisela Naucler
Agneta Almerud
Anders Lideståhl
Pehr A R M Lind
Author Affiliation
Department of Oncology, Karolinska University Hospital-Huddinge, Stockholm, Sweden. gubanski@kus.se
Source
Acta Oncol. 2005;44(3):236-9
Date
2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antimetabolites, Antineoplastic - administration & dosage - therapeutic use
Antineoplastic Agents - administration & dosage
Antineoplastic Agents, Phytogenic - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Camptothecin - administration & dosage - analogs & derivatives
Carcinoembryonic Antigen - analysis
Colonic Neoplasms - drug therapy
Deoxycytidine - analogs & derivatives - therapeutic use
Disease Progression
Drug Resistance, Neoplasm
Female
Fluorouracil - administration & dosage
Humans
Male
Middle Aged
Organoplatinum Compounds - administration & dosage
Palliative Care
Prodrugs - administration & dosage - therapeutic use
Rectal Neoplasms - drug therapy
Retrospective Studies
Survival Rate
Tumor Markers, Biological - analysis
Abstract
This study sought to determine whether third line therapy with capecitabine (cap.) could provide any clinical benefit in patients with advanced colorectal cancer who have progressed on 5-Fu combination therapy with both irinotecan and oxaliplatin. Twenty patients who were pretreated with and had progressed on irinotecan+Nordic FLv (5-Fu/leukovorin) and oxaliplatin+c.i. 5-Fu/leukovorin were studied. Cap. was administered at 1000-1250 mg/m2 bid d1-14 q 3 w. Time to progression (TTP) (either radiological or clinical) and overall survival (OS) were estimated with the Kaplan-Meier actuarial method. The median number of administered cap. courses was four. No radiological or biochemical responses were observed. Three patients were classified as having stable disease at three months. Two of these patients had, however, minor radiological progression and a =100% increase in CEA compared to base line. Seventeen patients were classified as having progressive disease during the first three months period. Median TTP and OS were 2.8 months and 6.1 months, respectively. A response rate of =15% for third line cap. in metastatic CRC can be ruled out. Median PFS was limited in the study population. This observation and the few cases with SD at three months, lead us to believe that little or no clinical benefit can be expected from single drug cap. in patients with irinotecan- and oxaliplatin-combination resistant advanced colorectal cancer.
PubMed ID
16076695 View in PubMed
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Cimetidine as an adjuvant treatment in colorectal cancer. A double-blind, randomized pilot study.

https://arctichealth.org/en/permalink/ahliterature23231
Source
Dis Colon Rectum. 1995 May;38(5):514-8
Publication Type
Article
Date
May-1995
Author
L B Svendsen
C. Ross
U. Knigge
H J Frederiksen
P. Graversen
J. Kjaergård
M. Luke
H. Stimpel
B H Sparsø
Author Affiliation
Department of Gastrointestinal Surgery, University of Copenhagen, Denmark.
Source
Dis Colon Rectum. 1995 May;38(5):514-8
Date
May-1995
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - drug therapy - mortality - surgery
Adult
Aged
Aged, 80 and over
Chemotherapy, Adjuvant
Cimetidine - therapeutic use
Colonic Neoplasms - drug therapy - mortality - surgery
Denmark - epidemiology
Double-Blind Method
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pilot Projects
Placebos
Rectal Neoplasms - drug therapy - mortality - surgery
Survival Rate
Treatment Outcome
Abstract
PURPOSE: To evaluate the influence of a H2 receptor antagonist (cimetidine) on survival in patients with colorectal carcinoma, a randomized, controlled pilot study was performed in three university hospitals in Copenhagen, Denmark. METHODS: A total of 192 patients, who had undergone a resection or an exploratory operation for adenocarcinoma of the colon or rectum between May 1988 and May 1991, were enrolled in the study. After a median observation time of 40 months, outcome was noted for each patient concerning cancer-specific mortality rate. RESULTS: In patients operated with curative intent (n = 148), no difference was found in cancer-specific mortality between the two treatments. However, a tendency toward reduction in mortality rate was found in patients with curatively operated Dukes Stage C carcinoma (P = 0.11, log-rank test; difference, 29 percent; 90 percent confidence interval, 2 to 57 percent) in the cimetidine-treated group. In patients with disseminated disease no total difference was found between the two treatment groups. CONCLUSIONS: Cimetidine does not seem to reduce mortality in patients with colorectal cancer, but there seems to be a tendency toward a survival benefit in patients undergoing surgery for Dukes Stage C carcinoma. Results seem to justify trials in this patient category to reveal a benefit of H2 receptor antagonists in adjuvant therapy of colorectal carcinoma.
