https://scholars.lib.ntu.edu.tw/handle/123456789/485672
標題: | Neoadjuvant bevacizumab and chemoradiotherapy in locally advanced rectal cancer: Early outcome and technical impact on toxicity | 作者: | CHIA-CHUN WANG JIN-TUNG LIANG CHIAO-LING TSAI YU-HSUAN CHEN Lin Y.-L. CHIA-TUNG SHUN CHIA-HSIEN CHENG |
公開日期: | 2014 | 出版社: | BioMed Central Ltd. | 卷: | 12 | 期: | 1 | 來源出版物: | World Journal of Surgical Oncology | 摘要: | Background: We aimed to evaluate early clinical and pathological results for treating locally advanced rectal cancer with bevacizumab and neoadjuvant concurrent chemoradiotherapy using the technique of prone-position volumetric modulated arc therapy and to compare the toxicity of volumetric modulated arc therapy with that of supine-position four-field box radiotherapy. Methods: Twelve patients with stage IIA to IVA rectal adenocarcinoma, treated with neoadjuvant concurrent chemoradiotherapy (45 Gy in 25 fractions to the rectal tumor and pelvic lymphatics) and bevacizumab, were prospectively enrolled. Chemotherapy included FOLFOX (leucovorin, fluorouracil, and oxaliplatin) (n =11) and 5-fluorouracil (n =1). All patients received prone-position volumetric modulated arc therapy. A historical cohort treated with supine-position box radiotherapy, including six other patients treated with bevacizumab-based concurrent chemoradiotherapy in our hospital, was used for comparison. Setup errors, toxicities, and potential biomarkers were evaluated. Results: All patients completed neoadjuvant concurrent chemoradiotherapy and underwent total mesorectal excision. Four (33.3%) patients had pathological complete response. Significantly more grade 2 or 3 diarrhea was associated with the supine-box technique (5/6 versus 2/12, P =0.01). The magnitude of setup errors was similar between the supine-box and prone volumetric modulated arc therapy techniques. The estimated 2-year survival and 2-year failure-free survival rates were 100% and 72.9% in the prone volumetric modulated arc therapy group and 66.7% and 66.7% in the supine box group, respectively. Conclusions: The early clinical outcome has been encouraging. Volumetric modulated arc therapy in prone-positioned patients was technically advantageous and reduced bowel toxicity. ? 2014 Wang et al. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84936122606&doi=10.1186%2f1477-7819-12-329&partnerID=40&md5=2bd4999de1dbaf5c9e28df0f5194ea1a https://scholars.lib.ntu.edu.tw/handle/123456789/485672 |
ISSN: | 1477-7819 | DOI: | 10.1186/1477-7819-12-329 | SDG/關鍵字: | bevacizumab; CD34 antigen; fluorouracil; folinic acid; oxaliplatin; protein kinase B; antineoplastic agent; bevacizumab; fluorouracil; folinic acid; monoclonal antibody; oxaliplatin; platinum complex; adjuvant chemotherapy; adult; advanced cancer; aged; anal pain; anemia; antigen expression; Article; cancer mortality; cancer radiotherapy; cancer recurrence; cancer survival; chemoradiotherapy; clinical article; controlled study; diarrhea; distant metastasis; failure free survival; feasibility study; febrile neutropenia; female; hospitalization; human; human tissue; intermethod comparison; male; multiple cycle treatment; outcome assessment; overall survival; pain; patient safety; perianal abscess; postoperative complication; prone position volumetric modulated arc therapy; prospective study; protein expression; rectum carcinoma; supine position four field box radiotherapy; surgical infection; survival rate; survival time; total mesorectal excision; treatment response; upregulation; adenocarcinoma; adjuvant therapy; cancer staging; cohort analysis; follow up; intensity modulated radiation therapy; middle aged; mortality; Neoplasm Recurrence, Local; pathology; prognosis; Rectal Neoplasms; remission; Adenocarcinoma; Adult; Aged; Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols; Chemoradiotherapy; Cohort Studies; Female; Fluorouracil; Follow-Up Studies; Humans; Leucovorin; Male; Middle Aged; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Neoplasm Staging; Organoplatinum Compounds; Prognosis; Radiotherapy, Intensity-Modulated; Rectal Neoplasms; Remission Induction; Survival Rate |
顯示於: | 腫瘤醫學研究所 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。