Current Trends in the Treatment of Locally Advanced Rectal Cancer: Where We Are and How We Got Here
Purpose of Review The trimodal treatment for LARC—surgery, radiotherapy, and chemotherapy—has been the standard of care for more than 30 years but is facing fresh challenges. Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or withou...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Shulman, Rebecca M. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2021 |
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| Schlagwörter: |
Locally advanced rectal cancer |
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| Anmerkung: |
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 |
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| Übergeordnetes Werk: |
Enthalten in: Current colorectal cancer reports - Heidelberg [u.a.] : Springer, 2005, 17(2021), 6 vom: 06. Nov., Seite 88-102 |
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| Übergeordnetes Werk: |
volume:17 ; year:2021 ; number:6 ; day:06 ; month:11 ; pages:88-102 |
| Links: |
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| DOI / URN: |
10.1007/s11888-021-00471-w |
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| Katalog-ID: |
SPR045822875 |
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| 520 | |a Purpose of Review The trimodal treatment for LARC—surgery, radiotherapy, and chemotherapy—has been the standard of care for more than 30 years but is facing fresh challenges. Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or without chemoradiation (total neoadjuvant therapy or “TNT”), and the withholding of surgery for patients who achieve a complete clinical response (cCR) to initial treatment (“watch-and-wait”). We review the historical development of these trends and propose an approach to LARC treatment that integrates newly emerging protocols with the traditional standard of care. Recent Findings Data from the recent randomized trials PRODIGE 23 and CAO/ARO/AIO-12 show that patients with LARC treated with TNT have a higher frequency of cCR, longer disease-free survival, and increased ability to tolerate chemotherapy. Preliminary results of the prospective OPRA study indicate that a watch-and-wait approach may permit sphincter preservation for a high proportion of patients without compromising survival. Summary The increasing adoption of TNT to treat LARC is due to high rates of cCR, low levels of toxicity, a superior ability to deliver full-dose chemotherapy, and better preservation of quality of life. Based on current evidence, the combination of preoperative systemic chemotherapy and non-surgical management is appropriate for selected patients who have achieved a cCR and face a high risk of sphincter loss or dysfunction with surgery. | ||
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10.1007/s11888-021-00471-w doi (DE-627)SPR045822875 (SPR)s11888-021-00471-w-e DE-627 ger DE-627 rakwb eng Shulman, Rebecca M. verfasserin aut Current Trends in the Treatment of Locally Advanced Rectal Cancer: Where We Are and How We Got Here 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 Purpose of Review The trimodal treatment for LARC—surgery, radiotherapy, and chemotherapy—has been the standard of care for more than 30 years but is facing fresh challenges. Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or without chemoradiation (total neoadjuvant therapy or “TNT”), and the withholding of surgery for patients who achieve a complete clinical response (cCR) to initial treatment (“watch-and-wait”). We review the historical development of these trends and propose an approach to LARC treatment that integrates newly emerging protocols with the traditional standard of care. Recent Findings Data from the recent randomized trials PRODIGE 23 and CAO/ARO/AIO-12 show that patients with LARC treated with TNT have a higher frequency of cCR, longer disease-free survival, and increased ability to tolerate chemotherapy. Preliminary results of the prospective OPRA study indicate that a watch-and-wait approach may permit sphincter preservation for a high proportion of patients without compromising survival. Summary The increasing adoption of TNT to treat LARC is due to high rates of cCR, low levels of toxicity, a superior ability to deliver full-dose chemotherapy, and better preservation of quality of life. Based on current evidence, the combination of preoperative systemic chemotherapy and non-surgical management