Notes
Comment In: Dis Colon Rectum. 1996 Jan;39(1):111-28601349
PubMed ID
7736883 View in PubMed
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Clinical characteristics and outcomes in patients with advanced rectal cancer: a national prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature79085
Source
Dis Colon Rectum. 2007 Mar;50(3):285-91
Publication Type
Article
Date
Mar-2007
Author
Sigurdsson Helgi Kjartan
Körner Hartwig
Dahl Olav
Skarstein Arne
Søreide Jon Arne
Author Affiliation
Department of Surgery, Stavanger University Hospital, Stavanger, Norway.
Source
Dis Colon Rectum. 2007 Mar;50(3):285-91
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Chi-Square Distribution
Decision Making
Female
Humans
Male
Middle Aged
Neoplasm Staging
Norway - epidemiology
Palliative Care
Prognosis
Proportional Hazards Models
Prospective Studies
Rectal Neoplasms - drug therapy - epidemiology - pathology - radiotherapy
Registries
Statistics, nonparametric
Survival Analysis
Treatment Outcome
Abstract
PURPOSE: At the time of diagnosis, approximately one third of patients with rectal cancer present with advanced disease. In this study we focus on a group of patients with primary advanced rectal cancer considered as not operable. We address various clinical aspects relevant for decision-making in a group of patients in need of palliative care. METHODS: Between January 1997 and December 2001, 4831 consecutive patients with rectal cancer were prospectively registered in the Norwegian Rectal Cancer Registry. In this national population-based cohort, 386 patients (8 percent) without surgical interventions were identified. These patients comprise the study population. Clinical characteristics and survivals were addressed. RESULTS: Patients not surgically treated were significantly older compared with other treatment groups (median age, 80 years; interquartile range, 72-86 vs. median age, 71 years; interquartile range, 62-79 years) (P
PubMed ID
17235720 View in PubMed
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[Combined radiotherapy and chemotherapy as adjuvant treatment of rectal cancer]

https://arctichealth.org/en/permalink/ahliterature23145
Source
Ugeskr Laeger. 1995 Jul 24;157(30):4223-8
Publication Type
Article
Date
Jul-24-1995
Author
H H Raskov
Author Affiliation
Kirurgisk gastroenterologisk afdeling D., Amtssygehuset i Gentofte.
Source
Ugeskr Laeger. 1995 Jul 24;157(30):4223-8
Date
Jul-24-1995
Language
Danish
Publication Type
Article
Keywords
Chemotherapy, Adjuvant
English Abstract
Humans
Prognosis
Radiotherapy, Adjuvant
Rectal Neoplasms - drug therapy - radiotherapy - therapy
Abstract
The prognosis following radical operation for rectal cancer is still dubious. There is urgent need for effective adjuvant treatment in order to control both local and distant recurrences. During the last years the use of combined adjuvant treatment (radiochemotherapy ) has increased both recurrence-free survival in several randomised trials. The trials are reviewed in this article. Adjuvant treatment has been recommended as standard therapy in the USA since 1990. Following the German national consensus conference in March 1994, adjuvant treatment is now being recommended in Germany as well. In several other countries in Europe adjuvant therapy is routinely being offered to high-risk colorectal cancer patients following the surgical procedure. The experiences and results that now are available ought to be discussed in the near future in order to establish a national consensus in Denmark.
PubMed ID
7653004 View in PubMed
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The consistency of panelists' appropriateness ratings: do experts produce clinically logical scores for rectal cancer treatment?

