Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer

doi:10.1056/NEJMoa040694

Volume 351:1731-1740		October 21, 2004		Number 17

Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer

Rolf Sauer, M.D., Heinz Becker, M.D., Werner Hohenberger, M.D., Claus Rödel, M.D., Christian Wittekind, M.D., Rainer Fietkau, M.D., Peter Martus, Ph.D., Jörg Tschmelitsch, M.D., Eva Hager, M.D., Clemens F. Hess, M.D., Johann-H. Karstens, M.D., Torsten Liersch, M.D., Heinz Schmidberger, M.D., Rudolf Raab, M.D., for the German Rectal Cancer Study Group

Full Text

PDF

PDA Full Text

PowerPoint Slide Set

Editorial
by Madoff, R. D.

Letters

Add to Personal Archive

Add to Citation Manager

Notify a Friend

E-mail When Cited

E-mail When Letters Appear

PubMed Citation

ABSTRACT

Background Postoperative chemoradiotherapy is the recommendedstandard therapy for patients with locally advanced rectal cancer.In recent years, encouraging results with preoperative radiotherapyhave been reported. We compared preoperative chemoradiotherapywith postoperative chemoradiotherapy for locally advanced rectalcancer.

Methods We randomly assigned patients with clinical stage T3or T4 or node-positive disease to receive either preoperativeor postoperative chemoradiotherapy. The preoperative treatmentconsisted of 5040 cGy delivered in fractions of 180 cGy perday, five days per week, and fluorouracil, given in a 120-hourcontinuous intravenous infusion at a dose of 1000 mg per squaremeter of body-surface area per day during the first and fifthweeks of radiotherapy. Surgery was performed six weeks afterthe completion of chemoradiotherapy. One month after surgery,four five-day cycles of fluorouracil (500 mg per square meterper day) were given. Chemoradiotherapy was identical in thepostoperative-treatment group, except for the delivery of aboost of 540 cGy. The primary end point was overall survival.

Results Four hundred twenty-one patients were randomly assignedto receive preoperative chemoradiotherapy and 402 patients toreceive postoperative chemoradiotherapy. The overall five-yearsurvival rates were 76 percent and 74 percent, respectively(P=0.80). The five-year cumulative incidence of local relapsewas 6 percent for patients assigned to preoperative chemoradiotherapyand 13 percent in the postoperative-treatment group (P=0.006).Grade 3 or 4 acute toxic effects occurred in 27 percent of thepatients in the preoperative-treatment group, as compared with40 percent of the patients in the postoperative-treatment group(P=0.001); the corresponding rates of long-term toxic effectswere 14 percent and 24 percent, respectively (P=0.01).

Conclusions Preoperative chemoradiotherapy, as compared withpostoperative chemoradiotherapy, improved local control andwas associated with reduced toxicity but did not improve overallsurvival.

Source Information

From the Departments of Radiation Therapy (R.S., C.R.) and Surgery (W.H.), University of Erlangen, Erlangen, Germany; the Departments of Surgery (H.B., T.L.) and Radiation Therapy (C.F.H., H.S.), University of Göttingen, Göttingen, Germany; the Institute of Pathology, University of Leipzig, Leipzig, Germany (C.W.); the Department of Radiation Therapy, University of Rostock, Rostock, Germany (R.F.); the Institute of Medical Informatics, Biometry, and Epidemiology, Charité University Medicine Berlin, Berlin (P.M.); the Department of Surgery, Krankenhaus der Barmherzigen Brüder, St. Veit an der Glan, Austria (J.T.); the Institute of Radiotherapy, Landeskrankenhaus Klagenfurt, Austria (E.H.); the Department of Radiation Therapy, Medizinische Hochschule Hannover, Hannover, Germany (J.-H.K.); and the Department of Surgery, Klinikum Oldenburg, Oldenburg, Germany (R.R.).

Address reprint requests to Dr. Sauer at the Department of Radiation Therapy, University of Erlangen, Universitätsstr. 27 91054, Erlangen, Germany, or at sekretariat{at}strahlen.med.uni-erlangen.de.

