FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W3202617467> ?p ?o ?g. }

• W3202617467 endingPage "e74" @default.
• W3202617467 startingPage "e73" @default.
• W3202617467 abstract "Purpose/Objective(s)While long course chemoradiation therapy has been studied as part of a watch-and-wait (WW) strategy for patients with locally advanced rectal cancer, it is unclear whether short-course radiation therapy (SCRT) will be associated with similar rates of organ preservation. We hypothesized that a WW strategy to facilitate organ preservation with SCRT, as part of a total neoadjuvant therapy (TNT) approach during the COVID-19 pandemic, would be both safe and feasible.Materials/MethodsFrom March to June of 2020, due to the COVID-19 pandemic, per institutional policy, all patients undergoing radiation therapy for locally advanced rectal cancer were treated with SCRT. After completion of SCRT-TNT, patients were clinically restaged by exam, endoscopy and MRI and the decision was made to manage the patient surgically or with a WW approach. The decision for WW or surgery was made by the surgeon in conjunction with patient consent. After IRB waiver was obtained, we reviewed consecutive patients treated during our SCRT mandate. The main outcome of interest was total mesorectal excision (TME)-free survival among patients eligible for WW after SCRT-TNT.ResultsOur cohort included 42 patients with a median age of 57 years (Interquartile Range [IQR] 48-67), 24 (57%) of whom were male. Median follow-up from end of SCRT-TNT was 7 months (IQR 6-8). The median tumor cranio-caudal size was 4.1 cm (IQR 3.3-5.2) with a median distance from the anal verge of 7 cm (IQR 5-9). The majority had cT3 (71%) or cN+ (74%) disease. Patients underwent a median of 14 weeks (IQR 13-15) of FOLFOX or CAPEOX chemotherapy, with 32 (76%) patients receiving chemotherapy prior to SCRT and 10 (24%) patients receiving chemotherapy after SCRT. The median time from completion of TNT to endoscopic restaging was 9 weeks (IQR 7-10). Nineteen (45%) patients were recommended to undergo surgical resection, of whom 17 went on to TME and 2 refused TME. Of the 15 patients with pathology available, 2 had a pCR (13%). Notably, one of these patients had a cCR at post-TNT endoscopy, but due to the presence of a stricture, WW was deemed unfeasible. Of the 23 patients managed by a WW strategy after SCRT-TNT completion, 19 had a clinical complete response (cCR), 3 had a near-CR, and 1 had an incomplete response. The 6-month TME-free survival was 85% for patients on WW. Four (17%) patients had a local regrowth at a median of 20 weeks (IQR 17-24), 3 of whom were salvaged with TME and 1 who declined surgery and opted for further surveillance. One of these patients had regrowth confirmed by biopsy, but had a pCR confirmed in the TME specimen. The 6-month TME- free survival of the entire cohort was 52%, and the combined pCR/6-month cCR was 52%.ConclusionOur data suggest WW after SCRT-TNT is feasible. Longer term follow-up is required to confirm the durability and oncologic safety of these results. While long course chemoradiation therapy has been studied as part of a watch-and-wait (WW) strategy for patients with locally advanced rectal cancer, it is unclear whether short-course radiation therapy (SCRT) will be associated with similar rates of organ preservation. We hypothesized that a WW strategy to facilitate organ preservation with SCRT, as part of a total neoadjuvant therapy (TNT) approach during the COVID-19 pandemic, would be both safe and feasible. From March to June of 2020, due to the COVID-19 pandemic, per institutional policy, all patients undergoing radiation therapy for locally advanced rectal cancer were treated with SCRT. After completion of SCRT-TNT, patients were clinically restaged by exam, endoscopy and MRI and the decision was made to manage the patient surgically or with a WW approach. The