https://arctichealth.org/en/permalink/ahliterature177224
Source
Health Policy. 2005 Jan;71(1):57-65
Publication Type
Article
Date
Jan-2005
Author
David C Hodgson
James D Brierley
Geta Cernat
Susan Bondy
Pamela M Slaughter
S Patricia Pinfold
Lawrence F Paszat
Author Affiliation
Department of Radiation Oncology, Princess Margaret Hospital, 610 University Ave., Toronto, Ont., Canada M5G 2M9. david.hodgson@rmp.uhn.on.ca
Source
Health Policy. 2005 Jan;71(1):57-65
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Aged
Canada
Combined Modality Therapy
Health Services Research
Humans
Middle Aged
Rectal Neoplasms - drug therapy - radiotherapy - surgery - therapy
Abstract
To quantify the clinical consistency of expert panelists' ratings of appropriateness of pre-operative and post-operative chemotherapy plus radiation for rectal cancer.
A panel of nine physicians (two surgeons, four medical oncologists, three radiation oncologists) rated the appropriateness of providing pre-operative and post-operative treatments for rectal cancer, utilizing a modified-Delphi (RAND/UCLA) approach. Clinical scenarios were paired so that each component of a pair differed by only one clinical feature (e.g. tumor stage). A pair of appropriateness ratings was defined as inconsistent when the clinical scenario that should have had the higher (or at least equal) appropriateness rating was given a lower rating. The rate of inconsistency was analyzed for panelists' ratings of pre- and post-operative chemotherapy plus radiation.
The final panel rating was inconsistent for 1.19% of pre-operative scenario pairs, and 0.77% of post-operative scenario pairs. Using the conventional RAND/UCLA definition of appropriateness, the magnitude of the inconsistency would produce inconsistent appropriateness ratings in 0.43% of pre-operative and 0.11% of post-operative scenario pairs. There was significant variation in the rate of inconsistency among individual panelists' final ratings of both pre-operative (range: 0.43-5.17%, P
PubMed ID
15563993 View in PubMed
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Differences between referred and nonreferred patients in cancer research.

https://arctichealth.org/en/permalink/ahliterature107045
Source
Can J Surg. 2013 Oct;56(5):E135-41
Publication Type
Article
Date
Oct-2013
Author
Jason Faulds
Colleen E McGahan
P T Phang
Manoj J Raval
Carl J Brown
Author Affiliation
The Department of Surgery, St. Paul's Hospital and University of British Columbia, Vancouver, BC.
Source
Can J Surg. 2013 Oct;56(5):E135-41
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - drug therapy
Adult
Aged
Aged, 80 and over
British Columbia
Cancer Care Facilities
Carcinoma in Situ - drug therapy
Colonic Neoplasms - drug therapy
Female
Health Services Accessibility
Health Services Research
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Outcome Assessment (Health Care)
Rectal Neoplasms - drug therapy
Referral and Consultation - statistics & numerical data
Registries
Retrospective Studies
Abstract
In Canada, provincial cancer registries have been established to provide rigorous population-based data for patients with colorectal cancer. Databases maintained by regional cancer agencies contain a broader scope of information and have been used as a surrogate source of information for colorectal cancer research. It is unclear whether these data can be reliably extrapolated to all patients affected by colorectal cancer. We sought to determine whether patients included in a referral-based database are systematically different from patients who are not included.
We conducted a retrospective cohort study to compare patients referred to the British Columbia Cancer Agency with those who were not referred. Comparison was based on age, sex and geographic location. We used univariate and logistic regression analysis to identify significant differences between the cohorts.
Univariate analysis demonstrated that the referral and nonreferral cohorts differed in sex, age and geographic location. For patients with rectal cancer, the referral and nonreferral cohorts varied in age and geographic location. Multivariate analysis demonstrated significant differences in age and geographic location but not sex for patients with colon and rectal cancer.
Patients included in the referral database differed in age and geographic location from those included only in the provincial database. Studies using large data sets from referral centres must be interpreted with caution and may not be representative of the entire patient population.
Notes
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PubMed ID
24067529 View in PubMed
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Does neoadjuvant therapy alter KRAS and/or MSI results in rectal adenocarcinoma testing?

https://arctichealth.org/en/permalink/ahliterature132252
Source
Am J Surg Pathol. 2011 Sep;35(9):1327-30
Publication Type
Article
Date
Sep-2011
Author
Sarah L Ondrejka
David F Schaeffer
Maureen A Jakubowski
David A Owen
Mary P Bronner
Author Affiliation
Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA.
