جستجوی مقالات مرتبط با کلیدواژه « complete clinical response » در نشریات گروه « پزشکی »

Cisplatin-based neoadjuvant chemotherapy (NAC) is the standard of care in non-metastatic muscle-in-vasive bladder cancer (MIBC). There are limited data regarding the alternative choices for cisplatin-ineligible patients. This study has investigated the oncological outcomes of gemcitabine plus cisplatin (Gem/Cis) and gem-citabine plus carboplatin (Gem/Carbo) in this setting.

One hundred forty consecutive patients with MIBC (cT2–T4a) receiving neoadjuvant Gem/Cis or Gem/Carbo before chemoradiation (CRT) or radical cystectomy (RC) were retrospectively evaluated between April 2009 and April 2019. Patients with ECOG performance status 2, creatinine clearance < 60 mL/min, hydronephrosis, ejection fraction < 50%, or single kidney received Gem/Carbo. The complete clinical response (cCR) and overall survival (OS) of NAC regimens were compared. Prognostic significance was assessed with Cox proportional hazards model.

In total, 79 patients (56.4%) received Gem/Cis. The cCR was not significantly different between Gem/Cis and Gem/Carbo regimens (38.7% vs. 36.2%, P = .771). After NAC, 79 patients (56.4%) received CRT, and other cases underwent RC. After a median follow-up of 43 months, patients in the Gem/Cis group had significantly better OS than Gem/Carbo (median OS: 41.0 vs. 26.0 months, P = .008). Multivariable Cox proportional hazards models identified cT4a stage (95% confidence interval [95% CI]: 1.001–4.85, hazard ratio [HR] = 2.08, P = .03) and cCR (95% CI: 0.26–0.99, HR = 0.51, P = .04) as the only independent prognostic factors of OS, and ruled out the type of NAC regimen.

The choice of NAC (between Gem/Cis and Gem/Carbo) is not the predictor of survival and both regimens had similar cCR.

This study assessed the optimal timing of computed tomography for detection of metastatic disease in locoregional lymph nodes in patients with rectal cancer who have undergone chemoradiotherapy.
This observational retrospective study was performed in a single institution. All patients with locally advanced rectal cancer treated with chemoradiotherapy, followed by a total mesorectum excision from January 1, 2003 to December 31, 2012, were included. Lymph node metastases evident on preoperative computed tomography were compared with postoperative pathologic lymph node status.
The study population consisted of 108 patients: Group A (nodal negative on preoperative computed tomography, n = 52) and Group B (nodal positive on preoperative computed tomography, n = 56). Analysis of the computed tomography scans in Group A revealed a high ability (98.07%) to predict negative lymph nodes, compared to 58.92% for predicting positive lymph nodes in Group B.
The results of this study suggest that the optimal timing of computed tomography for assessing lymph nodes after neoadjuvant chemoradiotherapy for rectal cancer is after 6 weeks; this timing might be key for prediction of complete clinical responses.