Current Controversies in Neoadjuvant Chemoradiation of Rectal Cancer

Surgical Oncology Clinics of North America

Volumn 23, Issue 1, 2014, Pages 79-92

  Phang, P Terry ^a   Wang, Xiaodong ^b  

^a UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^b SICHUAN UNIVERSITY   (China)

Author keywords

Complete pathologic response; Long course; Neo adjuvant chemoradiation; Rectal cancer; Short course

Indexed keywords

ANTINEOPLASTIC AGENT; BEVACIZUMAB; CAPECITABINE; CETUXIMAB; FLUOROURACIL; FOLINIC ACID; IRINOTECAN; LEVAMISOLE; OXALIPLATIN; SEMUSTINE;

ADJUVANT CHEMORADIOTHERAPY; CANCER PROGNOSIS; CANCER RECURRENCE; CANCER STAGING; CANCER SURVIVAL; CLINICAL EFFECTIVENESS; DIARRHEA; DISEASE FREE SURVIVAL; DRUG EFFICACY; DRUG POTENTIATION; DRUG RESPONSE; ENDOSCOPIC SURGERY; HUMAN; INTENSITY MODULATED RADIATION THERAPY; LEUKOPENIA; MICROSURGERY; NAUSEA; NUCLEAR MAGNETIC RESONANCE IMAGING; OVERALL SURVIVAL; POSTOPERATIVE CARE; PREOPERATIVE CARE; RADIATION INJURY; RECTUM CANCER; RECTUM RESECTION; REVIEW; STOMATITIS; THROMBOCYTOPENIA; TREATMENT DURATION; TREATMENT OUTCOME; UNSPECIFIED SIDE EFFECT; VOMITING;

COMPLETE PATHOLOGIC RESPONSE; LONG COURSE; NEO-ADJUVANT CHEMORADIATION; RECTAL CANCER; SHORT COURSE;

CHEMORADIOTHERAPY; HUMANS; NEOADJUVANT THERAPY; PROGNOSIS; RECTAL NEOPLASMS; RISK FACTORS;

EID: 84888388485     PISSN: 10553207     EISSN: 15585042     Source Type: Journal    
DOI: 10.1016/j.soc.2013.09.008     Document Type: Review

References (85)

