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Efficacy and safety of short duration radiotherapy combined with chemotherapy for advanced rectal cancer

World Journal of Clinical Cases 2021年第7期9卷 1524-1531页

作者： Shu-Quan Gao Ying-Chun Zhang Chao Zhang Sheng-Jie Wang Wei Ren Na Yuan Jun-Ye Wen Department of Hepatobiliary Surgery The First Affiliated Hospital of Hebei North UniversityZhangjiakou 075061Hebei ProvinceChina Department of Interventional Medicine The First Affiliated Hospital of Hebei North UniversityZhangjiakou 075061Hebei ProvinceChina The First Affiliated Hospital of Hebei North University Zhangjiakou 075061Hebei ProvinceChina Department of Radiotherapy The First Affiliated Hospital of Hebei North UniversityZhangjiakou 075061Hebei ProvinceChina Department of General Surgery Hebei Provincial People’s HospitalShijiazhuang 050003Hebei ProvinceChina

BACKGROUND Radiotherapy or chemoradiotherapy is widely used for the treatment of rectal cancer *** the combination of radiotherapy and chemotherapy as an established preoperative neoadjuvant therapy shows high efficacy in the treatment of rectal cancer,some patients experience a response of poor tolerance and outcomes due to the long duration *** study compared short duration radiotherapy plus chemotherapy vs long duration radiotherapy plus chemotherapy for rectal cancer to determine whether short duration radiation treatment should be considered to diminish complications,reduce risk of recurrence and improve survival in patients with rectal *** To evaluate the efficacy and safety of short duration radiotherapy combined with chemotherapy for the treatment of advanced rectal *** One hundred patients with stage IIIB or higher severe rectal cancer were selected as the study subjects at The First Affiliated Hospital of Hebei North University between December 2018 and December *** patients were assigned to different groups based on the treatment *** patients who received preoperative short durations of radiotherapy plus chemotherapy were enrolled in an observation group and fifty patients who received conventional radiotherapy and chemotherapy were enrolled in a control *** biopsy was performed for all patients with pathological diagnosis of rectal *** expression of tumor-related factors such as RUNX3 and Ki-67 was quantitatively analyzed using immunohistochemistry in the tissues of the patients before and after ***,the duration of procedure,the amount of bleeding during the operation,the anus-conserving rate,the incidence of postoperative complications(wound infection,anastomotic leakage,postoperative intestinal obstruction,etc.)and postoperative pathology were compared between the two *** overall survival rate,recurrence rate and distant metastasis rate were a

关键词： Short course radiotherapy Chemotherapy advanced rectal cancer Runx3 Ki-67

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Compare clinical efficacy and safety of neoadjuvant therapy and neoadjuvant chemoradiotherapy for locally advanced rectal cancer: Meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1845-1856页

作者： Ying Wang Yan Yang Qi-Qi Liu Shao-Zhao Wang Department of Anus Intestinal Surgery Feicheng People’s HospitalFeicheng 271600Shandong ProvinceChina Department of Gastroenterology Qingdao Hospital of University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital)Qingdao 266011Shandong ProvinceChina Department of Gastrointestinal Surgery Peking University Shenzhen HospitalShenzhen 518036Guangdong ProvinceChina Department of Anorectal Words Central Hospital Affiliated Shandong First Medical UniversityJinan 250013Shandong ProvinceChina

BACKGROUND To compare the efficacy and safety of total neoadjuvant therapy(TNT)and neoadjuvant chemoradiotherapy(nCRT)in the treatment of middle and low locally advanced rectal *** study will systematically collect and integrate studies to evaluate the ability of these two treatments to improve tumor shrinkage rates,surgical resection rates,tumor-free survival,and severe adverse *** To provide clinicians and patients with more reliable treatment options to optimize treatment outcomes and quality of life for patients with locally advanced rectal cancer by comparing the advantages and disadvantages of the two treatment *** A full search of all clinical studies on the effectiveness and safety of TNT and nCRT for treating locally advanced rectal cancer identified in Chinese(CNKI,Wanfang,China Biomedical Literature Database)and English(PubMed,Embase)databases was *** system assessors independently screened the studies according to the inclusion and exclusion *** evaluation and RESULTS Finally,14 studies were included,six of which were randomized controlled studies.A total of 3797 patients were included,including 1865 in the TNT group and 1932 in the nCRT *** two sets of baseline data were *** results of the meta-analysis showed that the pCR rate[odds ratio(OR)=1.57,95%confidence interval(CI):1.30-1.90,Padvanced rectal cancer.

关键词： Neoadjuvant therapy Neoadjuvant chemoradiotherapy advanced rectal cancer Clinical efficacy Meta-analysis

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Extralevator abdominoperineal excision for advanced low rectal cancer:Where to go

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World Journal of Gastroenterology 2020年第22期26卷 3012-3023页

作者： Yu Tao Jia-Gang Han Zhen-Jun Wang Department of General Surgery Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China

Since its introduction,extralevator abdominoperineal excision(ELAPE)in the prone position has gained significant attention and recognition as an important surgical procedure for the treatment of advanced low rectal *** studies suggest that because of adequate resection and precise anatomy,ELAPE could decrease the rate of positive circumferential resection margins,intraoperative perforation,and may further decrease local recurrence rate and improve *** studies show that extensive resection of pelvic floor tissue may increase the incidence of wound complications and urogenital ***/robotic ELAPE and trans-perineal minimally invasive approach allow patients to be operated in the lithotomy position,which has advantages of excellent operative view,precise dissection and reduced postoperative *** floor reconstruction with biological mesh could significantly reduce wound complications and the duration of *** proposal of individualized ELAPE could further reduce the occurrence of postoperative urogenital dysfunction and chronic perianal *** ELAPE procedure emphasizes precise anatomy and conforms to the principle of radical resection of tumors,which is a milestone operation for the treatment of advanced low rectal cancer.

