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Short-course radiot...
Short-course radiotherapy followed by neo-adjuvant chemotherapy in locally advanced rectal cancer - the RAPIDO trial
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- Nilsson, Per J. (författare)
- Karolinska Institutet
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van Etten, Boudewijn (författare)
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Hospers, Geke A. P. (författare)
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- Påhlman, Lars (författare)
- Uppsala universitet,Kolorektalkirurgi
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van de Velde, Cornelis J. H. (författare)
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Beets-Tan, Regina G. H. (författare)
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- Blomqvist, Lennart (författare)
- Karolinska Institutet
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Beukema, Jannet C. (författare)
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Kapiteijn, Ellen (författare)
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Marijnen, Corrie A. M. (författare)
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Nagtegaal, Iris D. (författare)
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Wiggers, Theo (författare)
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- Glimelius, Bengt (författare)
- Uppsala universitet,Enheten för onkologi
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(creator_code:org_t)
- 2013-06-07
- 2013
- Engelska.
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 13, s. 279-
- Relaterad länk:
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https://uu.diva-port... (primary) (Raw object)
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https://bmccancer.bi...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background: Current standard for most of the locally advanced rectal cancers is preoperative chemoradiotherapy, and, variably per institution, postoperative adjuvant chemotherapy. Short-course preoperative radiation with delayed surgery has been shown to induce tumour down-staging in both randomized and observational studies. The concept of neo-adjuvant chemotherapy has been proven successful in gastric cancer, hepatic metastases from colorectal cancer and is currently tested in primary colon cancer. Methods and design: Patients with rectal cancer with high risk features for local or systemic failure on magnetic resonance imaging are randomized to either a standard arm or an experimental arm. The standard arm consists of chemoradiation (1.8 Gy x 25 or 2 Gy x 25 with capecitabine) preoperatively, followed by selective postoperative adjuvant chemotherapy. Postoperative chemotherapy is optional and may be omitted by participating institutions. The experimental arm includes short-course radiotherapy (5 Gy x 5) followed by full-dose chemotherapy (capecitabine and oxaliplatin) in 6 cycles before surgery. In the experimental arm, no postoperative chemotherapy is prescribed. Surgery is performed according to TME principles in both study arms. The hypothesis is that short-course radiotherapy with neo-adjuvant chemotherapy increases disease-free and overall survival without compromising local control. Primary end-point is disease-free survival at 3 years. Secondary endpoints include overall survival, local control, toxicity profile, and treatment completion rate, rate of pathological complete response and microscopically radical resection, and quality of life. Discussion: Following the advances in rectal cancer management, increased focus on survival rather than only on local control is now justified. In an experimental arm, short-course radiotherapy is combined with full-dose chemotherapy preoperatively, an alternative that offers advantages compared to concomitant chemoradiotherapy with or without postoperative chemotherapy. In a multi-centre setting this regimen is compared to current standard with the aim of improving survival for patients with locally advanced rectal cancer.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- Rectal cancer
- Radiotherapy
- Chemotherapy
- Neo-adjuvant
- Magnetic resonance imaging
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Nilsson, Per J.
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van Etten, Boude ...
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Hospers, Geke A. ...
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Påhlman, Lars
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van de Velde, Co ...
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Beets-Tan, Regin ...
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visa fler...
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Blomqvist, Lenna ...
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Beukema, Jannet ...
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Kapiteijn, Ellen
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Marijnen, Corrie ...
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Nagtegaal, Iris ...
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Wiggers, Theo
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Glimelius, Bengt
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visa färre...
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- Artiklar i publikationen
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BMC Cancer
- Av lärosätet
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Uppsala universitet
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Karolinska Institutet