decision for WW or surgery was made by the surgeon in conjunction with patient consent. After IRB waiver was obtained, we reviewed consecutive patients treated during our SCRT mandate. The main outcome of interest was total mesorectal excision (TME)-free survival among patients eligible for WW after SCRT-TNT. Our cohort included 42 patients with a median age of 57 years (Interquartile Range [IQR] 48-67), 24 (57%) of whom were male. Median follow-up from end of SCRT-TNT was 7 months (IQR 6-8). The median tumor cranio-caudal size was 4.1 cm (IQR 3.3-5.2) with a median distance from the anal verge of 7 cm (IQR 5-9). The majority had cT3 (71%) or cN+ (74%) disease. Patients underwent a median of 14 weeks (IQR 13-15) of FOLFOX or CAPEOX chemotherapy, with 32 (76%) patients receiving chemotherapy prior to SCRT and 10 (24%) patients receiving chemotherapy after SCRT. The median time from completion of TNT to endoscopic restaging was 9 weeks (IQR 7-10). Nineteen (45%) patients were recommended to undergo surgical resection, of whom 17 went on to TME and 2 refused TME. Of the 15 patients with pathology available, 2 had a pCR (13%). Notably, one of these patients had a cCR at post-TNT endoscopy, but due to the presence of a stricture, WW was deemed unfeasible. Of the 23 patients managed by a WW strategy after SCRT-TNT completion, 19 had a clinical complete response (cCR), 3 had a near-CR, and 1 had an incomplete response. The 6-month TME-free survival was 85% for patients on WW. Four (17%) patients had a local regrowth at a median of 20 weeks (IQR 17-24), 3 of whom were salvaged with TME and 1 who declined surgery and opted for further surveillance. One of these patients had regrowth confirmed by biopsy, but had a pCR confirmed in the TME specimen. The 6-month TME- free survival of the entire cohort was 52%, and the combined pCR/6-month cCR was 52%. Our data suggest WW after SCRT-TNT is feasible. Longer term follow-up is required to confirm the durability and oncologic safety of these results." @default.
• W3202617467 created "2021-10-11" @default.
• W3202617467 creator A5013157364 @default.
• W3202617467 creator A5016694714 @default.
• W3202617467 creator A5017049966 @default.
• W3202617467 creator A5022293657 @default.
• W3202617467 creator A5028404725 @default.
• W3202617467 creator A5030566148 @default.
• W3202617467 creator A5031539570 @default.
• W3202617467 creator A5037120205 @default.
• W3202617467 creator A5038339239 @default.
• W3202617467 creator A5052448371 @default.
• W3202617467 creator A5054605021 @default.
• W3202617467 creator A5060751046 @default.
• W3202617467 creator A5062202820 @default.
• W3202617467 creator A5069136703 @default.
• W3202617467 creator A5070237400 @default.
• W3202617467 creator A5070324294 @default.
• W3202617467 creator A5074971164 @default.
• W3202617467 creator A5083740899 @default.
• W3202617467 creator A5085296689 @default.
• W3202617467 date "2021-11-01" @default.
• W3202617467 modified "2023-10-18" @default.
• W3202617467 title "Feasibility of Organ Preservation With Short Course Radiation Therapy as Part of Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer During the COVID-19 Pandemic" @default.
• W3202617467 doi "https://doi.org/10.1016/j.ijrobp.2021.07.434" @default.
• W3202617467 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/8536238" @default.
• W3202617467 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/34701958" @default.
• W3202617467 hasPublicationYear "2021" @default.
• W3202617467 type Work @default.
• W3202617467 sameAs 3202617467 @default.
• W3202617467 citedByCount "0" @default.
• W3202617467 crossrefType "journal-article" @default.
• W3202617467 hasAuthorship W3202617467A5013157364 @default.
• W3202617467 hasAuthorship W3202617467A5016694714 @default.
• W3202617467 hasAuthorship W3202617467A5017049966 @default.
• W3202617467 hasAuthorship W3202617467A5022293657 @default.