关键词： Extralevator abdominoperineal excision advanced rectal cancer Advantages Complications Pelvic reconstruction Intraoperative position Trans-perineal approach Laparoscopic/robotic-extralevator abdominoperineal excision Individual-extralevator abdominoperineal excision

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Impact of interval between neoadjuvant chemoradiotherapy and surgery in rectal cancer patients

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World Journal of Gastroenterology 2020年第31期26卷 4624-4638页

作者： Shi-Wen Mei Zheng Liu Fang-Ze Wei Jia-Nan Chen Zhi-Jie Wang Hai-Yu Shen Juan Li Fu-Qiang Zhao Wei Pei Zheng Wang Xi-Shan Wang Qian Liu Department of Colorectal Surgery National Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND Epidemiologically,in China,locally advanced rectal cancer is a more common form of rectal *** neoadjuvant concurrent chemoradiotherapy can effectively reduce the size of locally invasive tumors and improve disease-free survival(DFS)and pathologic response after *** present,this modality has become the standard protocol for the treatment of locally advanced rectal cancer in many centers,but the optimal time for surgery after neoadjuvant therapy is still *** To investigate the impact of time interval between neoadjuvant therapy and surgery on DFS and pathologic response in patients with locally advanced rectal *** A total of 231 patients who were classified as having clinical stage II or III advanced rectal cancer and underwent neoadjuvant chemoradiation followed by surgery at the National cancer Center/cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from November 2014 to August 2017 were involved in this retrospective cohort *** patients were divided into two groups based on the different time intervals between neoadjuvant therapy and surgery:139(60.2%)patients were in group A(≤9 wk),and 92(39.2%)patients were in group B(>9 wk).DFS and pathologic response were analyzed as the primary *** secondary endpoints were postoperative complications and sphincter *** For the 231 patients included,surgery was performed at≤9 wk in 139(60.2%)patients and at>9 wk in 92(39.8%).The patients’clinical characteristics,surgical results,and tumor outcomes were analyzed through univariate analysis combined with multivariate regression *** overall pathologic complete response(pCR)rate was 27.2%(n=25)in the longer time interval group(>9 wk)and 10.8%(n=15)in the shorter time interval group(≤9 wk,P=0.001).The postoperative complications did not differ between the groups(group A,5%vs group B,5.4%;P=0.894).Surgical procedures for sphincter preservation were p

关键词： Interval time advanced rectal cancer Disease-free survival Pathologic complete response Neoadjuvant therapy Surgery Complication Sphincter preservation

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Relation between skeletal muscle volume and prognosis in rectal cancer patients undergoing neoadjuvant therapy

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World Journal of Gastrointestinal Oncology 2022年第2期14卷 423-433页

作者： Paola De Nardi Alessandro Giani Giulia Maggi Marco Braga Department of Gastrointestinal Surgery IRCCS San Raffaele Scientific InstituteMilano 20132Italy Department of Surgery School of MedicineUniversity of Milano-BicoccaMilan ItalyMonza 20900Italy Department of Oncologic Surgery Policlinico CasilinoRome 00169Italy Department of Surgery San Gerardo HospitalUniversity Milano BicoccaMonza 20900Italy

The prognostic role of body composition indexes,and specifically sarcopenia,has recently been explored in different cancer ***,conflicting results have been *** in cancer type,cancer stage or oncological treatments,as well as different methodology and definition of sarcopenia,could be accounted for different conclusions retrieved from *** focusing on colorectal cancer,it clearly appears that colon and rectal cancers are often treated as a single entity though they have different behaviors and ***,patients with advanced rectal cancer represent a peculiar group of patients that according to current guidelines are treated with neoadjuvant chemotherapy and radiotherapy followed by radical *** review was restricted to a homogeneous group of patients with advanced lower rectal cancer and the aim of exploring whether there is a correlation between skeletal muscle depletion and *** was searched for articles related to patients with advanced rectal cancer undergoing neoadjuvant chemo-radiotherapy(NCRT)followed by radical surgery,in whom muscle mass and/or change in muscle mass during neoadjuvant treatment were *** full-text articles were selected and included in the present *** main findings of our review were:(1)The majority of the studies defined sarcopenia as muscle mass alone over muscle strength or physical performance;(2)There was a great deal of heterogeneity in the definition and measures of sarcopenia,in the definition of cut-off values,and in the method to measure change in muscle mass;(3)There was not full agreement on the association between sarcopenia at baseline and/or after chemoradiotherapy and prognosis,and only few studies found a significance in the multivariate analysis;and(4)It seems that a loss in skeletal muscle mass during NCRT is associated with the worst outcomes in terms of disease-free *** conclusion,analysis of muscle mass might provid

关键词： advanced rectal cancer Sarcopenia Neoadjuvant treatment Chemoradiotherapy Surgery Muscle mass change Prognosis Survival Review

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