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Aim Previous randomized controlled trials and meta-analyses have demonstrated the ineffectiveness of fluorouracil-based adjuvant chemotherapy for patients with rectal cancer who have undergone neoadjuvant chemoradiotherapy and subsequent surgery. The role of oxaliplatin/fluorouracil-based adjuvant chemotherapy in such patients is unknown. We performed a meta-analysis to evaluate the efficacy of oxaliplatin/fluorouracil-based adjuvant chemotherapy based on a comparison with fluorouracil-based adjuvant chemotherapy for patients with rectal cancer. Method A literature search of MEDLINE, Embase, Web of Science, Cochrane Library and ClinicalTrials.gov was performed to identify eligible studies. The primary end-point of interest was disease-free survival ( DFS). The secondary end-points were overall survival, compliance and the incidence of Grade 3 or 4 toxicity. Results The literature search identified four randomized controlled trials that met the inclusion criteria for the meta-analysis, and 2793 patients with pathological TNM or clinical TNM Stage II or III disease were included. The meta-analysis showed that oxaliplatin/fluorouracil-based adjuvant chemotherapy was associated with a significantly improved DFS (hazard ratio 0.85; 95% CI 0.73−0.98; P = 0.03), comparable compliance ( OR 1.18; 95% CI 0.95−1.46; P = 0.13) and a higher incidence of vomiting or nausea ( OR 2.47; 95% CI 1.21−5.05; P = 0.01). No significant differences were observed between the groups with respect to overall survival and the incidence of leucopaenia, anaemia, thrombocytopaenia and diarrhoea. Conclusion Adjuvant oxaliplatin/fluorouracil-based chemotherapy can improve the DFS of patients after neoadjuvant chemoradiotherapy and radical surgery, compared with adjuvant fluorouracil-based chemotherapy. Data of the longer-term survival outcome are needed. [ABSTRACT FROM AUTHOR]

Background: Lymphoma combined with hepatitis B infection occupies a relatively higher incidence in China than that of in Europe and America.Aims: To observe the efficacy and safety of rituximab in combination with chemotherapy in patients with B-cell non-Hodgkin's lymphoma (NHL) and hepatitis B virus (HBV) infection.Methods: Ninety-two B-cell lymphoma patients with HBV infection in Sichuan Cancer Hospital from January 2009 to October 2015 were divided into two groups. Patients in Group A (n = 33) were treated with rituximab combined with chemotherapy, while Group B (n = 59) accepted chemotherapy alone.Results: The effective rate (complete response + partial response) was 69.7% in Group A and 44.1% in Group B with significantly statistical difference (P = 0.018). Some of the patients got different grades of hepatic function damage during the period of chemotherapy, but there was no statistically significant difference between these two groups (P = 0.071).Conclusions: For CD20-positive NHL patients complicated with HBV infection, rituximab combined with chemotherapy modality is effective. The promise efficacy of this regimen could be achieved relying on controllable safety based on antiviral treatment. [ABSTRACT FROM AUTHOR]

The INT0116 trial established the role of adjuvant chemoradiation (CRT) in the multidisciplinary approach to the management of locally advanced gastric cancer. However, whether adjuvant CRT is indispensable for patients undergoing D2 dissection remains undefined. The adjuvant chemoradiation therapy in stomach cancer (ARTIST) trial, which was designed to compare adjuvant chemotherapy to CRT, failed to demonstrate differences in disease-free and overall survival in the whole study group; however, subgroup analysis indicated that patients with lymph node metastasis may benefit from additional radiation. A follow-up ARTIST II trial is currently under way. The efficacy of adjuvant CRT remains controversial because of variation among studies in the inclusion criteria and treatment delivery methods; however, the identification of patients who would benefit from CRT is critical. Advanced radiotherapy techniques such as intensity-modulated radiotherapy protect normal tissues via motion management and decreased radiation-induced toxicity and contribute to plan optimization. Further studies integrating clinical and molecular factors as well as neoadjuvant CRT are warranted. [ABSTRACT FROM AUTHOR]