• W3202617467 hasAuthorship W3202617467A5028404725 @default.
• W3202617467 hasAuthorship W3202617467A5030566148 @default.
• W3202617467 hasAuthorship W3202617467A5031539570 @default.
• W3202617467 hasAuthorship W3202617467A5037120205 @default.
• W3202617467 hasAuthorship W3202617467A5038339239 @default.
• W3202617467 hasAuthorship W3202617467A5052448371 @default.
• W3202617467 hasAuthorship W3202617467A5054605021 @default.
• W3202617467 hasAuthorship W3202617467A5060751046 @default.
• W3202617467 hasAuthorship W3202617467A5062202820 @default.
• W3202617467 hasAuthorship W3202617467A5069136703 @default.
• W3202617467 hasAuthorship W3202617467A5070237400 @default.
• W3202617467 hasAuthorship W3202617467A5070324294 @default.
• W3202617467 hasAuthorship W3202617467A5074971164 @default.
• W3202617467 hasAuthorship W3202617467A5083740899 @default.
• W3202617467 hasAuthorship W3202617467A5085296689 @default.
• W3202617467 hasBestOaLocation W32026174671 @default.
• W3202617467 hasConcept C119060515 @default.
• W3202617467 hasConcept C121608353 @default.
• W3202617467 hasConcept C126322002 @default.
• W3202617467 hasConcept C141071460 @default.
• W3202617467 hasConcept C2777201421 @default.
• W3202617467 hasConcept C2778292576 @default.
• W3202617467 hasConcept C509974204 @default.
• W3202617467 hasConcept C526805850 @default.
• W3202617467 hasConcept C530470458 @default.
• W3202617467 hasConcept C61434518 @default.
• W3202617467 hasConcept C71924100 @default.
• W3202617467 hasConcept C72563966 @default.
• W3202617467 hasConceptScore W3202617467C119060515 @default.
• W3202617467 hasConceptScore W3202617467C121608353 @default.
• W3202617467 hasConceptScore W3202617467C126322002 @default.
• W3202617467 hasConceptScore W3202617467C141071460 @default.
• W3202617467 hasConceptScore W3202617467C2777201421 @default.
• W3202617467 hasConceptScore W3202617467C2778292576 @default.
• W3202617467 hasConceptScore W3202617467C509974204 @default.
• W3202617467 hasConceptScore W3202617467C526805850 @default.
• W3202617467 hasConceptScore W3202617467C530470458 @default.
• W3202617467 hasConceptScore W3202617467C61434518 @default.
• W3202617467 hasConceptScore W3202617467C71924100 @default.
• W3202617467 hasConceptScore W3202617467C72563966 @default.
• W3202617467 hasIssue "3" @default.
• W3202617467 hasLocation W32026174671 @default.
• W3202617467 hasLocation W32026174672 @default.
• W3202617467 hasLocation W32026174673 @default.
• W3202617467 hasLocation W32026174674 @default.
• W3202617467 hasOpenAccess W3202617467 @default.
• W3202617467 hasPrimaryLocation W32026174671 @default.
• W3202617467 hasRelatedWork W1490115438 @default.
• W3202617467 hasRelatedWork W2009038529 @default.
• W3202617467 hasRelatedWork W2348403918 @default.
• W3202617467 hasRelatedWork W2362524478 @default.
• W3202617467 hasRelatedWork W2533817868 @default.
• W3202617467 hasRelatedWork W2905710227 @default.
• W3202617467 hasRelatedWork W3031583833 @default.
• W3202617467 hasRelatedWork W3160068387 @default.
• W3202617467 hasRelatedWork W3167504304 @default.
• W3202617467 hasRelatedWork W3183013201 @default.
• W3202617467 hasVolume "111" @default.
• W3202617467 isParatext "false" @default.
• W3202617467 isRetracted "false" @default.
• W3202617467 magId "3202617467" @default.
• W3202617467 workType "article" @default.