Full Text of this Article

Related Letters:

Chemoradiotherapy for Rectal Cancer
Gaur S., Shukla V., Julianov A., Ferretti G., Bria E., Mandalà M., Bujko K., Nowacki M. P., Kepka L., Unnikrishnan G., Dhar P., Sudhindran S., Sauer R., Rödel C.
Extract | Full Text | PDF
N Engl J Med 2005; 352:509-511, Feb 3, 2005. Correspondence

This article has been cited by other articles:

Myers, A. P., Meyerhardt, J. A., Cantley, L. C. (2009). Getting Knit-PI3Ky: PIK3CA Mutation Status to Direct Multimodality Therapy?. Clin. Cancer Res. 15: 6748-6750 [Abstract] [Full Text]
Roh, M. S., Colangelo, L. H., O'Connell, M. J., Yothers, G., Deutsch, M., Allegra, C. J., Kahlenberg, M. S., Baez-Diaz, L., Ursiny, C. S., Petrelli, N. J., Wolmark, N. (2009). Preoperative Multimodality Therapy Improves Disease-Free Survival in Patients With Carcinoma of the Rectum: NSABP R-03. JCO 27: 5124-5130 [Abstract] [Full Text]
Minsky, B. D. (2009). Is Preoperative Chemoradiotherapy Still the Treatment of Choice for Rectal Cancer?. JCO 27: 5115-5116 [Full Text]
Okoshi, K., Nagayama, S., Furu, M., Mori, Y., Yoshizawa, A., Toguchida, J., Sakai, Y. (2009). A Case Report of Pathologically Complete Response of a Huge Rectal Cancer after Systemic Chemotherapy with mFOLFOX6. Jpn J Clin Oncol 39: 528-533 [Abstract] [Full Text]
Dresen, R. C., Beets, G. L., Rutten, H. J. T., Engelen, S. M. E., Lahaye, M. J., Vliegen, R. F. A., de Bruine, A. P., Kessels, A. G. H., Lammering, G., Beets-Tan, R. G. H. (2009). Locally Advanced Rectal Cancer: MR Imaging for Restaging after Neoadjuvant Radiation Therapy with Concomitant Chemotherapy Part I. Are We Able to Predict Tumor Confined to the Rectal Wall?. Radiology 252: 71-80 [Abstract] [Full Text]
Lahaye, M. J., Beets, G. L., Engelen, S. M. E., Kessels, A. G. H., de Bruine, A. P., Kwee, H. W. S., van Engelshoven, J. M. A., van de Velde, C. J. H., Beets-Tan, R. G. H. (2009). Locally Advanced Rectal Cancer: MR Imaging for Restaging after Neoadjuvant Radiation Therapy with Concomitant Chemotherapy Part II. What Are the Criteria to Predict Involved Lymph Nodes?. Radiology 252: 81-91 [Abstract] [Full Text]
Willett, C. G., Duda, D. G., di Tomaso, E., Boucher, Y., Ancukiewicz, M., Sahani, D. V., Lahdenranta, J., Chung, D. C., Fischman, A. J., Lauwers, G. Y., Shellito, P., Czito, B. G., Wong, T. Z., Paulson, E., Poleski, M., Vujaskovic, Z., Bentley, R., Chen, H. X., Clark, J. W., Jain, R. K. (2009). Efficacy, Safety, and Biomarkers of Neoadjuvant Bevacizumab, Radiation Therapy, and Fluorouracil in Rectal Cancer: A Multidisciplinary Phase II Study. JCO 27: 3020-3026 [Abstract] [Full Text]
Carlomagno, C., Farella, A., Bucci, L., D'Armiento, F. P., Pesce, G., Pepe, S., Cannella, L., Pacelli, R., De Stefano, A., Solla, R., D'Armiento, M. R., De Placido, S. (2009). Neo-adjuvant treatment of rectal cancer with capecitabine and oxaliplatin in combination with radiotherapy: a phase II study. Ann Oncol 20: 906-912 [Abstract] [Full Text]
Glimelius, B., Oliveira, J., On behalf of the ESMO Guidelines Working Group, (2009). Rectal cancer: ESMO Clinical Recommendations for diagnosis, treatment and follow-up. Ann Oncol 20: iv54-iv56 [Full Text]
DRZYMALA, M, HAWKINS, M A, HENRYS, A J, BEDFORD, J, NORMAN, A, TAIT, D M (2009). The effect of treatment position, prone or supine, on dose-volume histograms for pelvic radiotherapy in patients with rectal cancer. Br. J. Radiol. 82: 321-327 [Abstract] [Full Text]
