Postoperative Chemotherapy Cycles Research Articles

Monthly tegafur\u2013uracil maintenance for increasing relapse-free survival in ypStage III rectal cancer patients after preoperative radiotherapy, radical resection, and 12 postoperative chemotherapy cycles: a retrospective study

BackgroundCurrent advancements in neoadjuvant therapy and total mesorectal excision have engendered increased local control. However, the survival benefit of preoperative radiotherapy (RT; 5 × 5 Gy) in rectal cancer patients remains inadequate, primarily because of systemic recurrence. In this retrospective single-center study, the effects of monthly tegafur–uracil maintenance (≥6 cycles) after 12 fluorouracil-based adjuvant chemotherapy cycles on 3-year relapse-free survival (RFS) was estimated in ypStage III rectal cancer patients.MethodsOf ypStage III rectal cancer patients who received preoperative RT (5 × 5 Gy) in January 2006–December 2015, those who had ypStage III cancer after preoperative radiation, radical resection, and postoperative chemotherapy were enrolled; excluded patients had ypStage I and II rectal cancer, had double cancer, had synchronous distant metastasis, had local excision, received preoperative chemoradiation, and were lost to follow-up within 1 year after cancer treatment. Included patients received either maintenance therapy or observation after postoperative chemotherapy. The primary endpoint was the effect of maintenance therapy on 3-year RFS. We set the median follow-up duration to be 69.7 (range, 15.4–148.3) months.ResultsOf 259 ypStage III rectal cancer patients, 102 (59 men and 43 women) were enrolled based on the inclusion criteria. The maintenance and observation groups comprised 55 and 57 patients, respectively (mean age = 62.2 and 65.7 years, respectively; p = 0.185). The 3-year RFS observed in the maintenance group (85.1%) was longer than that observed in the observation group (67.5%; p = 0.039). Multivariate analysis proved the following to be independent prognostic factors for RFS: higher metastatic lymph node ratio (LNR ≥0.3), tegafur–uracil maintenance (≥6 cycles), and lower rectal cancer (< 6 cm from the anal verge). The higher the rectal cancer location (≥6 cm from the anal verge) was, the higher the tegafur–uracil maintenance survival benefit became (p = 0.041). Moreover, lower cancer location (< 6 cm from the anal verge) and LNR ≥0.3 were both associated with a trend of longer RFS after tegafur–uracil maintenance therapy (p = 0.164 and 0.113, respectively).ConclusionsAfter the execution of fluorouracil-based adjuvant chemotherapy, administering monthly tegafur–uracil (≥6 cycles) may improve the 3-year RFS of ypStage III rectal cancer patients.

Clinical outcomes in ovarian cancer patients receiving three versus more cycles of chemotherapy after neoadjuvant treatment and interval cytoreductive surgery

ObjectivesTo compare clinical outcomes for stage IIIC and IV ovarian cancer patients receiving neoadjuvant chemotherapy and interval cytoreductive surgery followed by up to three versus more cycles of post-operative chemotherapy.MethodsWe...

Resultados del tratamiento de osteosarcoma convencional de alto grado en niños y adolescentes: análisis de supervivencia de una cohorte tratada sin metotrexato

ObjectiveTo report event-free overall survival rates and histological response results for neoadjuvant chemotherapy and limb-salvage surgery in conventional osteosarcoma patients treated without high methotrexate doses in the National Cancer Institute of Colombia. Patients and MethodsA cohort of under 21-year old patients diagnosed with conventional osteosarcoma, with or without metastasis, underwent preoperative chemotherapy for twelve weeks, followed by local control surgery in week 15, and three postoperative chemotherapy cycles. Treatment did not include methotrexate. Four drugs were administered: ifosfamide, doxorubicin, cisplatin, and etoposide. The Kaplan-Meier method was used to calculate overall survival and event-free rates. A multivariate analysis of survival predictors was carried out with the Cox proportional hazards method. Statistical analysis was based on an α of 0.05. ResultsFrom January 1997 to December 2007, a total of l22 conventional osteosarcoma patients received treatment, with a median follow-up of 24.4 months (range 1.13 to 169). The mean patient age was 13.7 years (SD±2.9 yrs). Limb-salvage surgery was performed in 52% and ablative surgery in 38%. Overall survival and event-free rates were higher in the good responders to chemotherapy than in the poor responders: (HR=4.33; 95% CI; 1.77-10.58) and (HR=2.90; 95% CI; 1.60–5.27. The overall survival and event-free rates were different between patients with and without metastasis at diagnosis: (HR=2.13; 95% CI; 0.97–4.72) and (HR=2.07; (95% CI; 1.10–3.90. ConclusionOsteosarcoma can be treated with chemotherapy without high methotrexate doses to achieve moderately effective survival rates comparable with those in developed countries

The Effect of CA125 Nadir Level on Survival of Advanced-Stage Epithelial Ovarian Carcinoma after Interval Debulking Surgery.

