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Background: The standard treatment for locally advanced cervical cancer (LACC) is concomitant chemoradiotherapy. In the majority of patients with LACC after properly executed concomitant chemoradiotherapy local control of the disease is achieved, and consequently distant relapse becomes the main cause of death for these patients. In an attempt to improve the outcome of patients with LACC, we designed a regimen of concomitant chemobrachyradiotherapy with cisplatin and ifosfamide followed by consolidation chemotherapy. Patients and Methods: Between 1999 and 2012, 118 patients diagnosed with LACC, The International Federation of Gynecology and Obstetrics (FIGO) stages IB2-IVA, regardless of histology, were treated with concomitant chemobrachyradiotherapy and consolidation chemotherapy at our Institution. Chemotherapy consisted of two cycles of cisplatin and ifosfamide applied concomitantly with two intracavitary lowdose rate brachytherapy applications, and of four cycles of the same drug combination as an adjuvant/consolidation part of the treatment. The primary outcome in this analysis was distant disease-specific survival. Results: A total of 118 patients had documented relapse of cervical cancer, with only three local recurrences observed ; 15 patients developed only distant recurrence, and one patient developed both local and distant recurrence. The distant disease- specific survival after a median follow-up of 96 months was 86.4%. Conclusion: Consolidation or adjuvant chemotherapy that follows concomitant chemoradiotherapy has a potential role in further improving control of the disease, especially distant control of the disease.

Radiation boosting has been shown in a number of studies to be effective in the prevention of cancer recurrence. To further the effectiveness of this technique, we propose a new method of enhancing dose locally by administrating nanoparticles of carboplatin (CaNPs) and oxaliplatin (ONPs) as adjuvants to brachytherapy and external beam therapy (EBRT). To investigate the efficacy of this method, dose enhancement calculations were carried out to calculate the energy deposited by photoelectrons and Auger electrons produced by low energy photons from either EBRT or brachytherapy sources with CaNPs and ONPs. Our results show a significant increase in the dose enhancement for various carboplatin and oxaliplatin concentrations up to their allowed FDA limits.

1998年から2003年までの6年間にT1，T2下咽頭扁平上皮癌37例（男34例，女3例）の初回治療を行った。年齢は45～88歳（平均67歳）で，病期分類ではI期：7例，II期：15例，III期：4例，IV期：11例で，亜部位分類では梨状陥凹型：27例，咽頭後壁型：5例，輪状後部型：5例であった。当科におけるT1，T2下咽頭癌症例に対する治療は，原則としてUFT®450mg/body内服及び低濃度CDDP 4～5mg/m2点滴静注による化学療法同時併用放射線療法（CRT）を基本方針としているが，CRT施行の条件にあわない症例は放射線療法（RT）単独で対処してきた。RT群（16例）とCRT群（21例）の2年局所制御率はRT：56.3%，CRT：59.9%で有意差を認めず，現在までのところCRTがRTに比して有用とはいえなかった。

The optimal regimen for organ preservation for laryngeal cancer remains an area of active investigation. Multiple organ-preservation strategies have been explored, including radiation therapy alone, induction chemotherapy followed by radiation therapy, and concomitant chemoradiotherapy. Until recently, induction chemotherapy followed by radiation therapy was the standard of care for organ preservation in the United States. However, recent data from the Intergroup Trial, R 91-11 has placed concomitant chemoradiotherapy in the forefront as the standard of care for organ preservation. Newer strategies are being investigated and include the use of induction chemotherapy before concomitant chemoradiotherapy and the integration of novel biological agents. It remains to be seen whether such interventions can improve on the excellent locoregional control shown in the landmark Intergroup trial.

下咽頭癌17例に対して，Docetaxelの超選択的動注療法を中心とした放射線化学療法を施行した。一時効果は，原発巣に対してはCR率94.1%，奏効率100%と高く，頸部転移巣に対してはCR率13.3%，奏効率80.0%とCR例は少なかった。総合でCR率23.5%，奏効率100%であった。有害事象については，Grade 3以上の白血球減少を29.4%に認め，Grade 3の粘膜炎を23.5%に認めた。また軽度の心不全とSIADHを1例ずつ認めたが，その他重篤な合併症は認めていない。喉頭温存率は93.3%と極めて良好であった。Kaplan-Meier法による生存率は，全症例では2年生存率41.3%であるが，TXTを40 mg/m2に固定し，続いてCDDP・5-FUの点滴静注するregimenの13例では2年生存率77.9%と良好であった。下咽頭癌に対して，本療法は効果，喉頭温存，有害事象を総合し極めて有用性が高い治療として，今後も施行可能と思われた。

Quality of life (QOL) measures give patients the possibility to express subjective changes in wellbeing. We aimed to translate the radiation specific quality of life questionnaire (QOL-RTI) and the companion head and neck module (HN) questionnaire into German and to test its reliability, validity and sensitivity.After translation and final revisions based on qualitative interviews with ten patients, 97 head and neck cancer patients were screened for eligibility. Patients answered the 38 items questionnaire at baseline and twice in week 4 of radiotherapy for test-retest reliability. Internal consistency was calculated using Chronbach's alpha. Patients also completed the functional assessment of cancer tool plus head and neck (FACT-G plus HN) for concurrent validity. Item analyses were performed to test the sensitivity.Chronbach's alpha yielded alpha = 0.85 for the QOL-RTI and alpha = 0.80 for the HN module, test-retest reliability scores were r = 0.87 and r = 0.83, respectively. The correlation of the QOL-RTI plus HN and the FACT plus HN was r = 0.79. Questionnaire sensitivity was supported by significant changes in the mean score of 45.8% of the QOL-RTI items and 78.6% of the HN items between baseline and week 4 of radiotherapy.The German version of the QOL-RTI was shown to be a reliable, valid and sensitive tool to assess the quality of life of patients undergoing radiotherapy. The HN module is useful for patients undergoing treatment for head and neck cancer.

We have used a combination of vitamin A (all-trans-retinyl palmitate), 5-fluorouracil (5-FU) and radiation to treat human head and neck squamous cell carcinoma (HNSCC). This chemoradiotherapy is called "FAR therapy." In this study we examined the effects of all-trans-retinoic acid (ATRA), the active metabolite of vitamin A, and ATRA plus 5-FU on two HNSCC cell lines (YCU-N861 and YCU-H891) to gain insight into the molecular mechanisms of FAR therapy. ATRA at 1 mM (the order of concentration found in HNSCC tumors treated with FAR therapy) inhibited cell proliferation and caused G1 cell cycle arrest in both cell lines. This was associated with a decrease in cyclin D1, an increase in p27(Kip1) and a reduction in the hyperphosphorylated form of retinoblastoma protein (pRB). With YCU-N861 cells, ATRA also caused a decrease in Bcl-2 and Bcl-X(L) and an increase in Bax. Both ATRA and 5-FU activated c-Jun N-terminal kinase (JNK) 1 and the combination of both agents resulted in additive or synergistic activation of JNK1, and also enhanced the induction of apoptosis. The YCU-H891 cells, in which the epidermal growth factor receptor (EGFR)-signal transducer and activator of transcription 3 (Stat3) pathway is constitutively activated, were more resistant to treatments with ATRA, 5-FU and the combination of both agents than YCU-N861 cells. A dominant negative Stat3 construct strongly enhanced the cellular sensitivity of this cell line to 5-FU but not to ATRA. In addition there is evidence that activation of Stat3 is associated with cellular resistance to radiation in HNSCC. Therefore, the addition to FAR therapy of agents that inhibit activation of the Stat3 pathway may enhance the clinical response of patients with HNSCC to FAR therapy.

TPS6090 Background: Approximately half of patients (pts) with HNSCC are diagnosed with locally advanced disease and treated with surgery or concomitant chemoradiotherapy (CRT) with cisplatin. Unfortunately, disease recurs in 40% to 60% of patients. The PD-l inhibitor pembro is approved for recurrent/metastatic HNSCC. CRT has immunomodulatory effects; preclinical data suggest that efficacy can be improved by adding pembro. The phase 3 KEYNOTE-412 trial (NCT03040999) will explore if CRT + pembro can improve outcomes of pts with LA-HNSCC. Methods: Adult pts with newly diagnosed, pathologically proven, treatment-naive LA-HNSCC will be enrolled. Study population will include p16-negative HNSCC (any T3-T4 or any N2a-N3 [AJCC 7th edition]) and p16-positive oropharyngeal cancer (any T4 or any N3). Other eligibility criteria: measurable disease per RECIST v1.1 by blinded independent central review (BICR), provision of tumor sample for biomarker analyses, ECOG PS 0 or 1, and eligible for definitive CRT but not considered for primary surgery. Pts will be randomly assigned 1:1 to receive either pembro 200 mg every 3 weeks (Q3W) plus CRT, which includes radiotherapy (RT; accelerated [70 Gy, six 2 Gy fractions/wk] or standard [70 Gy, five 2 Gy fractions/week] fractionation) plus cisplatin 100 mg/m2 Q3W for 3 cycles only, or placebo Q3W plus CRT. Pts will be stratified by RT regimen, tumor site/p16 status, and disease stage. Treatment will continue until centrally confirmed disease progression, unacceptable AEs, decision to withdraw by pt or investigator, or completion of 17 doses of pembro/placebo. Disease status will be evaluated by CT or MRI 12 weeks after end of CRT, every 4 months during the next 2 years, and then every 6 months during years 3-5. Pts will be evaluated for neck dissection at 12 weeks after CRT. AEs will be monitored and graded using CTCAE v4.0 throughout the trial and for 30 days (90 days for serious AEs) after end of treatment. Primary efficacy end point is event-free survival per RECIST v1.1 by BICR. Key secondary end points: overall survival, quality of life, and safety and tolerability of pembro. Approximately 780 pts will be enrolled. Clinical trial information: NCT03040999.

Notre étude consistera en l’évaluation du pronostic des patients porteurs d'un adénocarcinome gastrique opérés et traités par radio-chimiothérapie adjuvante en technique conformationnelle. Entre Janvier 2007 et Décembre 2011, 34 patients ont reçu après une chirurgie radicale (R0 ou R1), un à trois cycles de 5-Fluoro-uracile associé à de l'Elvorine en adjuvant, suivi d'une radio-chimiothérapie selon le même protocole à la dose de 45Gy, puis de deux cycles de chimiothérapie à un mois d'intervalle après la radio-chimiothérapie concomitante. Dans le groupe d’étude, il y avait 34 patients d’âge médian 50 ans (47-58), avec un sexe ratio (H/F) de 2,4. Une chirurgie de type R1 a été réalisée dans 26,5% des cas, et 53% des patients étaient de stade III-IV. Le rapport nombres de ganglions positifs, sur nombre de ganglions prélevés étaient > 0,4 dans 26,5% des cas. Durant le traitement mené à terme, une neutropénie de grade III a été observée chez quatre patients, avec des troubles digestifs (nausées, vomissement, ou diarrhée) de grade I/II dans la majorité des cas. Après un suivi médian de 20 mois, 70,6% des patients étaient en survie sans rechute, et 29,4% ont présenté une récidive métastatique; la survie globale à 5 ans était de 35,4% et la survie sans progression de 58,7%. La radio-chimiothérapie concomitante postopératoire pourrait être un régime efficace et sûre chez les patients ayant bénéficié d'une gastrectomie à visée curative dans le cancer de l'estomac localement avancé.

We predict, for the first time, that by using United States Food and Drug Administration approved concentrations of cisplatin, major radiosensitization may be achieved via photoelectric mechanism during concomitant chemoradiotherapy (CCRT). Our analytical calculations estimate that radiotherapy (RT) dose to cancer cells may be enhanced via this mechanism by over 100% during CCRT. The results proffer new potential for significantly enhancing CCRT via an emerging clinical scenario, where the cisplatin is released in-situ from RT biomaterials loaded with cisplatin nanoparticles.

There are still controversies about the benefit of surgery after concurrent radiochemotherapy (CRT) for locally advanced cervical cancer. The aim of this study was to evaluate toxicity, local tumor control and overall survival of surgery after CRT in stage IB-IIB cervical cancer. Between 2002 and 2008, 24 patients with stage IB-IIB cervical cancer were treated with external-beam radiotherapy concomitantly with chemotherapy. High-dose rate brachytherapy fractions were given once weekly. Radical hysterectomy was undertaken after a median of 42 days. Overall survival at five years was estimated at 75% (95% confidence interval=52-88%) and sustained thereafter through to 8.9 years. No patient experienced local failure in the surgical bed. Postoperative complications were recorded in two patients. Surgery after CRT in stage IB-IIB cervical cancer is safe and leads to better local control of the disease and overall survival.

Amaç: Mide kanseri tanısı ile postoperatif kemo-radyoterapi uygulanan hastalarda dört alan teknik ile sanal wedge (kama) kullanılarak yapılan üç alan tekniği dozimetrik açıdan karşılaştırmayı amaçladık. Gereç ve Yöntem: Mide kanseri tanısı ile total/subtotal gastrektomi ve lenf nodu diseksiyonu yapılan on hasta çalışmaya dahil edildi. Her hasta için tümör yatağı ve bölgesel lenf nodlarına yönelik iki farklı tedavi planı yapıldı. Planlanan hedef hacim (PTV), risk altındaki organlar (böbrekler, karaciğer, dalak ve spinal kord), doz homojenite indeksi (DHI) ve tedavi için gerekli olan monitör ünitler (MU) açısından dört alan teknik ile üç alan teknik karşılaştırıldı. İstatistiksel analizde student t test kullanıldı. Bulgular: İki teknik arasında DHI açısından anlamlı bir farklılık saptanmadı (p: 0.576). Karaciğerin aldığı ortalama doz üç alan teknik ile anlamlı olarak azalırken (p0.001); sol böbrek, spinal kord ve dalağın ortalama dozları dört alan teknik ile anlamlı olarak daha az bulundu (p değerleri sırası ile 0.007, 0.021 ve 0.001). Toplam karaciğer hacminin %10, %30, %40 ve %50sinin aldığı dozlar üç alan teknik ile anlamlı olarak daha düşük olarak bulundu (p değerleri sırası ile 0.026, 0.009, 0.001 ve 0.001). Üç alan teknik için gerekli olan MU sayısı dört alan tekniğe göre anlamlı olarak daha fazla bulundu (p0.001). Sonuç: Mide kanseri tanısı ile mide yatağı ve bölgesel lenf nodlarına yönelik radyoterapi uygulanan hastalarda PTVdeki doz homojenitesi ve DHI açısından dört alan teknik ile sanal wedge kullanılarak oluşturulan üç alan teknik arasında fark yoktur. Sanal wedge kullanılan teknikte MU sayısının artması beklenen bir sonuçtur. Sanal wedge ile uygulanan üç alan teknikte karaciğerin aldığı dozlar anlamlı derecede azalmıştır. Bu nedenle eşlik eden bir karaciğer rahatsızlığı bulunan hastalarda üç alan tekniği uygun bir tedavi şekli olarak görülmektedir., Objective: We aimed to compare four field radiotherapy techniques with three field radiotherapy technique with enhanced dynamic wedges (EDW) in patients with stomach cancer who underwent postoperative chemo-radiotherapy. Material and Methods: Ten consecutive stomach cancer patients who underwent total/ subtotal gastrectomy and lymph node dissection were included to the study. For each patient, two different treatment plans were created for the tumor bed and regional lymph nodes. Three field and four field plans were compared for the doses in the planning target volume (PTV), the organ at risk (OAR) volumes (including kidneys, liver, spleen and spinal cord), the dose homogeneity index (DHI), and the monitor unit counts (MU) required for the treatment. Student-t test was used for statistical analysis. Results: There was no difference between two techniques in terms of DHI (p:0.576). The mean dose received by the liver was significantly reduced with three field technique (p

1991年8月から1999年11月までに, 当科で一次治療を行った中咽頭扁平上皮癌60例について検討した。進行癌に対しては, 1997年までは主に neoajuvant chemotherapy を2コース行った後に, 手術か放射線治療かを選択していた。1998年からは, 一部の早期癌を除き concomitant chemoradiotherapy を行っている。全体の疾患特異的5年生存率は50%で, Stage 別では, I, II: 100%, III: 45%, IV A: 36%, IV B: 0%であった。進行癌における手術適応例35例を検討すると, 5年生存率は根治照射群で35%, 手術群で66%であった。concomitant chemoradiotherapy については, 手術可能例12症例では全例にCRが得られ, 10例が現在も非担癌の状態である。しかし, 問題点も多く, 今後さらに症例を重ね検討すべき課題である。

Resume La radiotherapie apparait relativement efficace dans le traitement des gliomes malins de l'adulte. De ce fait, la potentialisation de l'effet de cette derniere apparait logique. De plus, l'utilisation d'une chimiotherapie precoce avant, ou au cours de la radiotherapie, est seduisante car a ce moment-la, la barriere hematoencephalique semble plus largement permeable, permettant une penetration et une diffusion des produits cytotoxiques hydrosolubles plus aisee. Sur ces bases theoriques, plusieurs equipes ont teste l'efficacite d'une chimioradiotherapie concomitante dans le traitement des gliomes malins. Malheureusement, l'analyse de ces etudes est difficile, car, la plupart portent sur un petit nombre de patients souvent disparates en termes d'âge, de diagnostic histologique et de gravite de l'atteinte neurologique. De plus, les protocoles et les produits utilises sont differents d'une etude a l'autre, ce qui rend toute comparaison impossible. Les donnees de la litterature sont donc pour l'instant insuffisantes pour que l'on se fasse une idee claire de l'inter^et de l'association d'une chimioradiotherapie concomitante dans le traitement des gliomes malins, mais les premiers travaux ne sont guere encourageants et ne semblent pas montrer une efficacite superieure a la radiotherapie seule.

Resume But de l'etude Analyse des resultats preliminaires d'un essai phase 1 dont le but etait d'etudierlafaisabilite d'une chimiotherapie par carboplatine quotidien (a partir de 20 a 25 mg/m2//j en perfusion de 45 ou 10 min) associee a une radiotherapie acceleree de 60 a 64 Gy delivree sur 4 semaines par fractions de 2 Gy en utilisant la technique du t conc concomitant. Materiel et methodes L'association de radiotherapie et de chimiotherapie etait utilisee seule ou apres chimiotherapie d'induction comportant trois cycles espaces de 4 semaines de 5-fluorouracile (5-FU) (600 mg/m2 de j1 a j5 en perfusion continue), du cisplatine (CDDP) (25 mg/m2 de j1 a j5 en perfusion continue) et de la vinorelbine (25 mg/m2 a j1 et j5 en perfusion de 20 min). Quinze patients ont ete traites selon ce protocole pour un carcinome bronchique non a petites cellules (CNPC), non resecable et localement avance. Resultats Tous les patients ont recu le traitement prevu. La toxicite limitante etait l'œsophagite avec cinq cas de grade 4 sur 15. Aucune toxicite letale n'a ete observee. Le taux de reponse complete etait de 6 sur 15 et le taux de reponse objective de 14 sur 15. La survie mediane n'etait pas atteinte a 14 mois (extremes, 6–28 mois). Conclusion A la suite de ces resultats, nous discutons l'opportunite de realiser un essai de phase 2 muticentrique pour confirmer les resultats.

Item does not contain fulltext The potential of (18)F-FDG PET changes was evaluated for prediction of response to concomitant chemoradiotherapy in patients with locally advanced non-small cell lung cancer (NSCLC). METHODS: For 28 patients, (18)F-FDG PET was performed before treatment, at the end of the second week of treatment, and at 2 wk and 3 mo after the completion of treatment. Standardized uptake value (SUV), maximum SUV, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were obtained. Early metabolic changes were defined as fractional change (DeltaTLG) when (18)F-FDG PET at the end of the second week was compared with pretreatment (18)F-FDG PET. In-treatment metabolic changes, as measured by serial (18)F-FDG PET, were correlated with standard criteria of response evaluation of solid tumors by means of CT imaging (Response Evaluation Criteria In Solid Tumors 1.1). Parameters were analyzed for stratification in progression-free survival (PFS). RESULTS: When compared with early metabolic nonresponders, a DeltaTLG decrease of 38% or more was associated with a significantly longer PFS (1-y PFS 80% vs. 36%, P = 0.02). Pretreatment TLG was found to be a prognostic factor for PFS. CONCLUSION: The degree of change in TLG was predictive for response to concomitant chemoradiotherapy as early as the end of the second week into treatment for patients with locally advanced NSCLC. Pretreatment TLG was prognostic for PFS.

to 0.86; P .001) was demonstrated for concomitant treatment. 3 Nooverallsurvivalbenefitwasidentifiedfromtheinductionchemotherapyschedules,althoughamarginalimprovementwasseenin those trials using the fluorouracil and cisplatin combination. Patterns of failure differed between the two treatment schedules. Induction chemotherapy significantly improved the rate of distant metastases (HR, 0.73; 95% CI, 0.61 to 0.88; P .001) but did not influence locoregional failure. The concomitant schedules markedly improved the locoregional control (HR, 0.74; 95% CI, 0.70 to 0.79; P .001) with a significant but less impressive improvement in distant control (HR, 0.88; 95% CI, 0.77 to 1.00; P .04). These reports solidified concomitant chemoradiotherapy as a treatment standard in the definitive management of locoregionally advanced HNSCC. Induction chemotherapy remained investigational except in the larynx preservation setting. Thisclearimpactondistantmetastasesfueledcontinuedinterest

Adenosquamous carcinoma of the nasal cavity and paranasal sinuses is very rare. We report a 56-year-old man with adenosquamous carcinoma of the left ethmoid sinus extending to the anterior skull base. Chief complaints of the patient were left nasal obstruction and left epistaxis. CT scan and MRI revealed a tumor shadow in the left ethmoid sinus extending to the nasal cavity, the left maxillary sinus, and the anterior skull base. Concomitant chemoradiotherapy (CBDCA+radiation) was performed preoperatively. Using a combined craniof acial approach, the tumor was completely removed, including the anterior skull base. There has been no evidence of recurrence for two years and six months since the operation.

BACKGROUND: In patients with non-small cell lung cancer (NSCLC), approximately 25% have locally advanced disease. For patients with irresectable (N2-3 or T4) or inoperable disease, treatment consists of chemoradiotherapy. Concomitant chemoradiotherapy improves survival compared to sequential chemoradiotherapy in these patients. PATIENTS AND METHODS: Treatment plans and completion of treatment was evaluated for all patients treated at the St. Antonius Hospital from 2008-2011 for NSCLC stage IIIA/B not eligible for surgery. RESULTS: Between 2008 and 2011, 180 patients with NSCLC stage III were treated at our hospital. A total of 152 patients were not eligible for surgery; in 78 (51%) patients, primary treatment was chemoradiotherapy; 31 (20%) were planned for concomitant treatment. The most frequent reasons for refraining from concomitant chemoradiotherapy were limitations of radiotherapy constraints and condition of the patients (87%). CONCLUSION: Although concomitant chemoradiotherapy is the standard-of-care in patients with stage IIIA/B NSCLC ineligible for surgery, the majority (80%) of the patients were treated otherwise.

10050Background: CCRT has been shown to improve survival in OPC compared to radiation alone, but has demonstrated no survival benefit in patients > 70 years old, possibly due to toxicity. However, ...

10513Background: cNPC is a rare malignancy that typically presents as WHO type III histology in association with EBV infection, and has a higher incidence among African-American (AA) children. Trea...

e17502Background: Efficacy and usefulness of concomitant chemoradiotherapy (CCRT) using TPF protocol has not yet been clearly distinguished, although it has been effective in the neo-adjuvant setti...

The best way to assess the response to chemoradiotherapy of locally advanced oesophageal carcinomas is not known. We used (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT to evaluate the metabolic response during chemoradiotherapy and tried to correlate this response to survival.Patients with biopsy-proven oesophageal carcinoma underwent FDG PET/CT with evaluation of the standardized uptake value (SUV) before any treatment (SUV1) and during chemoradiotherapy after two cycles of 5-fluorouracil (FU)/cisplatin and 20 Gy (SUV2). Metabolic response was defined as 1-(SUV2/SUV1). Surgery was discussed after 40 Gy and three cycles of chemotherapy. Results of interim PET were not considered for the therapeutic decision.Among 72 patients who underwent a first FDG PET/CT before any treatment, 59 (82 %) could receive the second FDG PET/CT examination. Median survival was 22.2 months with 1-year and 2-year survivals of 70 and 46 %, respectively. Nineteen patients (32 %) underwent surgery. Mean SUV1 and SUV2 were 12.3 ± 6.2 and 6 ± 4.1, respectively (p 0.001). Using a cut-off for metabolic response of 50 %, sensitivity and specificity for survival were 0.7 and 0.58. The 2-year overall survival of good responders was 62 % as compared to 27 % for poor metabolic responders. A multivariate analysis was performed, including T and N stages, surgery, histology and metabolic response: only metabolic response was significantly (p = 0.009) associated with 2-year survival.Early evaluation of metabolic response had a great prognostic value and could help identify good responders to chemoradiotherapy.

Neoadjuvant (preoperative) concomitant chemoradiotherapy (CRT) has become a standard treatment of locally advanced rectal adenocarcinomas. The clinical stages II (cT3-4, N0, M0) and III (cT1-4, N+, M0) according to International Union Against Cancer (IUCC) are concerned. It can reduce tumor volume and subsequently lead to an increase in complete resections (R0 resections), shows less toxicity, and improves local control rate. The aim of this review is to summarize actual approaches, main problems, and discrepancies in the treatment of locally advanced rectal adenocarcinomas.

The aim of the project was to assess the effectiveness and safety of weekly epoetin-beta (EB) in patients with gastrointestinal cancer (GIC) subjected to concomitant chemoradiotherapy (CCTRT).In this clinical prospective and multicentre cohort study EB was administered at a dose of 30,000 IU/ week, during CCTRT and in the four weeks thereafter, and suspended if haemoglobin (Hb) increased2 g/dl or Hb12-13 g/dl. Effectiveness was defi ned as Hb increase ≥1 g/dl vs. baseline. Time to response, treatment toxicity and transfusion requirements were also assessed.EB was effective in 75.8% of the evaluable population within a median of four weeks from EB initiation, without blood transfusions. Over 80% of all patients remained below the threshold (Hb ≤13 g/dl) and no study drug-related adverse reactions were recorded.Weekly EB proved to be effective and well tolerated by patients with GIC subjected to CCTRT.

MicroRNAs are endogenously expressed regulatory noncoding RNAs. Previous studies showed altered expression levels of several microRNAs in glioblastomas. In this study, we examined the expression levels of selected microRNAs in 22 primary glioblastomas and six specimens of adult brain tissue by real-time PCR method. In addition, we examined methylation status of MGMT promoter by methylation-specific real-time PCR, as this has been shown to be a predictive marker in glioblastomas. MGMT methylation status was not correlated with response to concomitant chemoradiotherapy with temozolomide (RT/TMZ). MiR-221 (p=0.016), miR-222 (p=0.038), miR-181b (p=0.036), miR-181c (p=0.043) and miR-128a (p=0.001) were significantly down-regulated in glioblastomas. The most significant change was observed for up-regulation in miR-21 expression in glioblastomas (p0.001). MiR-181b and miR-181c were significantly down-regulated in patients who responded to RT/TMZ (p=0.016; p=0.047, respectively) in comparison to patients with progredient disease. Our data indicate for the first time that expression levels of miR-181b and miR-181c could serve as a predictive marker of response to RT/TMZ therapy in glioblastoma patients.