Barbaro, B., Fiorucci, C., Tebala, C., Valentini, V., Gambacorta, M. A., Vecchio, F. M., Rizzo, G., Coco, C., Crucitti, A., Ratto, C., Bonomo, L. (2009). Locally Advanced Rectal Cancer: MR Imaging in Prediction of Response after Preoperative Chemotherapy and Radiation Therapy. Radiology 250: 730-739 [Abstract] [Full Text]
Castaldo, E. T., Parikh, A. A., Pinson, C. W., Feurer, I. D., Merchant, N. B. (2009). Improvement of Survival With Response to Neoadjuvant Radiation Therapy for Rectal Cancer. Arch Surg 144: 129-134 [Abstract] [Full Text]
Moore, H. G. (2009). Improvement of Survival With Response to Neoadjuvant Radiation Therapy for Rectal Cancer--Invited Critique. Arch Surg 144: 134-135 [Full Text]
Bertagnolli, M. M (2008). Doing our best: surgery for rectal cancer. Gut 57: 1643-1645 [Full Text]
Taylor, F. G. M., Swift, R. I., Blomqvist, L., Brown, G. (2008). A Systematic Approach to the Interpretation of Preoperative Staging MRI for Rectal Cancer. Am. J. Roentgenol. 191: 1827-1835 [Abstract] [Full Text]
Smith, N. J., Shihab, O., Arnaout, A., Swift, R. I., Brown, G. (2008). MRI for Detection of Extramural Vascular Invasion in Rectal Cancer. Am. J. Roentgenol. 191: 1517-1522 [Abstract] [Full Text]
Kornmann, M., Henne-Bruns, D., Porzsolt, F. (2008). Neoadjuvant Treatment of Rectal Carcinoma: Assessment of Health Care Services by Physicians and Lay Persons. JCO 26: 4866-4868 [Full Text]
Braendengen, M., Tveit, K. M., Berglund, A., Birkemeyer, E., Frykholm, G., Pahlman, L., Wiig, J. N., Bystrom, P., Bujko, K., Glimelius, B. (2008). Randomized Phase III Study Comparing Preoperative Radiotherapy With Chemoradiotherapy in Nonresectable Rectal Cancer. JCO 26: 3687-3694 [Abstract] [Full Text]
Assumpcao, L., Choti, M. A., Gleisner, A. L., Schulick, R. D., Swartz, M., Herman, J., Gearhart, S. L., Pawlik, T. M. (2008). Patterns of Recurrence Following Liver Resection for Colorectal Metastases: Effect of Primary Rectal Tumor Site. Arch Surg 143: 743-749 [Abstract] [Full Text]
Casado, E., Pfeiffer, P., Feliu, J., Gonzalez-Baron, M., Vestermark, L., Jensen, H. A. (2008). UFT (tegafur-uracil) in rectal cancer. Ann Oncol 19: 1371-1378 [Abstract] [Full Text]
Small, W. Jr, Berlin, J., Freedman, G. M., Konski, A. A., Lawrence, T. S., Talamonti, M. S., Mulcahy, M. F., Chakravarthy, A. B., Zalupski, M. M., Philip, P. A., Kinsella, T. J., Merchant, N. B., Hoffman, J. P., Benson, A. B. III, McGinn, C. J. (2008). In Reply. JCO 26: 3100-3101 [Full Text]
Leibold, T., Shia, J., Ruo, L., Minsky, B. D., Akhurst, T., Gollub, M. J., Ginsberg, M. S., Larson, S., Riedel, E., Wong, W. D., Guillem, J. G. (2008). Prognostic Implications of the Distribution of Lymph Node Metastases in Rectal Cancer After Neoadjuvant Chemoradiotherapy. JCO 26: 2106-2111 [Abstract] [Full Text]
Harrison, J. D., Solomon, M. J., Young, J. M., Meagher, A., Butow, P., Salkeld, G., Hruby, G., Clarke, S. (2008). Patient and Physician Preferences for Surgical and Adjuvant Treatment Options for Rectal Cancer. Arch Surg 143: 389-394 [Abstract] [Full Text]
Kunnumakkara, A. B., Diagaradjane, P., Guha, S., Deorukhkar, A., Shentu, S., Aggarwal, B. B., Krishnan, S. (2008). Curcumin Sensitizes Human Colorectal Cancer Xenografts in Nude Mice to {gamma}-Radiation by Targeting Nuclear Factor-{kappa}B-Regulated Gene Products. Clin. Cancer Res. 14: 2128-2136 [Abstract] [Full Text]