is appropriate for selected patients who have achieved a cCR and face a high risk of sphincter loss or dysfunction with surgery. Locally advanced rectal cancer (dpeaa)DE-He213 Total neoadjuvant therapy (dpeaa)DE-He213 Watch-and-wait (dpeaa)DE-He213 Short-course radiation therapy (dpeaa)DE-He213 Long-course radiation therapy (dpeaa)DE-He213 Meyer, Joshua E. aut Enthalten in Current colorectal cancer reports Heidelberg [u.a.] : Springer, 2005 17(2021), 6 vom: 06. Nov., Seite 88-102 (DE-627)511638213 (DE-600)2233562-6 1556-3804 nnns volume:17 year:2021 number:6 day:06 month:11 pages:88-102 https://dx.doi.org/10.1007/s11888-021-00471-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 17 2021 6 06 11 88-102 |
| spelling |
10.1007/s11888-021-00471-w doi (DE-627)SPR045822875 (SPR)s11888-021-00471-w-e DE-627 ger DE-627 rakwb eng Shulman, Rebecca M. verfasserin aut Current Trends in the Treatment of Locally Advanced Rectal Cancer: Where We Are and How We Got Here 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 Purpose of Review The trimodal treatment for LARC—surgery, radiotherapy, and chemotherapy—has been the standard of care for more than 30 years but is facing fresh challenges. Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or without chemoradiation (total neoadjuvant therapy or “TNT”), and the withholding of surgery for patients who achieve a complete clinical response (cCR) to initial treatment (“watch-and-wait”). We review the historical development of these trends and propose an approach to LARC treatment that integrates newly emerging protocols with the traditional standard of care. Recent Findings Data from the recent randomized trials PRODIGE 23 and CAO/ARO/AIO-12 show that patients with LARC treated with TNT have a higher frequency of cCR, longer disease-free survival, and increased ability to tolerate chemotherapy. Preliminary results of the prospective OPRA study indicate that a watch-and-wait approach may permit sphincter preservation for a high proportion of patients without compromising survival. Summary The increasing adoption of TNT to treat LARC is due to high rates of cCR, low levels of toxicity, a superior ability to deliver full-dose chemotherapy, and better preservation of quality of life. Based on current evidence, the combination of preoperative systemic chemotherapy and non-surgical management is appropriate for selected patients who have achieved a cCR and face a high risk of sphincter loss or dysfunction with surgery. Locally advanced rectal cancer (dpeaa)DE-He213 Total neoadjuvant therapy (dpeaa)DE-He213 Watch-and-wait (dpeaa)DE-He213 Short-course radiation therapy (dpeaa)DE-He213 Long-course radiation therapy (dpeaa)DE-He213 Meyer, Joshua E. aut Enthalten in Current colorectal cancer reports Heidelberg [u.a.] : Springer, 2005 17(2021), 6 vom: 06. Nov., Seite 88-102 (DE-627)511638213 (DE-600)2233562-6 1556-3804 nnns volume:17 year:2021 number:6 day:06 month:11 pages:88-102 https://dx.doi.org/10.1007/s11888-021-00471-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 17 2021 6 06 11 88-102 |
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10.1007/s11888-021-00471-w doi (DE-627)SPR045822875 (SPR)s11888-021-00471-w-e DE-627 ger DE-627 rakwb eng Shulman, Rebecca M. verfasserin aut Current Trends in the Treatment of Locally Advanced Rectal Cancer: Where We Are and How We Got Here 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 Purpose of Review The trimodal treatment for LARC—surgery, radiotherapy, and chemotherapy—has been the standard of care for more than 30 years but is facing fresh challenges. Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or without chemoradiation (total neoadjuvant therapy or “TNT”), and the withholding of surgery for patients who achieve a complete clinical response (cCR) to initial treatment (“watch-and-wait”). We review the historical development of these trends and propose an approach to LARC treatment that integrates newly emerging protocols with the traditional standard of care. Recent Findings Data from the recent randomized trials PRODIGE 23 and CAO/ARO/AIO-12 show that patients with LARC treated with TNT have a higher frequency of cCR, longer disease-free survival, and increased ability to tolerate chemotherapy. Preliminary results of the prospective OPRA study indicate that a watch-and-wait approach may permit sphincter preservation for a high proportion of patients without compromising survival. Summary