Purpose. The study aims at investigating the most reliable CA125-related factors in terms of predicting survival outcomes in advanced-stage epithelial ovarian carcinoma (EOC) patients received neoadjuvant chemotherapy (NAC).Methods. The EOC patients treated with NAC at Peking Union Medical College Hospital by a single gynecological oncology team were enrolled for the retrospective study. The CA125-related variables were categorized into four groups: normalizations, nadirs, half-life and percentage reductions. Associations of these variables with progress-free survival (PFS) and overall survival (OS) were evaluated.Results. Of the 101 patients included, 81 patients (80.2%) had progressed, and 51 patients (50.5%) had died of the disease progression. Univariate analysis showed that the CA125 nadir, reduction after the first, second and third postoperative chemotherapy cycles, and time to normalization were significantly (P<0.05) associated with PFS. The CA125 nadir, reduction after the first, second and third postoperative chemotherapy cycles were significantly (P<0.05) associated with OS. In the multivariate analysis, the CA125 nadir value was the most significant factor for PFS and OS, using the CA125 median level 13 U/ml as a cutoff value.Conclusions. Our study suggests that the CA125 nadir value is the most reliable prognostic factor to predict PFS and OS in advanced EOC patients treated with NAC. This information is important in patient counseling and creating individualized follow-up plans.

"Magic" of our gastric cancer results on perioperative chemotherapy.

To determine reproducibility of perioperative chemotherapy for gastric cancer (GC) on our settings by identifying patient's overall survival and comparing them to larger studies. Retrospective analysis of our series, where we present our eleven-year's experience on GC managed according to perioperative approach of three preoperative chemotherapy cycles followed by surgery and finally three postoperative chemotherapy cycles. Chemotherapic scheme used was Xelox (Oxaliplatin and Capecitabine). Epidemiologic parameters as well as surgical variables were analysed, presented, and compared to other series with similar approaches. Survival was estimated by Kaplan Meier/log rank method and also compared to these studies. Mean age was 65 years old. Overall survival in our series was 37.7%, similar to other groups using perioperative schemes. Mortality was 4% and morbidity 30%, which are also similar to those groups. Survival curves were compared to larger studies, finding similarities on them. Subgroup survival analysis between chemotherapy responders and non-responders didn't reach statically significant differences. Perioperative chemotherapic scheme can be reproduced on our setting with good results and without increasing morbidity or mortality.

Perioperative chemotherapy in gastroesophageal cancer. A retrospective monocenter evaluation of 42 cases.

BackgroundPerioperative chemotherapy increases the overall and progression-free survival of patients suffering from resectable adenocarcinomas of the lower esophagus, gastroesophageal junction and stomach (GEC). Comparing different chemotherapy regimens platin-based protocols with 5-fluorouracil (5-FU)/calcium folinate (CF) or oral fluoropyrimidines were favorable in terms of efficacy and side-effects. However, there is no consensus which regimen is the most efficacious.Methods42 consecutive patients with resectable GEC (UICC II and III) were treated with 3 pre- and postoperative chemotherapy cycles each consisting of epirubicin, oxaliplatin and capecitabine (EOX). We analyzed the overall survival, progression-free survival and toxicity retrospectively in comparison to published data.ResultsThe median overall survival in our cohort was 29 months and the progression-free survival was 17 months. The most frequent grade 3 and 4 toxicities during preoperative chemotherapy were diarrhea (16.7%), leukocytopenia (9.5%) and nausea (9.5%); overall 38.1% of our patients suffered from grade 3 or 4 toxicity. Surgery was carried out in 83% of our patients, 69% of those achieved R0 resection.ConclusionComparing our data with the results of previously published randomized trials EOX is at least non-inferior with regard to overall survival, progression-free survival and toxicity. In conclusion, EOX is an appropriate perioperative therapy for patients with resectable GEC.

Analysis of prognostic factors in 333 Chinese patients with high‐grade osteosarcoma treated by multidisciplinary combined therapy

To investigate prognostic factors for long-term outcomes in Chinese patients with high-grade osteosarcoma of the extremities or trunk treated by multidisciplinary combined therapy. In total, 333 consecutive patients with non-metastatic or primary metastatic high-grade osteosarcoma of the extremities or trunk were retrospectively reviewed to analyze the correlation between survival and sex, age, site, histological type, clinical stage, alkaline phosphatase (ALP) level, preoperative chemotherapy or not, response to preoperative chemotherapy, postoperative chemotherapy cycles and manner of surgery. The combined therapy included preoperative and postoperative chemotherapy as well as limb salvage surgery or amputation. The median survival time was 52 months for all 333 patients. Univariate analysis revealed that sex, ALP level, preoperative chemotherapy and cycle numbers of postoperative chemotherapy may influence the prognosis of high-grade osteosarcoma of the extremities or trunk. Multivariate analysis revealed that the female, a normal ALP level, preoperative chemotherapy with good response and ≥4 cycles of postoperative chemotherapy correlated with a better outcome. Preoperative chemotherapy is important in high-grade osteosarcoma treatment and a good response to it is an important marker of prognosis. It should be given with ≥ cycles of postoperative chemotherapy after surgery.