Lahaye, M. J., Engelen, S. M. E., Kessels, A. G. H., de Bruine, A. P., von Meyenfeldt, M. F., van Engelshoven, J. M. A., van de Velde, C. J. H., Beets, G. L., Beets-Tan, R. G. H. (2008). USPIO-enhanced MR Imaging for Nodal Staging in Patients with Primary Rectal Cancer: Predictive Criteria. Radiology 246: 804-811 [Abstract] [Full Text]
Lee, S. H., Lee, K. C., Choi, J. H., Oh, J. H., Baek, J.-H., Park, S. H., Shin, D. B. (2008). Chemoradiotherapy Followed by Surgery in Rectal Cancer: Improved Local Control Using a Moderately High Pelvic Radiation Dose. Jpn J Clin Oncol 0: hym164v1-10 [Abstract] [Full Text]
Vliegen, R. F. A., Beets, G. L., Lammering, G., Dresen, R. C., Rutten, H. J., Kessels, A. G., Oei, T.-K., de Bruine, A. P., van Engelshoven, J. M. A., Beets-Tan, R. G. H. (2008). Mesorectal Fascia Invasion after Neoadjuvant Chemotherapy and Radiation Therapy for Locally Advanced Rectal Cancer: Accuracy of MR Imaging for Prediction. Radiology 246: 454-462 [Abstract] [Full Text]
Kachnic, L. A., Hong, T. S., Ryan, D. P. (2008). Rectal Cancer at the Crossroads: The Dilemma of Clinically Staged T3, N0, M0 Disease. JCO 26: 350-351 [Full Text]
Guillem, J. G., Diaz-Gonzalez, J. A., Minsky, B. D., Valentini, V., Jeong, S.-Y., Rodriguez-Bigas, M. A., Coco, C., Leon, R., Hernandez-Lizoain, J. L., Aristu, J. J., Riedel, E. R., Nitti, D., Wong, W. D., Pucciarelli, S. (2008). cT3N0 Rectal Cancer: Potential Overtreatment With Preoperative Chemoradiotherapy Is Warranted. JCO 26: 368-373 [Abstract] [Full Text]
Nagtegaal, I. D., Quirke, P. (2008). What Is the Role for the Circumferential Margin in the Modern Treatment of Rectal Cancer?. JCO 26: 303-312 [Abstract] [Full Text]
Hudis, C., Modi, S. (2007). Preoperative Chemotherapy for Breast Cancer: Miracle or Mirage?. JAMA 298: 2665-2667 [Full Text]
Beart, R. W. Jr. (2007). Multidisciplinary Management of Patients with Advanced Rectal Cancer. Clin. Cancer Res. 13: 6890s-6893s [Abstract] [Full Text]
Willett, C. G., Czito, B. G., Bendell, J. C. (2007). Radiation Therapy in Stage II and III Rectal Cancer. Clin. Cancer Res. 13: 6903s-6908s [Abstract] [Full Text]
Benson, A. B. III (2007). New Approaches to Assessing and Treating Early-Stage Colon and Rectal Cancers: Cooperative Group Strategies for Assessing Optimal Approaches in Early-Stage Disease. Clin. Cancer Res. 13: 6913s-6920s [Abstract] [Full Text]
Aschele, C., Lonardi, S. (2007). Multidisciplinary treatment of rectal cancer: medical oncology.. Ann Oncol 18: 1908-1915 [Full Text]
Glynne-Jones, R., Harrison, M. (2007). Locally Advanced Rectal Cancer: What Is the Evidence for Induction Chemoradiation?. The Oncologist 12: 1309-1318 [Abstract] [Full Text]
Czito, B. G., Willett, C. G. (2007). Commentary: Rectal Cancer An Evolution of Treatment. The Oncologist 12: 1319-1320 [Full Text]
Minsky, B. D. (2007). Adjuvant Management of Rectal Cancer: The More We Learn, the Less We Know. JCO 25: 4339-4340 [Full Text]
Collette, L., Bosset, J.-F., den Dulk, M., Nguyen, F., Mineur, L., Maingon, P., Radosevic-Jelic, L., Pierart, M., Calais, G. (2007). Patients With Curative Resection of cT3-4 Rectal Cancer After Preoperative Radiotherapy or Radiochemotherapy: Does Anybody Benefit From Adjuvant Fluorouracil-Based Chemotherapy? A Trial of the European Organisation for Research and Treatment of Cancer Radiation Oncology Group. JCO 25: 4379-4386 [Abstract] [Full Text]
