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1. O'Neill B, Brown G, Wotherspoon A, Burton S, Norman A, Tait D: Successful downstaging of high rectal and recto-sigmoid cancer by neo-adjuvant chemo-radiotherapy. Clin Med Oncol; 2008;2:135-44
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Successful downstaging of high rectal and recto-sigmoid cancer by neo-adjuvant chemo-radiotherapy.
  • The purpose of this study is to demonstrate the feasibility and downstaging of treating locally advanced tumours from high rectum to distal sigmoid with preoperative chemoradiotherapy (CRT).
  • METHODS AND MATERIALS: Seventeen patients with high rectal, rectosigmoid or distal sigmoid tumours above the peritoneal reflection received neoadjuvant CRT, selected on MRI findings indicating T4 disease or threatened circumferential resection margin.
  • Nine patients (52.9%) lowered pathologic disease AJCC stage, i.e. 'downstaged'.
  • One patient suffered a grade III acute toxicity, but no grade IV (RTOG).
  • There were 3 grade III and 3 grade IV late toxicities (LENT-SOMA).
  • CONCLUSIONS: Locally advanced high rectal and recto-sigmoid tumours may be treated with pre-operative CRT with acceptable toxicity, impressive down-staging, and clear surgical margins.

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  • (PMID = 21892276.001).
  • [ISSN] 1177-9314
  • [Journal-full-title] Clinical medicine. Oncology
  • [ISO-abbreviation] Clin Med Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] New Zealand
  • [Other-IDs] NLM/ PMC3161699
  • [Keywords] NOTNLM ; chemoradiotherapy / chemotherapy / downstaging / radiotherapy / total mesorectal excision
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2. Yi SK, Yoder M, Zaner K, Hirsch AE: Palliative radiation therapy of symptomatic recurrent bladder cancer. Pain Physician; 2007 Mar;10(2):285-90
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  • [Title] Palliative radiation therapy of symptomatic recurrent bladder cancer.
  • RT is effective at palliating both locally advanced and metastatic cancer, including related symptoms of pain, bleeding, or obstruction.
  • There are also data that support RT palliation for locally advanced or recurrent rectal, prostate, and gynecological cancers.
  • With regard to bladder cancer there is some evidence of the benefit of palliative RT for the control of urinary symptoms and hematuria; however, there is little evidence for the use of palliative RT for pain associated with locally recurrent bladder cancer.
  • We report a case of locally advanced recurrent bladder cancer which was refractory to medical pain management, and was found to be highly responsive to palliative RT.
  • CASE REPORT: An 80-year-old woman with recurrent bladder cancer and intractable pelvic pain refractory to oral and transdermal pain medications, received palliative pelvic RT to a dose of 50 Gy (5000 cGy) in 25 fractions with complete resolution of pain.
  • The patient was originally found to have dysuria, frequency, and hematuria, secondary to an invasive high grade transitional cell carcinoma of the bladder with an adenocarcinoma component, AJCC pT2b N1 M0 Stage IV, for which she underwent a radical cystectomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, partial vaginectomy, and ileal conduit reconstruction.
  • Repeat staging CT of the abdomen and pelvis confirmed tumor recurrence in the left pelvis.
  • CONCLUSIONS: Palliative radiation therapy has been well studied in the setting of bone metastases and treatment of hematuria for locally advanced bladder cancer.
  • There is little data that we are aware of on the use of RT for pain control with patients that have recurrent, locally advanced bladder cancer.
  • RT is an excellent option for pain management in recurrent bladder cancer and should be offered to patients whose pain is not otherwise optimally controlled.
  • Palliative RT is an important component in the multimodality approach to cancer pain management and optimization of quality of life.

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  • (PMID = 17387350.001).
  • [ISSN] 1533-3159
  • [Journal-full-title] Pain physician
  • [ISO-abbreviation] Pain Physician
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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3. Rades D, Kuhn H, Schultze J, Homann N, Brandenburg B, Schulte R, Krull A, Schild SE, Dunst J: Prognostic factors affecting locally recurrent rectal cancer and clinical significance of hemoglobin. Int J Radiat Oncol Biol Phys; 2008 Mar 15;70(4):1087-93
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic factors affecting locally recurrent rectal cancer and clinical significance of hemoglobin.
  • PURPOSE: To investigate potential prognostic factors, including hemoglobin levels before and during radiotherapy, for associations with survival and local control in patients with unirradiated locally recurrent rectal cancer.
  • PATIENTS AND METHODS: Ten potential prognostic factors were investigated in 94 patients receiving radiotherapy for recurrent rectal cancer: age (<or=68 vs. >or=69 years), gender, Eastern Cooperative Oncology Group performance status (0-1 vs. 2-3), American Joint Committee on Cancer (AJCC) stage (<or=II vs. III vs. IV), grading (G1-2 vs. G3), surgery, administration of chemotherapy, radiation dose (equivalent dose in 2-Gy fractions: <or=50 vs. >50 Gy), and hemoglobin levels before (<12 vs. >or=12 g/dL) and during (majority of levels: <12 vs. >or=12 g/dL) radiotherapy.
  • RESULTS: Improved survival was associated with better performance status (p<0.001), lower AJCC stage (p=0.023), surgery (p=0.011), chemotherapy (p=0.003), and hemoglobin levels>or=12 g/dL both before (p=0.031) and during (p<0.001) radiotherapy.
  • On multivariate analyses, performance status, AJCC stage, and hemoglobin levels during radiotherapy maintained significance.
  • Improved local control was associated with better performance status (p=0.040), lower AJCC stage (p=0.010), lower grading (p=0.012), surgery (p<0.001), chemotherapy (p<0.001), and hemoglobin levels>or=12 g/dL before (p<0.001) and during (p<0.001) radiotherapy.
  • CONCLUSION: Predictors for outcome in patients who received radiotherapy for locally recurrent rectal cancer were performance status, AJCC stage, chemotherapy, surgery, extent of resection, histologic grading, and hemoglobin levels both before and during radiotherapy.
  • [MeSH-major] Hemoglobins / analysis. Neoplasm Recurrence, Local. Rectal Neoplasms
  • [MeSH-minor] Aged. Female. Follow-Up Studies. Humans. Male. Multivariate Analysis. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Severity of Illness Index. Sex Factors

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  • (PMID = 17892921.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hemoglobins
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4. Rottoli M, Bona S, Rosati R, Elmore U, Bianchi PP, Spinelli A, Bartolucci C, Montorsi M: Laparoscopic rectal resection for cancer: effects of conversion on short-term outcome and survival. Ann Surg Oncol; 2009 May;16(5):1279-86
Genetic Alliance. consumer health - Rectal Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic rectal resection for cancer: effects of conversion on short-term outcome and survival.
  • BACKGROUND: Laparoscopic rectal resection (LRR) is an oncologically safe procedure.
  • No differences in age, gender, American Society of Anesthesiologists (ASA) score, and T and N stages were observed between CR and NCR patients.
  • Conversion was associated with higher body mass index (BMI) (27.3 versus 24.9 kg/m(2), P < 0.001) and American Joint Committee on Cancer (AJCC) stage IV (26.9% versus 4.8%, P < 0.001), and resulted in longer operative time (342 versus 285 min, P = 0.006) and increased intraoperative complication rate (31% versus 5%, P < 0.001).
  • After exclusion of stage IV patients from the analysis, 5-year disease-free survival was 71.1% in CR group and 85.3% in NCR group (P = 0.17), while the overall recurrence rate was 26.3% in CR patients and 11.4% in NCR patients (P = 0.07).
  • [MeSH-major] Colectomy / mortality. Rectal Neoplasms / surgery

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  • (PMID = 19252948.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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5. Chan AK, Wong A, Jenken D, Heine J, Buie D, Johnson D: Posttreatment TNM staging is a prognostic indicator of survival and recurrence in tethered or fixed rectal carcinoma after preoperative chemotherapy and radiotherapy. Int J Radiat Oncol Biol Phys; 2005 Mar 1;61(3):665-77
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Posttreatment TNM staging is a prognostic indicator of survival and recurrence in tethered or fixed rectal carcinoma after preoperative chemotherapy and radiotherapy.
  • PURPOSE: To evaluate the prognostic value of the posttreatment TNM stage as a predictor of outcome in locally advanced rectal cancers treated with preoperative chemotherapy and radiotherapy.
  • METHODS AND MATERIALS: Between 1993 and 2000, 128 patients with tethered (103) or fixed (25) rectal cancers were treated with 50 Gy preoperative pelvic radiotherapy and two cycles of concurrent 5-fluorouracil infusion (20 mg/kg/d) and leucovorin (200 mg/m(2)/d) chemotherapy on Days 1-4 and 22-25 and a single bolus mitomycin C injection (8 mg/m(2)) on Day 1.
  • Of the 128 patients, 111 had Stage T3 and 17 Stage T4 according to the rectal ultrasound or CT findings and clinical evaluation.
  • Postoperatively, the disease stage was determined according to the surgical and pathologic findings using the American Joint Committee on Cancer TNM staging system.
  • RESULTS: Of the 128 patients, 32 had postchemoradiotherapy (pCR) Stage 0 (T0N0M0), 37 pCR Stage I, 26 pCR Stage II, 28 pCR Stage III, and 5 pCR Stage IV disease.
  • Of the 128 patients, 79 had pCR Stage T0-T2, 35 pCR Stage T3, and 14 pCR Stage T4.
  • The rate of T stage downstaging was 66% (84 of 128).
  • The 5-year disease-specific survival rate was 97% for pCR Stage 0, 88% for pCR Stage I, 74% for pCR Stage II, 44% for pCR Stage III, and 0% for pCR Stage IV (p = 0.0000059).
  • The 5-year relapse-free survival rate was 97% for pCR Stage 0, 80% for pCR Stage I, 72% for pCR Stage II, 42% for pCR Stage III, and 0% for pCR Stage IV (p < 0.000001).
  • In univariate analysis, the pretreatment tumor status (fixed vs. tethered tumors), the pCR TNM stage, T stage downstaging, pathologic T4 tumors, node-positive disease after chemoradiotherapy, and lymphovascular or perineural invasion were statistically significant prognosticators of disease-specific survival and relapse-free survival. pCR Stage T4 disease was a strong predictor of local recurrence.
  • In multivariate analysis, the pCR TNM stage was the most statistically significant independent predictor of survival (p = 0.003) and relapse-free survival (p < 0.001).
  • CONCLUSION: For patients who underwent preoperative chemoradiotherapy for locally advanced rectal cancer, the pCR TNM stage was a strong prognosticator of recurrence and survival.
  • [MeSH-major] Neoplasm Staging / methods. Rectal Neoplasms / pathology

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  • (PMID = 15708244.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 50SG953SK6 / Mitomycin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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