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Your search keyword '"Adab, F."' showing total 3 results
Start Over Author "Adab, F." Topic rectal neoplasms
3 results on '"Adab, F."'

1. Multicentre prospective audit of surgical outcomes and acute complications following short course pre-operative radiotherapy for resectable rectal cancer.

Author

Giridharan S, Vakkalanka B, Anwar MS, Geh JI, Glaholm J, Churn M, Adab F, Grieve R, McConkey C, and Hartley A

Subjects
Acute Disease, Adenocarcinoma pathology, Age Factors, Dose Fractionation, Radiation, Female, Humans, Male, Medical Audit, Neoplasm Staging, Prospective Studies, Radiotherapy, Adjuvant methods, Rectal Neoplasms pathology, Risk Factors, Time Factors, Treatment Outcome, Adenocarcinoma radiotherapy, Adenocarcinoma surgery, Postoperative Complications, Rectal Neoplasms radiotherapy, Rectal Neoplasms surgery
Abstract

Background: The addition of short course pre-operative radiotherapy to total mesorectal excision reduces local recurrence in resectable adenocarcinoma of the rectum. In a previous retrospective study potential factors associated with early complications following this combination were identified. The aim of this study was to examine these relationships in a prospective multicentre audit., Methods: One hundred and seven patients who received short course pre-operative radiotherapy in four cancer centres between 1 October 2001 and 30 September 2002 were included. Data including patient age, radiotherapy field length, overall treatment time, operation type, surgical outcomes and complications occurring within 3 months of the 1st day of radiotherapy were collected. These were compared and combined with the previously studied cohort of 176 patients treated at one centre between 1st January 1998 and 31st December 1999., Results: In the prospective cohort only patient age (P=0.001) was significantly associated with acute complications. However, both the overall treatment time (median 9.0 vs 11.0 days P <0.0001) and field length (median 16.6 vs 17.0 cm P=0.03) were significantly shorter in this cohort when compared to the previous retrospective study. In patients from both studies (n=283), increasing age (P=0.002) and field length (independent of operation type) (P=0.02) were independently associated with an increased risk of acute complications., Conclusions: This study suggests that meticulous selection of patients for short course pre-operative radiotherapy and smaller planning target volumes may be associated with a lower risk of acute complications. The use of MRI scanning to stage pelvic disease may reduce the number of patients with R1 resections receiving short course pre-operative radiotherapy.

Published
2005
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2. A histopathological assessment of the response of rectal adenocarcinoma to combination chemo-radiotherapy: relationship to apoptotic activity, p53 and bcl-2 expression.

Author

Scott N, Hale A, Deakin M, Hand P, Adab FA, Hall C, Williams GT, and Elder JB

Subjects
Adenocarcinoma drug therapy, Adenocarcinoma physiopathology, Adenocarcinoma radiotherapy, Chemotherapy, Adjuvant, Humans, Mitotic Index drug effects, Mitotic Index radiation effects, Radiotherapy, Adjuvant, Rectal Neoplasms drug therapy, Rectal Neoplasms physiopathology, Rectal Neoplasms radiotherapy, Adenocarcinoma pathology, Adenocarcinoma therapy, Apoptosis drug effects, Apoptosis radiation effects, Gene Expression Regulation, Neoplastic drug effects, Gene Expression Regulation, Neoplastic radiation effects, Proto-Oncogene Proteins c-bcl-2 metabolism, Rectal Neoplasms pathology, Rectal Neoplasms therapy, Tumor Suppressor Protein p53 metabolism
Abstract

Aims: To investigate the use of pre-operative chemo-irradiation in downstaging advanced rectal cancer prior to surgical resection., Methods: We examined the pathological effects of chemo-irradiation on 24 rectal tumours and correlated the efficacy of treatment with the level of apoptosis, mitosis, P53 and bcl-2 protein expression on pre-treatment biopsies., Results: All tumours were resectable following chemo-irradiation. Six cancers showed complete regression with no viable tumour in the resection specimen. A significant correlation was found between spontaneous tumour apoptosis and tumour regression., Conclusions: Our results suggest that in rectal cancer the apoptotic rate in untreated tumour tissue may predict sensitivity to radiation and cytotoxic agents. No relationship was found between regression and mitotic rate, p53 or bcl-2 expression.

Published
1998
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3. Randomized clinical trial of adjuvant radiotherapy and 5-fluorouracil infusion in colorectal cancer (AXIS)