Craven, I, Haselden, J, Miller, K E, Miller, G V, Bradford, I, Sebag-Montefiore, D (2007). Omission of concurrent chemoradiation after a response to neoadjuvant chemotherapy in locally advanced rectal cancer with a synchronous liver metastasis: a note of caution. Br. J. Radiol. 80: e257-e259 [Abstract] [Full Text]
de Heer, P., de Bruin, E. C., Klein-Kranenbarg, E., Aalbers, R. I.J.M., Marijnen, C. A.M., Putter, H., de Bont, H. J., Nagelkerke, J. F., van Krieken, J. H. J.M., Verspaget, H. W., van de Velde, C. J.H., Kuppen, P. J.K., for the Dutch Colorectal Cancer Group, (2007). Caspase-3 Activity Predicts Local Recurrence in Rectal Cancer. Clin. Cancer Res. 13: 5810-5815 [Abstract] [Full Text]
Kemeny, N. (2007). Presurgical Chemotherapy in Patients Being Considered for Liver Resection. The Oncologist 12: 825-839 [Abstract] [Full Text]
O'Dwyer, P. J., Eckhardt, S. G., Haller, D. G., Tepper, J., Ahnen, D., Hamilton, S., Benson, A. B. III, Rothenberg, M., Petrelli, N., Lenz, H.-J., Diasio, R., DuBois, R., Sargent, D., Sloan, J., Johnson, C. D., Comis, R. L., O'Connell, M. J. (2007). Priorities in Colorectal Cancer Research: Recommendations From the Gastrointestinal Scientific Leadership Council of the Coalition of Cancer Cooperative Groups. JCO 25: 2313-2321 [Abstract] [Full Text]
Wieder, H. A., Rosenberg, R., Lordick, F., Geinitz, H., Beer, A., Becker, K., Woertler, K., Dobritz, M., Siewert, J. R., Rummeny, E. J., Stollfuss, J. C. (2007). Rectal Cancer: MR Imaging before Neoadjuvant Chemotherapy and Radiation Therapy for Prediction of Tumor-Free Circumferential Resection Margins and Long-term Survival. Radiology 243: 744-751 [Abstract] [Full Text]
Wolpin, B. M., Meyerhardt, J. A., Mamon, H. J., Mayer, R. J. (2007). Adjuvant Treatment of Colorectal Cancer. CA Cancer J Clin 57: 168-185 [Abstract] [Full Text]
Haddock, M. G., Sloan, J. A., Bollinger, J. W., Soori, G., Steen, P. D., Martenson, J. A. (2007). Patient Assessment of Bowel Function During and After Pelvic Radiotherapy: Results of a Prospective Phase III North Central Cancer Treatment Group Clinical Trial. JCO 25: 1255-1259 [Abstract] [Full Text]
Machiels, J-P, Sempoux, C, Scalliet, P, Coche, J-C, Humblet, Y, Van Cutsem, E, Kerger, J, Canon, J-L, Peeters, M, Aydin, S, Laurent, S, Kartheuser, A, Coster, B, Roels, S, Daisne, J-F, Honhon, B, Duck, L, Kirkove, C, Bonny, M-A, Haustermans, K (2007). Phase I/II study of preoperative cetuximab, capecitabine, and external beam radiotherapy in patients with rectal cancer. Ann Oncol 18: 738-744 [Abstract] [Full Text]
Senan, S., Smit, E. F. (2007). Design of Clinical Trials of Radiation Combined with Antiangiogenic Therapy. The Oncologist 12: 465-477 [Abstract] [Full Text]
MERCURY Study Group, (2007). Extramural Depth of Tumor Invasion at Thin-Section MR in Patients with Rectal Cancer: Results of the MERCURY Study. Radiology 243: 132-139 [Abstract] [Full Text]
Baxter, N. N., Garcia-Aguilar, J. (2007). Organ Preservation for Rectal Cancer. JCO 25: 1014-1020 [Abstract] [Full Text]
Allen, S. D., Padhani, A. R., Dzik-Jurasz, A. S., Glynne-Jones, R. (2007). Rectal Carcinoma: MRI with Histologic Correlation Before and After Chemoradiation Therapy. Am. J. Roentgenol. 188: 442-451 [Abstract] [Full Text]
Rodel, C., Liersch, T., Hermann, R. M., Arnold, D., Reese, T., Hipp, M., Furst, A., Schwella, N., Bieker, M., Hellmich, G., Ewald, H., Haier, J., Lordick, F., Flentje, M., Sulberg, H., Hohenberger, W., Sauer, R. (2007). Multicenter Phase II Trial of Chemoradiation With Oxaliplatin for Rectal Cancer. JCO 25: 110-117 [Abstract] [Full Text]