Source
Am J Surg Pathol. 2011 Sep;35(9):1327-30
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - drug therapy - genetics - pathology - radiotherapy - therapy
Biopsy
British Columbia
Chemotherapy, Adjuvant
Codon
DNA Mutational Analysis
Genetic Testing - methods
Humans
Microsatellite Instability
Mutation
Neoadjuvant Therapy
Ohio
Polymerase Chain Reaction
Predictive value of tests
Proto-Oncogene Proteins - genetics
Radiotherapy, Adjuvant
Rectal Neoplasms - drug therapy - genetics - pathology - radiotherapy - therapy
Treatment Outcome
ras Proteins - genetics
Abstract
To our knowledge, the genotoxic effects of neoadjuvant chemoradiation therapy on molecular diagnostic testing results are unknown. However, if neoadjuvant treatments were to alter molecular test results, clinical decision-making could be misled. This raises questions about the appropriateness of using posttreatment tumor for testing. To address this, rectal adenocarcinomas both before and after neoadjuvant treatment were evaluated for alterations in KRAS and microsatellite instability (MSI) testing. Neoadjuvant chemoradiation therapy is common in this tumor type, and alterations in these 2 tests would significantly impact management. A total of 17 rectal adenocarcinoma patients with available pretreatment and posttreatment tumor were studied. MSI testing used the revised National Cancer Institute panel of 5 mononucleotide microsatellite repeats, comparing cancers with matched normal control tissues. KRAS codon 12-point and 13-point mutations were examined by polymerase chain reaction amplification and bidirectional sequencing. MSI and KRAS results were unchanged comparing rectal cancer tissue before and after chemoradiotherapy in all 17 patients (P=1.000; 95% CI: 0.3969-2.520). All 17 tumors (100%) were microsatellite stable. KRAS testing identified 12 (72%) wild-type tumors and 5 (28%) codon 12 or 13 mutant tumors with identical KRAS point mutations before and after treatment. The identified MSI and KRAS mutational prevalences parallel those reported in the rectal cancer literature. Neoadjuvant therapy did not alter KRAS codon 12 or 13 or MSI results in rectal adenocarcinoma, providing evidence that either pretreatment biopsy or posttreatment resection tissues are appropriate for testing.
PubMed ID
21836482 View in PubMed
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Dose-effect relationship in chemoradiotherapy for locally advanced rectal cancer: a randomized trial comparing two radiation doses.

https://arctichealth.org/en/permalink/ahliterature124317
Source
Int J Radiat Oncol Biol Phys. 2012 Nov 15;84(4):949-54
Publication Type
Article
Date
Nov-15-2012
Author
Anders Jakobsen
John Ploen
Té Vuong
Ane Appelt
Jan Lindebjerg
Soren R Rafaelsen
Author Affiliation
Danish Colorectal Cancer Group South, Vejle Hospital, Vejle, Denmark. anders.jakobsen@slb.regionsyddanmark.dk
Source
Int J Radiat Oncol Biol Phys. 2012 Nov 15;84(4):949-54
Date
Nov-15-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antimetabolites, Antineoplastic - administration & dosage
Brachytherapy - methods
Denmark
Dose-Response Relationship, Radiation
Female
Fluorouracil - administration & dosage
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Staging
Prospective Studies
Quebec
Radiotherapy Dosage
Rectal Neoplasms - drug therapy - pathology - radiotherapy
Remission Induction
Tegafur - administration & dosage
Abstract
Locally advanced rectal cancer represents a major therapeutic challenge. Preoperative chemoradiation therapy is considered standard, but little is known about the dose-effect relationship. The present study represents a dose-escalation phase III trial comparing 2 doses of radiation.
The inclusion criteria were resectable T3 and T4 tumors with a circumferential margin of =5 mm on magnetic resonance imaging. The patients were randomized to receive 50.4 Gy in 28 fractions to the tumor and pelvic lymph nodes (arm A) or the same treatment supplemented with an endorectal boost given as high-dose-rate brachytherapy (10 Gy in 2 fractions; arm B). Concomitant chemotherapy, uftoral 300 mg/m2 and L-leucovorin 22.5 mg/d, was added to both arms on treatment days. The primary endpoint was complete pathologic remission. The secondary endpoints included tumor response and rate of complete resection (R0).
