Chemo plus radiation before surgery increases tumor response for rectal cancer
Rectal cancer patients who use a new combination of the chemotherapy, Capecitabine, together with five weeks of radiation (50 Gy) before surgery have an 88 percent chance of surviving the cancer three years after treatment, according to randomized trial presented at the plenary session, October 3, 2011, at the 53rd Annual Meeting of the American Society for Radiation Oncology (ASTRO).
"The results of the trial allow us to recommend a new pre-operative treatment, the 'CAP 50' regimen, in locally advanced rectal cancer. It's safe and reduces the risk of the cancer coming back to less than 5 percent," Jean Pierre Gerard, MD, a radiation oncologist at Centre Antoine-Lacassagne in Nice, France, said.
The primary treatment for cancer of the rectum (found in the lower 15 centimeters of the bowel) is surgery. However, there is a risk of cancer re-growth within the bowel and surrounding tissues. Not only is this recurrence incurable in the majority of patients, but it can cause negative side effects. Depending on the location and stage of the cancer, doctors usually recommend radiation therapy and chemotherapy before surgery. The optimal regimen is still in discussion.
The ACCORD 12 trial involved 598 patients with locally advanced rectal cancer (tumors that have spread to the perirectal fat, but not travelled to distant parts of the body) who were diagnosed and treated in 50 hospitals in France between 2005 and 2008.
Researchers wanted to find the most effective and safe preoperative treatment for rectal cancer by comparing a combination of two different chemotherapies and two different radiation doses. Patients were randomized to receive either Cap45 (chemotherapy, Capecitabine, and radiation treatment at 45 Gy) or Capox50 (chemotherapies, Capecitabine and Oxaliplatin, along with radiation at 50 Gy). At three years after treatment, the Capox50 regimen did not significantly increase the chance of the cancer returning or surviving the disease, compared to the Cap45 treatment. Oxaliplatin, given as part of the Capox50 treatment, was shown to immediately increase side effects, with some cases of severe diarrhea, and was not effective in increasing the chance of local tumor sterilization.
However, the increase of radiation dose from 45 to 50 Gy in five weeks was effective, well tolerated and did not extend the duration of treatment.
"The results of this trial, when analyzed together with the Italian STAR01 and the American NSABP R04 randomized trials, bring solid scientific evidence that a 'CAP50 regimen' should be the standard treatment for locally advanced rectal cancer. Using Capecitabine avoids the intravenous injection of fluorouracil, while a radiation dose of 50 Gy in 25 fractions over five weeks increases the chance of tumor sterilization and limits the risk of local recurrence to 5 percent or less," Dr. Gerard said.
Provided by American Society for Radiation Oncology
- Radiation before surgery keeps colorectal cancer from returning Oct 25, 2010 | not rated yet | 0
- Preoperative radiation may improve survival rates in advanced rectal cancer patients Dec 02, 2008 | not rated yet | 0
- Newer, more intense chemotherapy with less radiation not more effective against Hodgkin's lymphoma Oct 25, 2010 | not rated yet | 0
- Effects of chemoradiation therapy by using capecitabine on gastric cancer patients Sep 20, 2010 | not rated yet | 0
- Researchers link genetic marker to rectal cancer treatment Jul 06, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
In recent years, microRNAs (miRNAs) and other non-coding RNAs are small molecules that help control the expression of specific proteins. In recent years they have emerged as disease biomarkers. miRNA profiles have been used ...
Cancer May 24, 2013 | not rated yet | 0
Cancer cells spread and grow by avoiding detection and destruction by the immune system. Stimulation of the immune system can help to eliminate cancer cells; however, there are many factors that cause the immune system to ...
Cancer May 24, 2013 | 5 / 5 (1) | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer May 24, 2013 | 5 / 5 (1) | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer May 24, 2013 | 5 / 5 (2) | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer May 24, 2013 | 5 / 5 (4) | 0
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
11 hours ago | 5 / 5 (2) | 5
(HealthDay)—Animals make great companions for senior citizens, but elderly people who always drive with a pet in the car are far more likely to crash than those who never drive with a pet, researchers have ...
3 hours ago | not rated yet | 0
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
11 hours ago | not rated yet | 1
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...
11 hours ago | not rated yet | 0
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
11 hours ago | not rated yet | 0