Gill, S., Blackstock, A. W., Goldberg, R. M. (2007). Colorectal Cancer. Mayo Clin Proc. 82: 114-129 [Abstract] [Full Text]
Harewood, G. C., Hoecht, S., Hinkelbein, W., Cromwell, J. W., Santiago, L. T., Marcet, J. E., Curigliano, G., Spitaleri, G., Zampino, G., Bosset, J.-F., Collette, L., Maingon, P. (2006). Treatment of rectal cancer.. NEJM 355: 2486-2486 [Full Text]
Han, N., Galandiuk, S. (2006). Induction Chemoradiation for Rectal Cancer. Arch Surg 141: 1246-1252 [Abstract] [Full Text]
Finlay, I. (2006). Preoperative staging for rectal cancer.. BMJ 333: 766-767 [Full Text]
MERCURY Study Group, (2006). Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. BMJ 333: 779- [Abstract] [Full Text]
Gerard, J.-P., Conroy, T., Bonnetain, F., Bouche, O., Chapet, O., Closon-Dejardin, M.-T., Untereiner, M., Leduc, B., Francois, E., Maurel, J., Seitz, J.-F., Buecher, B., Mackiewicz, R., Ducreux, M., Bedenne, L. (2006). Preoperative Radiotherapy With or Without Concurrent Fluorouracil and Leucovorin in T3-4 Rectal Cancers: Results of FFCD 9203. JCO 24: 4620-4625 [Abstract] [Full Text]
Bosset, J.-F., Collette, L., Calais, G., Mineur, L., Maingon, P., Radosevic-Jelic, L., Daban, A., Bardet, E., Beny, A., Ollier, J.-C., EORTC Radiotherapy Group Trial 22921, (2006). Chemotherapy with Preoperative Radiotherapy in Rectal Cancer. NEJM 355: 1114-1123 [Abstract] [Full Text]
Johnston, P. G. (2006). Prognostic Markers of Local Relapse in Rectal Cancer: Are We Any Further Forward?. JCO 24: 4049-4050 [Full Text]
Liersch, T., Langer, C., Ghadimi, B. M., Kulle, B., Aust, D. E., Baretton, G. B., Schwabe, W., Hausler, P., Becker, H., Jakob, C. (2006). Lymph Node Status and TS Gene Expression Are Prognostic Markers in Stage II/III Rectal Cancer After Neoadjuvant Fluorouracil-Based Chemoradiotherapy. JCO 24: 4062-4068 [Abstract] [Full Text]
Nissan, A., Stojadinovic, A., Shia, J., Hoos, A., Guillem, J. G., Klimstra, D., Cohen, A. M., Minsky, B. D., Paty, P. B., Wong, W. D. (2006). Predictors of Recurrence in Patients With T2 and Early T3, N0 Adenocarcinoma of the Rectum Treated by Surgery Alone. JCO 24: 4078-4084 [Abstract] [Full Text]
Smalley, S. R., Benedetti, J. K., Williamson, S. K., Robertson, J. M., Estes, N. C., Maher, T., Fisher, B., Rich, T. A., Martenson, J. A., Kugler, J. W., Benson, A. B. III, Haller, D. G., Mayer, R. J., Atkins, J. N., Cripps, C., Pedersen, J., Periman, P. O., Tanaka, M. S. Jr, Leichman, C. G., Macdonald, J. S. (2006). Phase III Trial of Fluorouracil-Based Chemotherapy Regimens Plus Radiotherapy in Postoperative Adjuvant Rectal Cancer: GI INT 0144. JCO 24: 3542-3547 [Abstract] [Full Text]
Glynne-Jones, R., Mawdsley, S., Pearce, T., Buyse, M. (2006). Alternative clinical end points in rectal cancer--are we getting closer?. Ann Oncol 17: 1239-1248 [Abstract] [Full Text]
Cascini, G. L., Avallone, A., Delrio, P., Guida, C., Tatangelo, F., Marone, P., Aloj, L., De Martinis, F., Comella, P., Parisi, V., Lastoria, S. (2006). 18F-FDG PET Is an Early Predictor of Pathologic Tumor Response to Preoperative Radiochemotherapy in Locally Advanced Rectal Cancer. JNM 47: 1241-1248 [Abstract] [Full Text]
Jonas, J, Bahr, R (2006). Neoadjuvant chemoradiation treatment impairs accuracy of MRI staging in rectal carcinoma.. Gut 55: 1214-1215 [Full Text]