The increasing adoption of TNT to treat LARC is due to high rates of cCR, low levels of toxicity, a superior ability to deliver full-dose chemotherapy, and better preservation of quality of life. Based on current evidence, the combination of preoperative systemic chemotherapy and non-surgical management is appropriate for selected patients who have achieved a cCR and face a high risk of sphincter loss or dysfunction with surgery. Locally advanced rectal cancer (dpeaa)DE-He213 Total neoadjuvant therapy (dpeaa)DE-He213 Watch-and-wait (dpeaa)DE-He213 Short-course radiation therapy (dpeaa)DE-He213 Long-course radiation therapy (dpeaa)DE-He213 Meyer, Joshua E. aut Enthalten in Current colorectal cancer reports Heidelberg [u.a.] : Springer, 2005 17(2021), 6 vom: 06. Nov., Seite 88-102 (DE-627)511638213 (DE-600)2233562-6 1556-3804 nnns volume:17 year:2021 number:6 day:06 month:11 pages:88-102 https://dx.doi.org/10.1007/s11888-021-00471-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 17 2021 6 06 11 88-102 |
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10.1007/s11888-021-00471-w doi (DE-627)SPR045822875 (SPR)s11888-021-00471-w-e DE-627 ger DE-627 rakwb eng Shulman, Rebecca M. verfasserin aut Current Trends in the Treatment of Locally Advanced Rectal Cancer: Where We Are and How We Got Here 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 Purpose of Review The trimodal treatment for LARC—surgery, radiotherapy, and chemotherapy—has been the standard of care for more than 30 years but is facing fresh challenges. Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or without chemoradiation (total neoadjuvant therapy or “TNT”), and the withholding of surgery for patients who achieve a complete clinical response (cCR) to initial treatment (“watch-and-wait”). We review the historical development of these trends and propose an approach to LARC treatment that integrates newly emerging protocols with the traditional standard of care. Recent Findings Data from the recent randomized trials PRODIGE 23 and CAO/ARO/AIO-12 show that patients with LARC treated with TNT have a higher frequency of cCR, longer disease-free survival, and increased ability to tolerate chemotherapy. Preliminary results of the prospective OPRA study indicate that a watch-and-wait approach may permit sphincter preservation for a high proportion of patients without compromising survival. Summary The increasing adoption of TNT to treat LARC is due to high rates of cCR, low levels of toxicity, a superior ability to deliver full-dose chemotherapy, and better preservation of quality of life. Based on current evidence, the combination of preoperative systemic chemotherapy and non-surgical management is appropriate for selected patients who have achieved a cCR and face a high risk of sphincter loss or dysfunction with surgery. Locally advanced rectal cancer (dpeaa)DE-He213 Total neoadjuvant therapy (dpeaa)DE-He213 Watch-and-wait (dpeaa)DE-He213 Short-course radiation therapy (dpeaa)DE-He213 Long-course radiation therapy (dpeaa)DE-He213 Meyer, Joshua E. aut Enthalten in Current colorectal cancer reports Heidelberg [u.a.] : Springer, 2005 17(2021), 6 vom: 06. Nov., Seite 88-102 (DE-627)511638213 (DE-600)2233562-6 1556-3804 nnns volume:17 year:2021 number:6 day:06 month:11 pages:88-102 https://dx.doi.org/10.1007/s11888-021-00471-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 17 2021 6 06 11 88-102 |
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10.1007/s11888-021-00471-w doi (DE-627)SPR045822875 (SPR)s11888-021-00471-w-e DE-627 ger DE-627 rakwb eng Shulman, Rebecca M. verfasserin aut Current Trends in the Treatment of Locally Advanced Rectal Cancer: Where We Are and How We Got Here 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 Purpose of Review The trimodal treatment for LARC—surgery, radiotherapy, and chemotherapy—has been the standard of care for more than 30 years but is facing fresh challenges. Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or without chemoradiation (total neoadjuvant therapy or “TNT”), and the withholding of surgery for patients who achieve a complete clinical response (cCR) to initial treatment (“watch-and-wait”). We review the historical development of these trends and propose an approach to LARC treatment that integrates newly emerging protocols with the traditional standard of care. Recent Findings Data from the recent randomized trials PRODIGE 23 and CAO/ARO/AIO-12 show that patients with LARC treated with TNT have a higher frequency of cCR, longer disease-free survival, and increased ability to tolerate chemotherapy. Preliminary results of the prospective OPRA study indicate that a watch-and-wait approach may permit sphincter preservation for a high proportion of patients without compromising survival. Summary The increasing adoption of TNT to treat LARC is due to high rates of cCR, low levels of toxicity, a superior ability to deliver full-dose chemotherapy, and better preservation of quality of life. Based on current evidence, the combination of preoperative systemic chemotherapy and non-surgical management is appropriate for selected patients who have achieved a cCR and face a high risk of sphincter loss or dysfunction with surgery. Locally advanced rectal cancer (dpeaa)DE-He213 Total neoadjuvant therapy (dpeaa)DE-He213 Watch-and-wait (dpeaa)DE-He213 Short-course radiation therapy (dpeaa)DE-He213 Long-course radiation therapy (dpeaa)DE-He213 Meyer, Joshua E. aut Enthalten in Current colorectal cancer reports Heidelberg [u.a.] : Springer, 2005 17(2021), 6 vom: 06. Nov., Seite 88-102 (DE-627)511638213 (DE-600)2233562-6 1556-3804 nnns volume:17 year:2021 number:6 day:06 month:11 pages:88-102 https://dx.doi.org/10.1007/s11888-021-00471-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 17 2021 6 06 11 88-102 |
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Enthalten in Current colorectal cancer reports 17(2021), 6 vom: 06. Nov., Seite 88-102 volume:17 year:2021 number:6 day:06 month:11 pages:88-102 |
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Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or without chemoradiation (total neoadjuvant therapy or “TNT”), and the withholding of surgery for patients who achieve a complete clinical response (cCR) to initial treatment (“watch-and-wait”). We review the historical development of these trends and propose an approach to LARC treatment that integrates newly emerging protocols with the traditional standard of care. Recent Findings Data from the recent randomized trials PRODIGE 23 and CAO/ARO/AIO-12 show that patients with LARC treated with TNT have a higher frequency of cCR, longer disease-free survival, and increased ability to tolerate chemotherapy. Preliminary results of the prospective OPRA study indicate that a watch-and-wait approach may permit sphincter preservation for a high proportion of patients without compromising survival. Summary The increasing adoption of TNT to treat LARC is due to high rates of cCR, low levels of toxicity, a superior ability to deliver full-dose chemotherapy, and better preservation of quality of life. 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Shulman, Rebecca M. |
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Shulman, Rebecca M. misc Locally advanced rectal cancer misc Total neoadjuvant therapy misc Watch-and-wait misc Short-course radiation therapy misc Long-course radiation therapy Current Trends in the Treatment of Locally Advanced Rectal Cancer: Where We Are and How We Got Here |
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Current Trends in the Treatment of Locally Advanced Rectal Cancer: Where We Are and How We Got Here Locally advanced rectal cancer (dpeaa)DE-He213 Total neoadjuvant therapy (dpeaa)DE-He213 Watch-and-wait (dpeaa)DE-He213 Short-course radiation therapy (dpeaa)DE-He213 Long-course radiation therapy (dpeaa)DE-He213 |
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current trends in the treatment of locally advanced rectal cancer: where we are and how we got here |
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Current Trends in the Treatment of Locally Advanced Rectal Cancer: Where We Are and How We Got Here |
| abstract |
Purpose of Review The trimodal treatment for LARC—surgery, radiotherapy, and chemotherapy—has been the standard of care for more than 30 years but is facing fresh challenges. Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or without chemoradiation (total neoadjuvant therapy or “TNT”), and the withholding of surgery for patients who achieve a complete clinical response (cCR) to initial treatment (“watch-and-wait”). We review the historical development of these trends and propose an approach to LARC treatment that integrates newly emerging protocols with the traditional standard of care. Recent Findings Data from the recent randomized trials PRODIGE 23 and CAO/ARO/AIO-12 show that patients with LARC treated with TNT have a higher frequency of cCR, longer disease-free survival, and increased ability to tolerate chemotherapy. Preliminary results of the prospective OPRA study indicate that a watch-and-wait approach may permit sphincter preservation for a high proportion of patients without compromising survival. Summary The increasing adoption of TNT to treat LARC is due to high rates of cCR, low levels of toxicity, a superior ability to deliver full-dose chemotherapy, and better preservation of quality of life. Based on current evidence, the combination of preoperative systemic chemotherapy and non-surgical management is appropriate for selected patients who have achieved a cCR and face a high risk of sphincter loss or dysfunction with surgery. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 |
| abstractGer |
Purpose of Review The trimodal treatment for LARC—surgery, radiotherapy, and chemotherapy—has been the standard of care for more than 30 years but is facing fresh challenges. Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or without chemoradiation (total neoadjuvant therapy or “TNT”), and the withholding of surgery for patients who achieve a complete clinical response (cCR) to initial treatment (“watch-and-wait”). We review the historical development of these trends and propose an approach to LARC treatment that integrates newly emerging protocols with the traditional standard of care. Recent Findings Data from the recent randomized trials PRODIGE 23 and CAO/ARO/AIO-12 show that patients with LARC treated with TNT have a higher frequency of cCR, longer disease-free survival, and increased ability to tolerate chemotherapy. Preliminary results of the prospective OPRA study indicate that a watch-and-wait approach may permit sphincter preservation for a high proportion of patients without compromising survival. Summary The increasing adoption of TNT to treat LARC is due to high rates of cCR, low levels of toxicity, a superior ability to deliver full-dose chemotherapy, and better preservation of quality of life. Based on current evidence, the combination of preoperative systemic chemotherapy and non-surgical management is appropriate for selected patients who have achieved a cCR and face a high risk of sphincter loss or dysfunction with surgery. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 |
| abstract_unstemmed |
Purpose of Review The trimodal treatment for LARC—surgery, radiotherapy, and chemotherapy—has been the standard of care for more than 30 years but is facing fresh challenges. Major contemporary developments include the delivery of full systemic chemotherapy in the preoperative period, with or without chemoradiation (total neoadjuvant therapy or “TNT”), and the withholding of surgery for patients who achieve a complete clinical response (cCR) to initial treatment (“watch-and-wait”). We review the historical development of these trends and propose an approach to LARC treatment that integrates newly emerging protocols with the traditional standard of care. Recent Findings Data from the recent randomized trials PRODIGE 23 and CAO/ARO/AIO-12 show that patients with LARC treated with TNT have a higher frequency of cCR, longer disease-free survival, and increased ability to tolerate chemotherapy. Preliminary results of the prospective OPRA study indicate that a watch-and-wait approach may permit sphincter preservation for a high proportion of patients without compromising survival. Summary The increasing adoption of TNT to treat LARC is due to high rates of cCR, low levels of toxicity, a superior ability to deliver full-dose chemotherapy, and better preservation of quality of life. Based on current evidence, the combination of preoperative systemic chemotherapy and non-surgical management is appropriate for selected patients who have achieved a cCR and face a high risk of sphincter loss or dysfunction with surgery. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 |
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Current Trends in the Treatment of Locally Advanced Rectal Cancer: Where We Are and How We Got Here |
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https://dx.doi.org/10.1007/s11888-021-00471-w |
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Meyer, Joshua E. |
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2024-07-03T18:30:34.413Z |
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| score |
7.4013777 |