1. Krook J.E., Moertel C.G., Gunderson L.L., et al. Effective surgical adjuvant therapy for high risk rectal carcinoma. NEngl J Med 1991, 324:709-715.
2. Gastrointestinal Tumor Study Group. Prolongation of disease free interval in surgically treated rectal carcinoma. NEngl J Med 1985, 312:1465-1472.
3. Fisher B., Wolmark N., Rockette H., et al. Postoperative adjuvant chemotherapy or radiation therapy for rectal cancer: results from NSABP protocol R-01. JNatl Cancer Inst 1988, 80:21-29.
4. NIH consensus conference on adjuvant therapy for patients with colon and rectal cancer. JAMA 1990, 264:1444-1450.
5. Heald R.J., Ryall R.D. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1986, 1:1479-1482.
6. MacFarlane J.K., Ryall R.D., Heald R.J. Mesorectal excision for rectal cancer. Lancet 1993, 341(8843):457-460.
7. Swedish Rectal Cancer Trial. Improved survival with preoperative radiotherapy in resectable rectal cancer. NEngl J Med 1997, 336(14):980-987.
8. Kapiteijn E., Marijnen C.A., Nagtegaal I.D., Dutch Colorectal Cancer Group, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. NEngl J Med 2001, 345(9):638-646.
9. Wibe A., Møller B., Norstein J., Norwegian Rectal Cancer Group, et al. Anational strategic change in treatment policy for rectal cancer-implementation of total mesorectal excision as routine treatment in Norway. A national audit. Dis Colon Rectum 2002, 45(7):857-866.
10. Bülow S., Harling H., Iversen L.H., Danish Colorectal Cancer Group, et al. Improved survival after rectal cancer in Denmark. Colorectal Dis 2010, 12(7 Online):e37-e42. 10.1111/j.1463-1318.2009.02012.x.
11. Birgisson H., Talbäck M., Gunnarsson U., et al. Improved survival in cancer of the colon and rectum in Sweden. Eur J Surg Oncol 2005, 31(8):845-853.
12. Phang P.T., McGahan C.E., McGregor G., et al. Effects of change in rectal cancer management on outcomes in British Columbia. Can J Surg 2010, 53:225-231.
13. Sauer R., Becker H., Hohenberger W., German Rectal Cancer Study Group, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. NEngl J Med 2004, 351:1731-1740.
14. Park J.H., Kim J.H., Ahn S.D., et al. Prospective phase II study of preoperative chemoradiation with capecitabine in locally advanced rectal cancer. Cancer Res Treat 2004, 36(6):354-359. 10.4143/crt.2004.36.6.354.
15. Roh M.S., Colangelo L.H., O'Connell M.J., et al. Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03. JClin Oncol 2009, 27(31):5124-5130. 10.1200/JCO.2009.22.0467.
16. Bujko K., Nowacki M.P., Nasierowska-Guttmejer A., et al. Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg 2006, 93:1215-1223.
17. Ngan S.Y., Burmeister B., Fisher R.J., et al. Randomized trial of short-course radiotherapy versus long-course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer: Trans-Tasman Radiation Oncology Group trial 01.04. JClin Oncol 2012, 30(31):3827-3833. [Erratum in J Clin Oncol 2013 Jan 20;31(3):399]. 10.1200/JCO.2012.42.9597.
18. Bujko K., Nowacki M.P., Nasierowska-Guttmejer A., et al. Sphincter preservation following preoperative radiotherapy for rectal cancer: report of a randomised trial comparing short-term radiotherapy vs. conventionally fractionated radiochemotherapy. Radiother Oncol 2004, 72:15-24.
19. Glimelius B., Påhlman L. Preoperative radiotherapy for rectal cancer: hypofractionation with multiple fractions (15-25 Gy). Ann Ital Chir 2001, 72(5):539-547.
20. Frykholm G.J., Isacsson U., Nygård K., et al. Preoperative radiotherapy in rectal carcinoma-aspects of acute adverse effects and radiation technique. Int J Radiat Oncol Biol Phys 1996, 35(5):1039-1048.
21. Duthoy W., De Gersem W., Vergote K., et al. Clinical implementation of intensity-modulated arc therapy (IMAT) for rectal cancer. Int J Radiat Oncol Biol Phys 2004, 60(3):794-806.
22. Jones W.E., Thomas C.R., Herman J.M., et al. ACR appropriateness criteria® resectable rectal cancer. Radiat Oncol 2012, 7:161. 10.1186/1748-717X-7-161.
23. Gevaert T., Engels B., Garibaldi C., et al. Implementation of HybridArc treatment technique in preoperative radiotherapy of rectal cancer: dose patterns in target lesions and organs at risk as compared to helical Tomotherapy and RapidArc. Radiat Oncol 2012, 7:120.
24. Mok H., Crane C.H., Palmer M.B., et al. Intensity modulated radiation therapy (IMRT): differences in target volumes and improvement in clinically relevant doses to small bowel in rectal carcinoma. Radiat Oncol 2011, 6:63. 10.1186/1748-717X-6-63.
25. Garofalo M., Moughan J., Hong T., et al. RTOG 0822: a phase II study of preoperative (PREOP) chemoradiotherapy (CRT) utilizing IMRT in combination with capecitabine (C) and oxaliplatin (O) for patients with locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 2011, 81(Suppl 2):S3-S4.
26. Peeters K.C., van de Velde C.J., Leer J.W., et al. Late side effects of short-course preoperative radiotherapy combined with total mesorectal excision for rectal cancer: increased bowel dysfunction in irradiated patients-a Dutch Colorectal Cancer Group Study. JClin Oncol 2005, 23(25):6199-6206.
27. Marijnen C.A., van de Velde C.J., Putter H., et al. Impact of short-term preoperative radiotherapy on health-related quality of life and sexual functioning in primary rectal cancer: report of a multicenter randomized trial. JClin Oncol 2005, 23(9):1847-1858.
28. Gastrointestinal Tumor Study Group. Radiation therapy and fluorouracil with or without semustine for the treatment of patients with surgical adjuvant adenocarcinoma of the rectum. JClin Oncol 1992, 10(4):549-557.
29. Moertel C.G., Fleming T.R., Macdonald J.S., et al. Levamisole and fluorouracil for adjuvant therapy of resected colon cancer. NEngl J Med 1990, 322:352-358.
30. Gerard J.P., Chapet O., Nemoz C., et al. Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. JClin Oncol 2006, 24(28):4620-4625. 10.1200/JCO.2006.06.7629.
31. Bosset J.F., Collette L., Calais G., et al. Chemotherapy with preoperative radiotherapy in rectal cancer. NEngl J Med 2006, 355:1114-1123.
32. De Paoli A., Chiara S., Luppi G., et al. Capecitabine in combination with preoperative radiation therapy in locally advanced, resectable, rectal cancer: a multicentric phase II study. Ann Oncol 2006, 17(2):246-251.
33. Hofheinz R.D., Wenz F., Post S., et al. Chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer: a randomised, multicentre, non-inferiority, phase 3 trial. Lancet Oncol 2012, 13(6):579-588. 10.1016/S1470-2045(12)70116-X.
34. Wong S.J., Winter K., Meropol N.J., et al. Radiation Therapy Oncology Group 0247: a randomized Phase II study of neoadjuvant capecitabine and irinotecan or capecitabine and oxaliplatin with concurrent radiotherapy for patients with locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 2012, 82(4):1367-1375. 10.1016/j.ijrobp.2011.05.027.
35. Gérard J.P., Azria D., Gourgou-Bourgade S., et al. Comparison of two neoadjuvant chemoradiotherapy regimens for locally advanced rectal cancer: results of the phase III trial ACCORD 12/0405-Prodige 2. JClin Oncol 2010, 28(10):1638-1644.
36. Mohiuddin M., Winter K., Mitchell E., et al. Randomized phase II study of neoadjuvant combined-modality chemoradiation for distal rectal cancer: Radiation Therapy Oncology Group Trial 0012. JClin Oncol 2006, 24(4):650-655.
37. Gollins S., Sun Myint A., Haylock B., et al. Preoperative chemoradiotherapy using concurrent capecitabine and irinotecan in magnetic resonance imaging-defined locally advanced rectal cancer: impact on long-term clinical outcomes. JClin Oncol 2011, 29(8):1042-1049. 10.1200/JCO.2010.29.7697.
38. Crane C.H., Eng C., Feig B.W., et al. Phase II trial of neoadjuvant bevacizumab, capecitabine, and radiotherapy for locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 2010, 76(3):824-830. 10.1016/j.ijrobp.2009.02.037.
39. Weiss C., Arnold D., Dellas K., et al. Preoperative radiotherapy of advanced rectal cancer with capecitabine and oxaliplatin with or without cetuximab: a pooled analysis of three prospective phase I-II trials. Int J Radiat Oncol Biol Phys 2010, 78(2):472-478. 10.1016/j.ijrobp.2009.07.1718.
40. Glynne-Jones R., Mawdsley S., Harrison M. Cetuximab and chemoradiation for rectal cancer-is the water getting muddy?. Acta Oncol 2010, 49(3):278-286. 10.3109/02841860903536010.
41. Marijnen C.A., Nagtegaal I.D., Klein Kranenbarg E., Pathology Review Committee and the Cooperative Clinical Investigators, et al. No downstaging after short-term preoperative radiotherapy in rectal cancer patients. JClin Oncol 2001, 19:1976-1984.
42. Graf W., Dahlberg M., Osman M.M., et al. Short-term preoperative radiotherapy results in down-staging of rectal cancer: a study of 1316 patients. Radiother Oncol 1997, 43(2):133-137.
43. Latkauskas T., Pauzas H., Gineikiene I., et al. Initial results of a randomized controlled trial comparing clinical and pathological downstaging of rectal cancer after preoperative short-course radiotherapy or long-term chemoradiotherapy, both with delayed surgery. Colorectal Dis 2012, 14(3):294-298. 10.1111/j.1463-1318.2011.02815.x.
44. Latkauskas T., Paskauskas S., Dambrauskas Z., et al. Preoperative chemoradiation vs radiation alone for stage II and III resectable rectal cancer: a meta-analysis. Colorectal Dis 2010, 12(11):1075-1083. 10.1111/j.1463-1318.2009.02015.x.
45. Pettersson D., Cedermark B., Holm T., et al. Interim analysis of the Stockholm III trial of preoperative radiotherapy regimens for rectal cancer. Br J Surg 2010, 97(4):580-587. 10.1002/bjs.6914.
46. Rödel C., Martus P., Papadoupolos T., et al. Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer. JClin Oncol 2005, 23(34):8688-8696.
47. Capirci C., Valentini V., Cionini L., et al. Prognostic value of pathologic complete response after neoadjuvant therapy in locally advanced rectal cancer: long-term analysis of 566 ypCR patients. Int J Radiat Oncol Biol Phys 2008, 72(1):99-107. 10.1016/j.ijrobp.2007.12.019.
48. Maas M., Nelemans P.J., Valentini V., et al. Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data. Lancet Oncol 2010, 11(9):835-844. 10.1016/S1470-2045(10)70172-8.
49. Habr-Gama A., Perez R.O., Nadalin W., et al. Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results. Ann Surg 2004, 240(4):711-717. [discussion: 717-8].
50. Habr-Gama A., Perez R., Proscurshim I., et al. Complete clinical response after neoadjuvant chemoradiation for distal rectal cancer. Surg Oncol Clin N Am 2010, 19(4):829-845. 10.1016/j.soc.2010.08.001.
51. Smith F.M., Chang K.H., Sheahan K., et al. The surgical significance of residual mucosal abnormalities in rectal cancer following neoadjuvant chemoradiotherapy. Br J Surg 2012, 99(7):993-1001. 10.1002/bjs. 8700.
52. Glynne-Jones R., Hughes R. Critical appraisal of the 'wait and see' approach in rectal cancer for clinical complete responders after chemoradiation. Br J Surg 2012, 99(7):897-909. 10.1002/bjs. 8732.
53. Habr-Gama A., Perez R.O., Sabbaga J., et al. Increasing the rates of complete response to neoadjuvant chemoradiotherapy for distal rectal cancer: results of a prospective study using additional chemotherapy during the resting period. Dis Colon Rectum 2009, 52(12):1927-1934. 10.1007/DCR.0b013e3181ba14ed.
54. Rödel C., Arnold D., Becker H., et al. Induction chemotherapy before chemoradiotherapy and surgery for locally advanced rectal cancer: is it time for a randomized phase III trial?. Strahlenther Onkol 2010, 186(12):658-664. 10.1007/s00066-010-2194-2.
55. NCCN guidelines. Available at: http://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf.
56. NIH/NCI guidelines. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/rectal/Patient/page4.
57. Peeters K.C., Marijnen C.A., Nagtegaal I.D., Dutch Colorectal Cancer Group, 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(5):693-701.
58. Sebag-Montefiore D., Stephens R.J., Steele R., on behalf of all the trial collaborators, 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(9666):811-820. 10.1016/S0140-6736(09)60484-0.
59. Merchant N.B., Guillem J.G., Paty P.B., et al. T3N0 rectal cancer: results following sharp mesorectal excision and no adjuvant therapy. JGastrointest Surg 1999, 3(6):642-647.
60. Picon A.I., Moore H.G., Sternberg S.S., et al. Prognostic significance of depth of gross or microscopic perirectal fat invasion in T3 N0 M0 rectal cancers following sharp mesorectal excision and no adjuvant therapy. Int J Colorectal Dis 2003, 18(6):487-492.
61. Willett C.G., Badizadegan K., Ancukiewicz M., et al. Prognostic factors in stage T3N0 rectal cancer: do all patients require postoperative pelvic irradiation and chemotherapy?. Dis Colon Rectum 1999, 42(2):167-173.
62. Gunderson L.L., Sargent D.J., Tepper J.E., et al. Impact of T and N substage on survival and disease relapse in adjuvant rectal cancer: a pooled analysis. Int J Radiat Oncol Biol Phys 2002, 54(2):386-396.
63. Guillem J.G., Díaz-González J.A., Minsky B.D., et al. cT3N0 rectal cancer: potential overtreatment with preoperative chemoradiotherapy is warranted. JClin Oncol 2008, 26(3):368-373. 10.1200/JCO.2007.13.5434.
64. Lombardi R., Cuicchi D., Pinto C., et al. Clinically-staged T3N0 rectal cancer: is preoperative chemoradiotherapy the optimal treatment?. Ann Surg Oncol 2010, 17(3):838-845. 10.1245/s10434-009-0796-7.
65. Heald R.J., O'Neill B.D., Moran B., et al. MRI in predicting curative resection of rectal cancer: new dilemma in multidisciplinary team management. BMJ 2006, 333(7572):808. 10.1136/bmj.333.7572.808.
66. Taylor F.G., Quirke P., Heald R.J., MERCURY study group, et al. Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study. Ann Surg 2011, 253(4):711-719. 10.1097/SLA.0b013e31820b8d52.
67. Benson R., Wong C.S., Cummings B.J., et al. Local excision and postoperative radiotherapy for distal rectal cancer. Int J Radiat Oncol Biol Phys 2001, 50(5):1309-1316. 10.1016/S0360-3016(01)01545-0.
68. Chakravarti A., Compton C.C., Shellito P.C., et al. Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation. Ann Surg 1999, 230(1):49-54. 10.1097/00000658-199907000-00008.
69. Mendenhall W.M., Morris C.G., Rout W.R., et al. Local excision and postoperative radiation therapy for rectal adenocarcinoma. Int J Cancer 2001, (Suppl 96):89-96.
70. Greenberg J.A., Shibata D., Herndon J.E., et al. Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984. Dis Colon Rectum 2008, 51(8):1185-1191. [discussion: 1191-4]. 10.1007/s10350-008-9231-6.
71. Borschitz T., Wachtlin D., Möhler M., et al. Neoadjuvant chemoradiation and local excision for T2-3 rectal cancer. Ann Surg Oncol 2008, 15(3):712-720.
72. Bonnen M., Crane C., Vauthey J.N., et al. Long-term results using local excision after preoperative chemoradiation among selected T3 rectal cancer patients. Int J Radiat Oncol Biol Phys 2004, 60(4):1098-1105.
73. Belluco C., De Paoli A., Canzonieri V., et al. Long-term outcome of patients with complete pathologic response after neoadjuvant chemoradiation for cT3 rectal cancer: implications for local excision surgical strategies. Ann Surg Oncol 2011, 18(13):3686-3693. 10.1245/s10434-011-1822-0.
74. Marks J.H., Valsdottir E.B., DeNittis A., et al. Transanal endoscopic microsurgery for the treatment of rectal cancer: comparison of wound complication rates with and without neoadjuvant radiation therapy. Surg Endosc 2009, 23(5):1081-1087. 10.1007/s00464-009-0326-5.
75. Perez R.O., Habr-Gama A., São Julião G.P., et al. Transanal endoscopic microsurgery for residual rectal cancer after neoadjuvant chemoradiation therapy is associated with significant immediate pain and hospital readmission rates. Dis Colon Rectum 2011, 54(5):545-551. 10.1007/DCR.0b013e3182083b84.
76. Callender G.G., Das P., Rodriguez-Bigas M.A., et al. Local excision after preoperative chemoradiation results in an equivalent outcome to total mesorectal excision in selected patients with T3 rectal cancer. Ann Surg Oncol 2010, 17(2):441-447. 10.1245/s10434-009-0735-7.
77. Bökkerink G.M., de Graaf E.J., Punt C.J., et al. The CARTS study: chemoradiation therapy for rectal cancer in the distal rectum followed by organ-sparing transanal endoscopic microsurgery. BMC Surg 2011, 11:34. 10.1186/1471-2482-11-34.
78. Mendenhall W.M., Rout W.R., Vauthey J.N., et al. Conservative treatment of rectal adenocarcinoma with endocavitary irradiation or wide local excision and postoperative irradiation. JClin Oncol 1997, 15(10):3241-3248.
79. Coatmeur O., Truc G., Barillot I., et al. Treatment of T1-T2 rectal tumors by contact therapy and interstitial brachytherapy. Radiother Oncol 2004, 70(2):177-182.
80. Christoforidis D., McNally M.P., Jarosek S.L., et al. Endocavitary contact radiation therapy for ultrasonographically staged T1 N0 and T2 N0 rectal cancer. Br J Surg 2009, 96(4):430-436. 10.1002/bjs.6478.
81. Lavertu S., Schild S.E., Gunderson L.L., et al. Endocavitary radiation therapy for rectal adenocarcinoma: 10-year results. Am J Clin Oncol 2003, 26(5):508-512.
82. Aumock A., Birnbaum E.H., Fleshman J.W., et al. Treatment of rectal adenocarcinoma with endocavitary and external beam radiotherapy: results for 199 patients with localized tumors. Int J Radiat Oncol Biol Phys 2001, 51(2):363-370.
83. Winslow E.R., Kodner I.J., Mutch M.G., et al. Outcome of salvage abdominoperineal resection after failed endocavitary radiation in patients with rectal cancer. Dis Colon Rectum 2004, 47(12):2039-2046.
84. Hesselager C., Vuong T., Påhlman L., et al. Neoadjuvant high dose endorectal brachytherapy or short course external beam radiotherapy in resectable rectal cancer. Colorectal Dis 2013, 10.1111/codi.12193.
85. Vuong T., Devic S., Podgorsak E. High dose rate endorectal brachytherapy as a neoadjuvant treatment for patients with resectable rectal cancer. Clin Oncol (RColl Radiol) 2007, 19(9):701-705.