Watanabe, T., Kiyomatsu, T., Kanazawa, T., Kazama, Y., Kojima, T., Tanaka, J., Tanaka, T., Nagawa, H. (2006). Weekly oxaliplatin and preoperative radiotherapy as a new neoadjuvant therapy for locally-advanced rectal cancer. Ann Oncol 17: 1173-1173 [Full Text]
Calvo, F. A., Serrano, F. J., Diaz-Gonzalez, J. A., Gomez-Espi, M., Lozano, E., Garcia, R., de la Mata, D., Arranz, J. A., Garcia-Alfonso, P., Perez-Manga, G., Alvarez, E. (2006). Improved incidence of pT0 downstaged surgical specimens in locally advanced rectal cancer (LARC) treated with induction oxaliplatin plus 5-fluorouracil and preoperative chemoradiation. Ann Oncol 17: 1103-1110 [Abstract] [Full Text]
Aschele, C., Friso, M. L., Del Bianco, P., Pucciarelli, S. (2006). Reply to Letter to the Editor 'Weekly oxaliplatin and pre-operative radiotherapy as a new neoadjuvant therapy for locally advanced rectal cancer', by T. Watanabe et al. (Ann Oncol 2006; 17: 1173). Ann Oncol 17: 1173-1174 [Full Text]
Ryan, D. P., Niedzwiecki, D., Hollis, D., Mediema, B. E., Wadler, S., Tepper, J. E., Goldberg, R. M., Mayer, R. J. (2006). Phase I/II Study of Preoperative Oxaliplatin, Fluorouracil, and External-Beam Radiation Therapy in Patients With Locally Advanced Rectal Cancer: Cancer and Leukemia Group B 89901. JCO 24: 2557-2562 [Abstract] [Full Text]
Cohen, S. M., Goel, A., Phillips, J., Ennis, R. D., Grossbard, M. L. (2006). The Role of Perioperative Chemotherapy in the Treatment of Urothelial Cancer. The Oncologist 11: 630-640 [Abstract] [Full Text]
Rex, D. K., Kahi, C. J., Levin, B., Smith, R. A., Bond, J. H., Brooks, D., Burt, R. W., Byers, T., Fletcher, R. H., Hyman, N., Johnson, D., Kirk, L., Lieberman, D. A., Levin, T. R., O'Brien, M. J., Simmang, C., Thorson, A. G., Winawer, S. J. (2006). Guidelines for Colonoscopy Surveillance after Cancer Resection: A Consensus Update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer.. CA Cancer J Clin 56: 160-167 [Abstract] [Full Text]
Rodel, C., Sauer, R. (2006). In Reply:. JCO 24: 1320-1321 [Full Text]
Glynne-Jones, R., Dunst, J., Sebag-Montefiore, D. (2006). The integration of oral capecitabine into chemoradiation regimens for locally advanced rectal cancer: how successful have we been?. Ann Oncol 17: 361-371 [Abstract] [Full Text]
Mohiuddin, M., Winter, K., Mitchell, E., Hanna, N., Yuen, A., Nichols, C., Shane, R., Hayostek, C., Willett, C. (2006). Randomized Phase II Study of Neoadjuvant Combined-Modality Chemoradiation for Distal Rectal Cancer: Radiation Therapy Oncology Group Trial 0012. JCO 24: 650-655 [Abstract] [Full Text]
Chau, I., Brown, G., Cunningham, D., Tait, D., Wotherspoon, A., Norman, A. R., Tebbutt, N., Hill, M., Ross, P. J., Massey, A., Oates, J. (2006). Neoadjuvant Capecitabine and Oxaliplatin Followed by Synchronous Chemoradiation and Total Mesorectal Excision in Magnetic Resonance Imaging-Defined Poor-Risk Rectal Cancer. JCO 24: 668-674 [Abstract] [Full Text]
De Paoli, A., Chiara, S., Luppi, G., Friso, M. L., Beretta, G. D., Del Prete, S., Pasetto, L., Santantonio, M., Sarti, E., Mantello, G., Innocente, R., Frustaci, S., Corvo, R., Rosso, R. (2006). Capecitabine in combination with preoperative radiation therapy in locally advanced, resectable, rectal cancer: a multicentric phase II study. Ann Oncol 17: 246-251 [Abstract] [Full Text]
