Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Colorectal Cancer Reports
Published in: Current Colorectal Cancer Reports 2/2013

01-06-2013 | Localized Rectal Cancer (R Glynne-Jones, Section Editor)

Is There a Role for Neoadjuvant Chemotherapy Without Radiotherapy in Locally Advanced Rectal Cancer?

Authors: Andrea Cercek, Karyn A. Goodman

Published in: Current Colorectal Cancer Reports | Issue 2/2013

Login to get access

Abstract

The treatment paradigm for locally advanced rectal cancer is multidisciplinary and includes chemoradiotherapy and surgery followed by adjuvant chemotherapy. This review discusses the rationale behind multimodality treatment, the role of radiotherapy, and the potential for its omission in selected patients in the future.
Literature
1.
NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA. 1990;264:1444–50.CrossRef
2.
Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351:1731–40.PubMedCrossRef
3.
Roh M, Yothers G, O'Connell M, et al. The impact of capecitabine and oxaliplatin in the preoperative multimodality treatment in patients with carcinoma of the rectum: NSABP R-04. J Clin Oncol. 2011;29(15 Suppl):3503.
4.
Gastrointestinal Tumor Study Group. Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med. 1985;312:1465–72.CrossRef
5.
Fisher B, Wolmark N, Rockette H, et al. Postoperative adjuvant chemotherapy or radiation therapy for rectal cancer: results from NSABP protocol R-01. J Natl Cancer Inst. 1988;80:21–9.PubMedCrossRef
6.
Kapiteijn E, Marijnen CA, Nagtegaal ID, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med. 2001;345:638–46.PubMedCrossRef
7.
Peeters KC, Marijnen CA, Nagtegaal ID, et al. The TME trial after a median follow-up of 6 years: Increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma. Ann Surg. 2007;246:693–701.PubMedCrossRef
8.
van Gijn W, Marijnen CA, Nagtegaal ID, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol. 2011;12:575–82.PubMedCrossRef
9.
Sebag-Montefiore D, Stephens RJ, Steele R, et al. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): A multicentre, randomised trial. Lancet. 2009;373:811–20.PubMedCrossRef
10.
Roh MS, Colangelo LH, O'Connell MJ, et al. Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03. J Clin Oncol. 2009;27:5124–30.PubMedCrossRef
11.
Matzel KE, Bittorf B, Gunther K, et al. Rectal resection with low anastomosis: Functional outcome. Colorectal Dis. 2003;5:458–64.PubMedCrossRef
12.
Paty PB, Enker WE, Cohen AM, et al. Treatment of rectal cancer by low anterior resection with coloanal anastomosis. Ann Surg. 1994;219:365–73.PubMedCrossRef
13.
Shibata D, Guillem JG, Lanouette N, et al. Functional and quality-of-life outcomes in patients with rectal cancer after combined modality therapy, intraoperative radiation therapy, and sphincter preservation. Dis Colon Rectum. 2000;43:752–8.PubMedCrossRef
14.
Temple LK, Wong WD, Minsky B. The impact of radiation on functional outcomes in patients with rectal cancer and sphincter preservation. Semin Radiat Oncol. 2003;13:469–77.PubMedCrossRef
15.
Minsky BD, Conti JA, Huang Y, et al. Relationship of acute gastrointestinal toxicity and the volume of irradiated small bowel in patients receiving combined modality therapy for rectal cancer. J Clin Oncol. 1995;13:1409–16.PubMed
16.
Gerard JP, Conroy T, Bonnetain F, et al. Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. J Clin Oncol. 2006;24:4620–5.PubMedCrossRef
17.
Fernández-Martos C, Pericay C, Aparicio J, et al. Phase II, randomized study of concomitant chemoradiotherapy followed by surgery and adjuvant capecitabine plus oxaliplatin (CAPOX) compared with induction CAPOX followed by concomitant chemoradiotherapy and surgery in magnetic resonance imaging-defined, locally advanced rectal cancer: Grupo Cancer de Recto 3 study. J Clin Oncol. 2010;28:859–65.PubMedCrossRef
18.
Bosset JF, Collette L, Calais G, et al. Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med. 2006;355:1114–23.PubMedCrossRef
19.
Land SR, Ritter MW, Costantino JP, et al. Compliance with patient-reported outcomes in multicenter clinical trials: methodologic and practical approaches. J Clin Oncol. 2007;25:5113–20.PubMedCrossRef
20.
Grothey A, Sargent D, Goldberg RM, et al. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. J Clin Oncol. 2004;22:1209–14.PubMedCrossRef
21.
Goldberg RM, Sargent DJ, Morton RF, et al. A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol. 2004;22:23–30.PubMedCrossRef
22.
Andre T, Boni C, Mounedji-Boudiaf L, et al. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med. 2004;350:2343–51.PubMedCrossRef
23.
Cercek A, Weiser M, Goodman K, et al. Complete pathologic response in the primary of rectal or colon cancer treated with FOLFOX without radiation. J Clin Oncol. 2010;28(15 Suppl):3649.
24.
• Schrag D, Weiser M, Goodman K, et al. Neoadjuvant FOLFOX-bev, without radiation, for locally advanced rectal cancer. J Clin Oncol. 2010;28(15):3511. This pilot study, published currently in abstract form only, was the first to demonstrate the potential for omission of radiotherapy in selected patients with locally advanced cancer and has led to a large multicenter trial, the PROSPECT study, which is ongoing.
25.
Fernandez-Martos C, Safont M, Feliu C, et al. Induction chemotherapy with or without chemoradiation in intermediate-risk rectal cancer patients defined by magnetic resonance imaging (MRI): a GEMCAD study. J Clin Oncol. 2010;28(15 Suppl), TPS196.
Metadata
Title
Is There a Role for Neoadjuvant Chemotherapy Without Radiotherapy in Locally Advanced Rectal Cancer?
Authors
Andrea Cercek
Karyn A. Goodman
Publication date
01-06-2013
Publisher
Current Science Inc.
Published in
Current Colorectal Cancer Reports / Issue 2/2013
Print ISSN: 1556-3790
Electronic ISSN: 1556-3804
DOI
https://doi.org/10.1007/s11888-013-0171-8

Other articles of this Issue 2/2013

Current Colorectal Cancer Reports 2/2013 Go to the issue

Localized Rectal Cancer (R Glynne-Jones, Section Editor)

How Could the TNM System Be Best Adapted for Staging Rectal Cancer in the Future?

Colorectal Cancer Hepatic Metastases (KK Tanabe, Section Editor)

The ALPPS Approach for the Management of Colorectal Carcinoma Liver Metastases

Colorectal Cancer Hepatic Metastases (KK Tanabe, Section Editor)

Safety of Simultaneous Bowel and Liver Resections for Colon and Rectal Cancer

Colorectal Cancer Hepatic Metastases (KK Tanabe, Section Editor)

Irreversible Electroporation: a Novel Option for Treatment of Hepatic Metastases

Localized Rectal Cancer (R Glynne-Jones, Section Editor)

Quality of Life and Functions After Chemoradiation for Rectal Cancer: A Review of Recent Publications

Localized Rectal Cancer (R Glynne-Jones, Section Editor)

Colorectal Cancer in the Elderly: How Do We Tailor Treatment with Chemotherapy and Radiotherapy Most Appropriately?
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits