ABSTRACT
Some of the patients with rectal cancer are less sensitive to preoperative concurrent chemoradiotherapy (CCRT).Patients who are resistant to CCRT have a poor local tumor control and CCRT may also increase adverse reactions.The sensitivity of rectal cancer patients to CCRT can be predicted by magnetic resonance imaging (MRI),positron emission tomography,serum carcinoembryonic antigen,molecular biomarkers and gene expression profiling before treatment.According to the predicted results,the clinicians are instructed to choose individualized treatment for the patients so that the therapeutic effects of rectal cancer are further improved.
ABSTRACT
This paper is about the clinical trials of preoperative concurrent chemoradiotherapy for advanced adenocarcinoma of the stomach or gastroesophageal junction reported in recent years. The radiation dose of most trials is 45 Gy. Chemotherapy drugs such as 5-fluorouracil, cisplatin and taxol are concurrently used as sensitizers. A number of trials have induction chemotherapy prior to chemoradiotherpy. The validity is evaluated by R0 resection rate, pathological complete response rate and overall survival rate. The safety is assessed by the adverse reaction, treatment related mortality, and its effect on postoperative complications and mortality. The results showed that preoperative chemoradiotherapy can significantly improve the R0 resection rate and benefit the prognosis of the patients. Meanwhile, the security and impact on operations of preoperative chemoradiotherapy is controllable. The recent researches are mostly in phase II, and more randomized controlled studies are needed. To fully accept the preoperative chemoradiotherapy as a standard treatment, more evidence and long-term efficacy index are indispensible.