Author

Miller, R, Dewar, EP, Kapadia, CR, Nejim, A, Hutchinson, IF, McAdam, WA, Morris, IR, Deasy, JM, Irwin, ST, Oates, GD, O'Dwyer, STP, Dorricott, NJ, Stock, SE, Wilkinson, MJS, Ostick, DG, Hobbiss, JH, Farrands, PA, Ross, AHM, Sauven, P, Sandilands, DGD, De Castella, HC, McCarthy, D, Lee, P, Allen-Mersh, TG, Haynes, S, Bristol, JB, Donovan, IA, Neoptolemos, JP, Wolverson, RL, Silverman, SH, Lee, M, Backhouse, C, Millar, DM, Kirwan, WO, Edwards, P, Morran, CG, Maddox, C, Palmer, JG, Nicoll, J, Jacob, GH, Archbold, JAA, Bell, JC, Rennie, JA, Turner, AR, Turner, J, Fearon, KCH, Vaar, A, Ratsep, V, Nasmyth, DG, McKee, RF, Cooke, TG, McArdle, C, Stephenson, RF, Baxter, JN, Rew, DA, Thomson, WHF, Gear, MW, Allan, A, Pearson, HJ, Goldberg, PA, Kmiot, WAW, Irving, MH, Bancewicz, J, Mughal, M, Jones, DJ, Kipping, RA, Dudley, NE, Mortensen, NJ, Parker, M, Armistead, PR, Gillison, EW, Loughlin, V, Kelly, MJ, Mosley, J, Cade, D, Guy, A, Moorehead, J, Harvey, CF, Parisi, VP, Delrio, P, Jones, DRB, Bozzino, JM, Griffin, SM, Griffith, CDM, Bulman, A, Stebbings, WSL, Deakin, M, Adab, F, Goulbourne, IA, Berry, AR, Cunningham, FO, Ingoldby, CJH, Talbot, R, Burgess, P, Stamatakis, J, Offori, T, Cullen, PT, Logie, JRC, Thomson, A, Maybury, NK, Fozard, BJ, Cooper, MJ, Vellacott, KD, Shorthouse, AJ, Poston, GJ, Simkin, EP, McIntosh, HR, Karran, DR, Royle, GT, Karanjia, N, Marks, CG, Maxwell, RJ, Varma, JS, Simson, JNL, Burkitt, D, Johnson, CD, Steer, HW, Primrose, JN, McGinn, FP, Taylor, I, Zeiderman, MR, Sagor, GR, Hawley, P, Northover, JMA, Donaldson, DR, Scott, HJ, Gallagher, P, Crossling, FT, McKelvey, STD, Rickett, JW, Kingston, RD, Davidson, T, Boulos, PB, Smith, DC, Smith, IS, Gillespie, G, Kashi, SH, Grieve, RJ, Fraser, IA, Roberts, PN, Lam, FT, Parker, RW, Stockdale, A, Jurewicz, A, Woodward, DAK, Taylor, BA, Thomas, JM, Sarin, S, Reilly, DT, Stebbings, W, Hamer-Hodges, DW, Nixon, SJ, Saunders, JH, Macintyre, IMC, Yosef, H, Smith, AN, Lock, MR, Lake, SP, Smart, PJG, Grimley, R, Hall, R, Jamison, MH, Jenkinson, LR, James, RD, Donaldson, D, Gray, R, Stenning, SP, Garten, L, McQueen, A, Simnett, S, Johnstone, C, Cain, D, Lallemand, E, Peto, R, Finan, P, Slevin, M, Altman, D, and Collaborators, AXIS

Subjects
Adult, Male, medicine.medical_specialty, Antimetabolites, Antineoplastic, Colorectal cancer, medicine.medical_treatment, Gastroenterology, law.invention, Folinic acid, Randomized controlled trial, law, Internal medicine, Preoperative Care, medicine, Humans, Infusions, Intravenous, Survival analysis, Aged, Aged, 80 and over, Postoperative Care, business.industry, Heparin, Portal Vein, Rectal Neoplasms, Hazard ratio, Cancer, Anticoagulants, Middle Aged, medicine.disease, Survival Analysis, Surgery, Radiation therapy, Treatment Outcome, Fluorouracil, Colonic Neoplasms, Patient Compliance, Drug Therapy, Combination, Female, Radiotherapy, Adjuvant, business, medicine.drug, Follow-Up Studies
Abstract

Background Postoperative portal vein infusion (PVI) of 5-fluorouracil (5-FU) is a well tolerated and widely applicable treatment for colorectal cancer that might have an enormous public health impact, even if it produced survival benefits of just a few per cent. Very large trials are required to detect such differences, and the Adjuvant X-ray and 5-FU Infusion Study (AXIS) is the largest such trial yet reported. Methods Consenting patients with presumed colorectal cancer were randomized to surgery with or without 7 days of PVI (1 g 5-FU plus 5000 units heparin in 1 litre 5 per cent dextrose infused over each 24-h period). In addition, patients with rectal cancer could be randomized to radiotherapy or no radiotherapy to be given either before or after surgery. Results Between November 1989 and December 1997, 3583 patients were randomized with respect to PVI. The survival hazard ratios (95 per cent confidence interval (c.i.)) in all patients randomized and in the curatively resected subgroup (71·2 per cent of patients) were 1·00 (0·92 to 1·11) and 0·94 (0·83 to 1·06) respectively. Tests for heterogeneity suggested a greater treatment benefit for patients with colonic cancer than for patients with rectal cancer with respect to disease-free survival (hazard ratio 0·79 versus 1·03; P = 0·07), and there was a non-significant trend with respect to overall survival (hazard ratio 0·87 versus 1·03; P = 0·17). No survival benefit was seen in the 761 patients randomized with respect to radiotherapy; although not statistically significant, the impact on local recurrence rates was similar to that reported in the literature. Conclusion No overall benefit of PVI was established in AXIS when colonic and rectal cancers were considered together, but the evidence suggesting a differential treatment effect according to site of cancer in AXIS was strongly supported by a meta-analysis incorporating the previous trials. Combining the data gave hazard ratios of 0·82 and 1·00 for colonic and rectal tumours respectively (test for interaction, P = 0·024), equating to an absolute survival benefit for patients with colonic cancer of 5·8 (95 per cent c.i. 2·8 to 8·5) per cent, a level close to that seen for prolonged systemic therapy.

Published
2003

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