Background We aimed to evaluate the association of serum C-reactive protein (CRP) with prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy. Methods We retrospectively reviewed 79 patients with locoregionally advanced nasopharyngeal carcinoma (cT3–4N0–3M0) treated with chemoradiotherapy. Chemoradiotherapy consisted of external-beam radiotherapy to the nasopharynx (70–80 Gy), the lymph node-positive area (60–70 Gy), and the lymph node–negative area (50–60 Gy) combined with 3 cycles of various platinum-based regimens delivered at 3-week intervals. Elevated CRP was defined as more than 8 mg/L. The survival rate was calculated using the Kaplan-Meier method, and univariate and multivariate analyses (Cox proportional hazards model) were used to identify factors significantly associated with prognosis. Results During the median follow-up of 3.9 years (range: 1–5.5 years), 23 patients died from nasopharyngeal cancer. The 5-year cancer-specific survival (CSS) rate was 62.90%. Before chemoradiotherapy, 18 patients had high serum CRP; the CSS rate in that subgroup was significantly worse than the rate in the remaining patients (p = 0.0002). Multivariate analysis showed that CRP was an independent prognostic indicator of CSS, with a hazard ratio of 3.04 (95% confidence interval: 1.22 to 7.55; p = 0.017). Among the 18 patients with elevated serum CRP, 9 achieved normal serum CRP after chemoradiotherapy, of whom 5 remained living with no evidence of recurrence or metastasis during follow-up. By contrast, the remaining 9 patients in whom serum CRP did not normalize after chemoradiotherapy died within 4.2 years. Conclusions Elevated serum CRP before treatment predicts poor prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy. [ABSTRACT FROM AUTHOR]

The standard of care for locally advanced head and neck cancer (HNC) includes radiation with concurrent chemotherapy due to superior disease control. Older adults with HNC experience higher rates of morbidity, treatment breaks, hospitalizations, and death. New strategies are needed to better support older adults with HNC through radiation and chemotherapy to minimize treatment morbidity. Geriatric assessment (GA) can be used to identify patient-specific deficits and facilitate interventions to improve patient outcomes. In this randomized pilot clinical trial (NCT05239000), we hypothesize that use of geriatric assessment with or without comanagement can reduce the risk of hospitalization for older adults with HNC. Patients aged 65 and older with newly diagnosed or post-operative mucosal HNC with squamous cell histology are eligible for enrollment. All patients are planned for 6-7 weeks of radiation with concurrent chemotherapy. Enrolled patients complete an electronic GA before treatment, shortly following treatment, and 3-4 months after treatment. Patients are randomized between two groups: Arm 1 involves a geriatric consultation for management of geriatric-specific deficits; Arm 2 involves management of geriatric deficits by the radiation oncology team without geriatric consultation. All patients are seen twice weekly in radiation oncology clinic to enhance supportive care. Forty patients will be randomized equally between the two arms. The primary endpoint is the proportion of patients with unplanned hospitalization during the course of radiation therapy. The historic rate of hospitalization at Memorial Sloan Kettering Cancer Center is 44.6% for this cohort, and the study will be considered promising if there are 7 or fewer hospitalizations in either group. A secondary objective is to measure changes in GA before and after radiation and chemotherapy. The long term goal of this research is to identify new strategies that improve the care and outcomes of older adults with HNC receiving radiation and chemotherapy. TBD TBD [ABSTRACT FROM AUTHOR]

Purpose To evaluate the efficacy and safety of pelvic irradiation combined systematic chemotherapy in patients with locally advanced (cT3–T4 and/or cN+) rectal cancer and synchronous unresectable distant metastases. Patients and methods A total of 76 eligible patients who received pelvic radiotherapy and concurrent capecitabine-based chemotherapy were retrospectively reviewed. Patients survival curves were constructed using the Kaplan-Meier method, and a multivariate analysis was performed to identify independent prognostic factors. Results Most of the adverse events were mild during the period of combined chemoradiotherapy. Twenty-two patients experienced resection of primary tumour and 16 patients underwent radical surgery of all lesions. Only five patients had pelvic progression during the follow-up period. The median progression-free survival and median overall survival were 13 and 30 months, respectively. Radical surgery of all lesions following chemoradiotherapy was found to be an independent prognostic factor according to multivariate analysis. Conclusions Pelvic irradiation combined with systematic chemotherapy in patients with locally advanced rectal cancer and synchronous unresectable distant metastases is effective and tolerable, both for pelvic and distant control. A curative resection following chemoradiotherapy was associated with prolonged survival. [ABSTRACT FROM AUTHOR]