Neoadjuvant chemotherapy for treatment patients with rectal cancer with adverse prognostic factors: A review

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Abstract

Rectal cancer (RC) is one of the leading tumor location in the structure of the incidence of malignant neoplasms in the Russian Federation and the world. And the standard approach to the treatment of patients with locally advanced forms of RC is preoperative chemo-radiotherapy (CRT) with delayed surgery. The use of such sort of approach in the recent decades has led to the reduction of the frequency of local recurrence up to 10% and even less. However, approximately a third of patients die of distant metastases. In this regard, one of the main tasks in the treatment of patients with locally advanced forms of RC with adverse prognostic factors is the prevention of distant metastasis formation. Early initiation of the systemic therapy before surgery is aimed at solving this issue. Conducting neoadjuvant chemotherapy (NCT) instead of CRT in RC treatment allows to avoid radiation reactions and injuries, occurring in some patients. Two-component oxaliplatin-containing regimens are the most well studied types of NCT in the treatment of patients with non-metastatic RC. In this connection, despite the differences in the treatment regimens and the number of cycles, a good tolerability of the method as well as no effect on the frequency of postoperative complications and in general a satisfactory results comparable to the effects of CRT were observed. The use of NCT in combination with targeted treatment modalities as well as three-component chemotherapy regimens are promising and encouraging treatment options for patients with RC with adverse prognostic factors.

About the authors

Aleksey A. Nevolskikh

Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre; Obninsk Institute for Nuclear Power Engineering

Email: nevol@mrrc.obninsk.ru
ORCID iD: 0000-0001-5961-2958
SPIN-code: 3787-6139

D. Sci. (Med.)

Russian Federation, Obninsk; Obninsk

Violetta A. Avdeenko

Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre; Obninsk Institute for Nuclear Power Engineering

Author for correspondence.
Email: avdeenko.vita@yandex.ru
ORCID iD: 0000-0002-2678-016X

Student

Russian Federation, Obninsk; Obninsk

Anna S. Belokhvostova

Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre

Email: avdeenko.vita@yandex.ru
ORCID iD: 0000-0002-4709-1726

Cand. Sci. (Med.)

Russian Federation, Obninsk

Yuliya Yu. Mikhaleva

Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre

Email: avdeenko.vita@yandex.ru
ORCID iD: 0000-0002-9449-2135

Oncologist

Russian Federation, Obninsk

Taras P. Pochuev

Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre

Email: avdeenko.vita@yandex.ru
ORCID iD: 0000-0002-9243-6519
SPIN-code: 1858-0968

Cand. Sci. (Med.)

Russian Federation, Obninsk

Ruslan F. Zibirov

Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre; Obninsk Institute for Nuclear Power Engineering

Email: avdeenko.vita@yandex.ru
ORCID iD: 0000-0001-5252-0436
SPIN-code: 6704-9766

Pathologist

Russian Federation, Obninsk; Obninsk

Sergei A. Ivanov

Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre; Obninsk Institute for Nuclear Power Engineering; People’s Friendship University of Russia (RUDN University)

Email: avdeenko.vita@yandex.ru
ORCID iD: 0000-0001-7689-6032
SPIN-code: 4264-5167

D. Sci. (Med.), Prof. RAS

Russian Federation, Obninsk; Obninsk; Moscow

Andrey D. Kaprin

National Medical Research Radiological Centre; People’s Friendship University of Russia (RUDN University)

Email: avdeenko.vita@yandex.ru
ORCID iD: 0000-0001-8784-8415

D. Sci. (Med.), Prof., Acad. RAS

Russian Federation, Obninsk; Moscow

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