The study included 248 patients. No significant difference was found in toxicity or surgical complications between the 2 groups. Based on intention to treat, no significant difference was found in the complete pathologic remission rate between the 2 arms (18% and 18%). The rate of R0 resection was different in T3 tumors (90% and 99%; P=.03). The same applied to the rate of major response (tumor regression grade, 1+2), 29% and 44%, respectively (P=.04).
This first randomized trial comparing 2 radiation doses indicated that the higher dose increased the rate of major response by 50% in T3 tumors. The endorectal boost is feasible, with no significant increase in toxicity or surgical complications.
Notes
Comment In: Int J Radiat Oncol Biol Phys. 2013 Jun 1;86(2):212-323642620
Comment In: Int J Radiat Oncol Biol Phys. 2013 Jun 1;86(2):21323642621
PubMed ID
22592048 View in PubMed
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[Effect of intraoperative intrapelvic chemotherapy with hyperthermia on the incidence of rectal cancer recurrences].

https://arctichealth.org/en/permalink/ahliterature104401
Source
Vopr Onkol. 2014;60(1):64-70
Publication Type
Article
Date
2014
Author
Iu A Shelygin
M V Alekseev
E G Rybakov
P V Eropkin
Source
Vopr Onkol. 2014;60(1):64-70
Date
2014
Language
Russian
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chemotherapy, Adjuvant
Chemotherapy, Cancer, Regional Perfusion
Female
Humans
Hyperthermia, Induced
Incidence
Intraoperative Period
Male
Middle Aged
Neoplasm Recurrence, Local - epidemiology - mortality - prevention & control
Neoplasm Staging
Peritoneal Cavity
Rectal Neoplasms - drug therapy - epidemiology - mortality - pathology - surgery
Russia - epidemiology
Survival Analysis
Treatment Outcome
Abstract
Often due to a severe somatic condition of the patient, the presence of perifocal inflammation, anemia, age, it is not possible to perform neoadjuvant chemoradiotherapy for rectal cancer. To improve cancer treatment outcomes in these patients intraoperative intrapelvic chemotherapy with hyperthermia is used at the Centre. In the present study there included 120 patients with rectal cancer at stage T3-4N0-2M0, while 60 patients underwent intraoperative intrapelvic chemotherapy with hyperthermia (cisplatin at a dose of 150 mg, the time of the procedure--60 minutes, the temperature of the perfusate--44-45 degrees C). Conducting of intraoperative intrapelvic chemotherapy with hyperthermia allowed reducing the frequency of local recurrence in 2 times from 16.7% to 8.3% and increasing a 3-year overall survival by 10%--from 63% to 73%, which shows intraoperative intrapelvic chemotherapy with hyperthermia as an effective method in the prevention of local recurrences.
PubMed ID
24772619 View in PubMed
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[Experience of surgical treatment of rectal cancer with chemoradiation component on the first stage]

https://arctichealth.org/en/permalink/ahliterature17795
Source
Klin Khir. 2004 Jan;(1):37-8
Publication Type
Article
Date
Jan-2004
Author
S V Peliukhovs'kyi
A V Chornobai
Source
Klin Khir. 2004 Jan;(1):37-8
Date
Jan-2004
Language
Ukrainian
Publication Type
Article
Keywords
Adenocarcinoma - drug therapy - radiotherapy - surgery
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Combined Modality Therapy
English Abstract
Female
Humans
Male
Middle Aged
Neoplasm Staging
Rectal Neoplasms - drug therapy - radiotherapy - surgery
Surgical Procedures, Operative - methods
Abstract
Experience of treatment of 14 patients with cancer recti, using chemoradiation impact on the tumor--endolymphatic polychemotherapy according to MFP (metotrexat, fluorouracyl cysplatin) schema and intense irradiation (summary focal dose 25 Gr) on the first stage with subsequent performance of surgical intervention in terms before 24 hours after completion of irradiation. The immediate results of treatment are estimated. There was not revealed the postoperative complications frequency enhancement. The anal sphincter function restoration was observed at the same terms as after performance of conventional surgical treatment.
PubMed ID
15071997 View in PubMed
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30 records – page 1 of 3.