Danijela Golo, Jasna But-Hadzic, Franc Anderluh, Erik Brecelj, Ibrahim Edhemovic, Ana Jeromen, Mirko Omejc, Irena Oblak, Ajra Secerov-Ermenc and Vaneja Velenik
standard of care for these patients. Still, the prognosis remains largely unsatisfactory due to a high rate of distant relapse, which is the most common cause of death. 1
The results of two meta-analyses suggest that the pathological stage of the disease and/or the rate of tumour reduction (pathohistological tumour regression - TRG) after pre-operative treatment are predictive factors for disease-free survival. A particularly low risk of recurrence of the disease has a subgroup of patients with a complete pathohistological response (pCR). 2 , 3 With standard 5-FU
with standard 3-dimensional conformal radiotherapy (3D CRT) in rectal cancer 6 , 7 , 8 , 9 , this novel radiation technique has been used in several prospective phase II studies with the aim of improving the treatment outcome in LARC. The treatment intensification consisted of a dose escalation with a simultaneous integrated boost (SIB), with or without the use of an additional drug alongside standard concomitant capecitabine. 10 , 11 , 12 , 13 , 14 , 15 Researchers report an encouraging rate of pathologiccompleteresponse (pCR) and local control (LC), but with
P Bulajic, N Bidzic, V Djordjevic, Μ Ceranic, D Βasaric, V Pesic and J Djordjevic-Pesic
process. Molecular targeted therapy is based on the specific genetics of every neoplastic process which implies individualized treatment according to detected genetic mutations. The role of some biomarkers, such as the KRAS (Kirsten rat sarcoma) gene mutation, is evaluated in determining molecular targeted therapy [ 6 ].
Neoadjuvant chemotherapy response is very important for disease-free and overall survival, and in the era of effective chemotherapy, various criteria for tumor response are established [ 10 ]. A completepathologicresponse of both primary and
Combined chemoradiotherapy (CRT) followed by total mesorectal excision (TME) is the standard treatment for patients with locally advanced rectal cancer. 1 This approach led to significantly enhanced tumor control, with local recurrence rates of < 10%.
Preoperative chemotherapy induces changes in both gross appearance of the surgical specimen and its pathological features. Pathologic tumor response to therapy is an important prognostic factor for long-term prognosis. Moreover, patients with completepathologicresponse to neoadjuvant
Alberto Bouzón, Ángela Iglesias, Benigno Acea, Cristina Mosquera, Paz Santiago and Joaquín Mosquera
(BCS). However, the primary goal of PST is to achieve pathologiccompleteresponse (pCR) prior to surgical treatment, which has been shown to predict favorable prognosis. 3 , 4 , 5
Over the past few years, the highest use of PST was seen among HER2-positive and triple-negative breast cancer (TNBC) patients. 6 Women with these tumor subtypes have the highest rates of BCS and pCR after PST. 7 Furthermore, prognostic impact of pCR is highest in HER2-positive and TNBC. 8 , 9 , 10
Currently, although the nuclear imaging techniques are promising, magnetic
Thiago Bassaneze, José Eduardo Gonçalves, Juliano Ferreira Faria, Rogério Tadeu Palma and Jaques Waisberg
characteristics are summarized in Table 1 .
The patients’ clinical characteristics and patohystologic characteristics of the tumor
Average age , years
Gender = number of individuals; CRT = chemoradiotherapy; pCR = pathologiccompleteresponse
Clinical T stage pre-CRT (MRI classification) = number of individuals; CRT = chemoradiotherapy; pCR = pathologiccompleteresponse
Alessandro Tuzi, Davide Lombardi, Diana Crivellari, Loredana Militello, Tiziana Perin, Manuela La Grassa, Samuele Massarut and Andrea Veronesi
4. Guarneri V, Broglio K, Kau SW, Cristofanilli M, Buzdar AU, Valero V, et al. Prognostic value of pathologiccompleteresponse after primary chemotherapy in relation to hormone receptor status and other factors. J Clin Oncol 2006; 24: 1037-44.
5. Gianni L, Baselga J, Eiermann W, Guillem Porta V, Semiglazov V, Lluch A, et al. Phase III trial evaluating the addition of paclitaxel to doxorubicin followed by cyclophosphamide, methotrexate, and fluorouracil, as adjuvant or primary systemic therapy: European cooperative trial in operable breast
; 22: 1706-12.
22. Shkoukani MA, Carron MA, Tulunay O, Kucuk O, Lin HS. Angiosarcoma of the scalp with completeresponse to a biweekly gemcitabine and docetaxel (GEMDOC) chemotherapy regimen. Ear Nose Throat J. 2011; 90:E26-9.
23. Wilson R, Glaros S, Brown RK, Michael C, Reisman D. Complete radiographic response of primary pulmonary angiosarcomas following gemcitabine and taxotere. Lung Cancer. 2008; 61:131-6.
al. FDG-PET in the prediction of pathologicresponse after neoadjuvant chemoradiotherapy in locally advanced, resectable esophageal cancer. Int J Radiat Oncol Biol Phys. 2005; 4:1053-9.
9. Zhong X, Yu J, Zhang B, Mu D, Zhang W, Li D, et al. Using 18F-fluorodeoxyglucose positron emission tomography to estimate the length of gross tumor in patients with squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys. 2009; 73: 136-41.
10. Han D, Yu J, Yu Y, Zhang G, Zhong X, Lu J, et al. Comparison of (18)F-fluorothymidine and