Research Article
Predictive and Prognostic Factors Related to Chemoradioresistance in Neoadjuvant Treatment of Locally Advanced Rectal Cancer at Panama
Issue:
Volume 12, Issue 2, June 2024
Pages:
21-26
Received:
5 March 2024
Accepted:
26 March 2024
Published:
12 April 2024
Abstract: Background: In Panama, and the rest of Latin America, there are few publications on chemoradioresistance, it leads to poor prognosis and represents the main reason for failure of therapy, ultimately it can lead to tumor recurrence and metastasis. Objective: Identify factors associated with chemoradioresistance in the neoadjuvant treatment of locally advanced rectal cancer at the Instituto Oncológico Nacional de Panamá, period 2016-2020. Methodology: This retrospective study included 71 patients with LARC who received neoadjuvant chemoradiotherapy and surgery. Chemoradioresistant patients were those who did not reach a higher pathological stage of ypT2NO and the results were compared. Results: Of the 71 patients, pathological complete response (pCR) was achieved in 34 patients (48%). 49% of patients met chemoradioresistance criteria. In this group, the median CEA was 136 ng/ml, the median hemoglobin was 12 g/dl, and the median BMI was 26 kg/m2. The median radiation dose was 5000Gy. The time between completion of chemoradiotherapy and surgery was 110 days (16 weeks). Depending on the type of surgery, 65% who underwent low anterior resection were chemoradioresistant. The variables with statistical significance were the CEA value >5 ng/mL (OR=1.81, p=0.026) prior to the start of neoadjuvant treatment, with a lower pCR rate. Likewise, the ECOG scale (OR=2.51, p=0.015) was a risk factor related to chemoradioresistance, the lower the ECOG, the lower the risk of chemoradioresistance. The median overall survival and median recurrence-free survival was not reached in both groups and there was no statistically significant difference. Conclusions: Significant interactions were identified between CEA levels prior to the start of neoadjuvant treatment with the pathological complete response rate and the ECOG score with chemoradioresistance. Therefore, these factors can be used to predict patient outcomes, will help optimize personalized treatment strategies and improve patient outcomes.
Abstract: Background: In Panama, and the rest of Latin America, there are few publications on chemoradioresistance, it leads to poor prognosis and represents the main reason for failure of therapy, ultimately it can lead to tumor recurrence and metastasis. Objective: Identify factors associated with chemoradioresistance in the neoadjuvant treatment of locall...
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Review Article
Stereotactic Body Radiation Therapy (SBRT) for Non-Small Cell Lung Cancer (NSCLC) Therapy
Issue:
Volume 12, Issue 2, June 2024
Pages:
27-35
Received:
19 May 2024
Accepted:
31 May 2024
Published:
19 June 2024
DOI:
10.11648/j.crj.20241202.12
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Abstract: For patients with early-stage non-small cell lung cancer (NSCLC) who cannot undergo surgery, stereotactic body radiotherapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), usually achieves good therapeutic effects. This new treatment method has the characteristics of low toxicity and high efficacy for peripheral lung cancer. However, in central type lung cancer, especially in lesions near structures such as bronchial trees or mediastinum, there is an increased risk of severity. This review summarizes the following areas: (1) the methods and indications of using SBRT to treat NSCLC patients in different areas; (2) the principle and advantages and disadvantages of targeted MRI linear accelerators; (3) the diagnostic and evaluation process of targeted MRI linear accelerator therapy for lung cancer; (4) the clinical process of targeted MRI linear accelerator treatment for lung cancer; (5) tracking and monitoring of targeted MRI linear accelerator therapy for lung cancer; (6) pulmonary MRI disorders may include the following situations; (7) how to evaluate stage I-IV non-small cell lung cancer with targeted MRI linear accelerator; (8) how to locate central and peripheral lung cancer using targeted MRI linear accelerators; (9) increase safety of SBRT in central locations.
Abstract: For patients with early-stage non-small cell lung cancer (NSCLC) who cannot undergo surgery, stereotactic body radiotherapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), usually achieves good therapeutic effects. This new treatment method has the characteristics of low toxicity and high efficacy for peripheral lung cancer. Howeve...
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,
Carla Eloy La Luz