Kalff, V., Duong, C., Drummond, E. G., Matthews, J. P., Hicks, R. J. (2006). Findings on 18F-FDG PET Scans After Neoadjuvant Chemoradiation Provides Prognostic Stratification in Patients with Locally Advanced Rectal Carcinoma Subsequently Treated by Radical Surgery. JNM 47: 14-22 [Abstract] [Full Text]
Grade, M., Ghadimi, B. M., Varma, S., Simon, R., Wangsa, D., Barenboim-Stapleton, L., Liersch, T., Becker, H., Ried, T., Difilippantonio, M. J. (2006). Aneuploidy-Dependent Massive Deregulation of the Cellular Transcriptome and Apparent Divergence of the Wnt/{beta}-catenin Signaling Pathway in Human Rectal Carcinomas. Cancer Res. 66: 267-282 [Abstract] [Full Text]
Birgisson, H., Pahlman, L., Gunnarsson, U., Glimelius, B. (2005). Adverse Effects of Preoperative Radiation Therapy for Rectal Cancer: Long-Term Follow-Up of the Swedish Rectal Cancer Trial. JCO 23: 8697-8705 [Abstract] [Full Text]
Rodel, C., Martus, P., Papadoupolos, T., Fuzesi, L., Klimpfinger, M., Fietkau, R., Liersch, T., Hohenberger, W., Raab, R., Sauer, R., Wittekind, C. (2005). Prognostic Significance of Tumor Regression After Preoperative Chemoradiotherapy for Rectal Cancer. JCO 23: 8688-8696 [Abstract] [Full Text]
Machiels, J.-P., Duck, L., Honhon, B., Coster, B., Coche, J.-C., Scalliet, P., Humblet, Y., Aydin, S., Kerger, J., Remouchamps, V., Canon, J.-L., Van Maele, P., Gilbeau, L., Laurent, S., Kirkove, C., Octave-Prignot, M., Baurain, J.-F., Kartheuser, A., Sempoux, C. (2005). Phase II study of preoperative oxaliplatin, capecitabine and external beam radiotherapy in patients with rectal cancer: the RadiOxCape study. Ann Oncol 16: 1898-1905 [Abstract] [Full Text]
Birgisson, H., Pahlman, L., Gunnarsson, U., Glimelius, B. (2005). Occurrence of Second Cancers in Patients Treated With Radiotherapy for Rectal Cancer. JCO 23: 6126-6131 [Abstract] [Full Text]
O'Connell, M. J. (2005). Combined-Modality Neoadjuvant Therapy for Rectal Cancer. JCO 23: 5450-5451 [Full Text]
Bosset, J.-F., Calais, G., Mineur, L., Maingon, P., Radosevic-Jelic, L., Daban, A., Bardet, E., Beny, A., Briffaux, A., Collette, L. (2005). Enhanced Tumorocidal Effect of Chemotherapy With Preoperative Radiotherapy for Rectal Cancer: Preliminary Results--EORTC 22921. JCO 23: 5620-5627 [Abstract] [Full Text]
Rengan, R., Paty, P., Wong, W. D., Guillem, J., Weiser, M., Temple, L., Saltz, L., Minsky, B. D. (2005). Distal cT2N0 Rectal Cancer: Is There an Alternative to Abdominoperineal Resection?. JCO 23: 4905-4912 [Abstract] [Full Text]
Andre, N, Schmiegel, W (2005). CHEMORADIOTHERAPY FOR COLORECTAL CANCER. Gut 54: 1194-1202 [Full Text]
Zlobec, I., Steele, R., Nigam, N., Compton, C. C. (2005). A Predictive Model of Rectal Tumor Response to Preoperative Radiotherapy Using Classification and Regression Tree Methods. Clin. Cancer Res. 11: 5440-5443 [Abstract] [Full Text]
Aschele, C., Friso, M. L., Pucciarelli, S., Lonardi, S., Sartor, L., Fabris, G., Urso, E. D. L., Del Bianco, P., Sotti, G., Lise, M., Monfardini, S. (2005). A phase I-II study of weekly oxaliplatin, 5-fluorouracil continuous infusion and preoperative radiotherapy in locally advanced rectal cancer. Ann Oncol 16: 1140-1146 [Abstract] [Full Text]
Rodel, F., Hoffmann, J., Distel, L., Herrmann, M., Noisternig, T., Papadopoulos, T., Sauer, R., Rodel, C. (2005). Survivin as a Radioresistance Factor, and Prognostic and Therapeutic Target for Radiotherapy in Rectal Cancer. Cancer Res. 65: 4881-4887 [Abstract] [Full Text]

Comments and questions? Please contact us.