Preoperative radiation therapy

Postoperative Radiation Therapy Postoperative Chemotherapy or Chemoradiation NeOADJUVANT THERAPY, In GENERAL Preoperative Radiation Therapy Preoperative Chemotherapy Preoperative Chemoradiation... 

Payne DG. Preoperative radiation therapy in non-small cell carcinoma of the lung. Lung Cancer 1991 7 47-56. 

Hoffman JP, et al. Phase II trial of preoperative radiation therapy and chemotherapy for patients with localized, resectable adenocarcinoma of the pancreas an Eastern Cooperative Oncology Group Study. J Clin Oncol 1998 16(1) 317—323. 

Prospective Trials of Preoperative Radiation Therapy With and Without Chemotherapy and Rate of Sphincter-Sparing Procedures... 

Wagman R, Minsky BD, Cohen AM, et al. Sphincter preservation in rectal cancer with preoperative radiation therapy and coloanal anastomosis long term follow-up. Int JRadiat Oncol Biol Phys 1998 42 51-57. 

Francois Y, Nemoz CJ, Baulieux J, et al. Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphincter-sparing surgery for rectal cancer the Lyon R90-01 randomized trial. J Clin Oncol 1999 17(8) 2396-2402. 

Skinner DG, Lieskovsky G. Contemporary cystectomy with pelvic node dissection compared to preoperative radiation therapy plus cystectomy in management of invasive bladder cancer. J Urol 1984 131 1069-1072. 

Ariyan S, Marfaggi RA, Harden G, et al. (1980) An experimental model to determine the effects of adjuvant therapy on the incidence of postoperative wound infection. I. Evaluating Preoperative Radiation Therapy. Plast Reconstr Surg 65328-337... 

There is currently no definitive role for adjuvant radiation in colon cancer. However, patients who receive surgery for rectal cancer receive radiation therapy to reduce local tumor recurrence. Adjuvant radiation plus chemotherapy is considered standard treatment for patients with stage II or III rectal cancer after the surgical procedure is complete.17 Preoperative radiation may be used to reduce the initial size of rectal cancers in order to make the surgical procedure easier. 

Another unique aspect of rectal cancer is the use of neoadjuvant therapy. Preoperative radiation with or without chemotherapy is given to downstage the tumor prior to surgical resection to improve sphincter preservation by making the surgical procedure easier to perform. The issue of preoperative versus postoperative radiation is a subject of debate and investigation in the United States and will require further data to determine the superiority of one method over the other. 

Optimal management of locally advanced NSCLC (stages IIB, IIIA, and IIIB) is controversial. Cisplatin-based doublet combinations are recommended for adjuvant and neoadjuvant (preoperative) chemotherapy, with or without concurrent radiation therapy. 

In this instance the early experience of Nigro et al. (45) suggested that there may not be a need to perform surgery as part of the initial therapy of this cancer and that it could be kept in reserve for local recurrence. Three patients treated with preoperative radiation,... 

Hoff PM, Janjan N, Saad Ed, et al. Phase I study of preoperative oral uracil and tegafurplus leucovorin and radiation therapy in rectal cancer. J Clin Oncol 2000 18 3529-3534. 

Herr HW, Yagoda A, Batata M, Sogani PC, Whitmore WF. Planned preoperative cisplatin and radiation therapy for locally advanced bladder Cancer. Cancer 1983 52 2205-2208. 

Weiden PL, Piantodosi S. Preoperative chemotherapy cisplatin and fluorouracil and radiation therapy in stage III non-small cell lung cancer A phase II study of the Lung Cancer Study Group. JNatl Cancer Oust 1991 83 266-272. 

Meluch AA, Hainsworth JD, Gray JR, et al. Preoperative combined modality therapy with paclitaxel, carboplatin, prolonged infusion 5-fluorouracil, and radiation therapy in localized esophageal cancer preliminary results of a Minnie Pearl Cancer Research Network phase II trial. Cancer J Sci Am 1999 5 (2) 84-91. 

Radiation Therapy Oncology Group RTOG R-0012 Randomized Phase II Trial of Preoperative Combined Modality Chemoradiation for Distal Rectal Cancer... 

Hoffman JP, McGinn CJ, Szarka C, et al. A phase I study of preoperative gemcitabine with radiation therapy followed by postoperative gemcitabine for patients with localized resectable pancreatic adenocarcinoma. Proc Am Soc Clin Oncol 1998 17 283a. 

Payne DG. Is preoperative or postoperative radiation therapy indicated in non-small cell cancer of the lung Lung Cancer 1994 10(Suppl 1) S205-S212. 

Yashar J, Weitberg AB, Glicksman AS, et al. Preoperative chemotherapy and radiation therapy for stage Ilia carcinoma of the lung. Ann ThorSurg 1992 53 445 448. 

In addition to trying to improve the results of standard chemoradiation by intensifying chemotherapy and/or radiation, a second approach has been to combine radiation therapy with some of the newer chemotherapeutic agents, which are also known to be potent radiation sensitizers. These agents have been used both in primary chemoradiation protocols, as well as in the preoperative setting. 

Meluch A, Greco F, Burris H m, et al. Preoperative Paclitaxel, Carbonplatin, 5-FU and Radiation Therapy for Localized Esophageal Cancer. Proc Annu Meet Am Soc Clin Oncol 2001 20 A636. 

Formenti SC, Dunnington G, Uzieli B, et al. Original p53 status predicts for pathological response in locally advanced breast cancer patients treated preoperatively with continuous infusion 5-fluorouracil and radiation therapy. Int J Radiat Oncol, Biol, Physics 1997 39 1059-1068. 

Staley CA, et al. Preoperative chemoradiation, pancreaticoduodenectomy, and intraoperative radiation therapy for adenocarcinoma of the pancreatic head. Am J Surg 1996 171 (1) 118-124 discussion 124-125. 

Advantages and Disadvantages of Preoperative vs Postoperative Radiation Therapy... 

Trials incorporating these newer agents with radiation therapy for rectal carcinoma either preoperatively or adjuvantly are ongoing or under development. The maximum... 

Minsky BD, Cohen AM, Enker WE, et al. Preoperative 5-FU, low-dose leucovorin, and radiation therapy for locally advanced and unresectable rectal cancer. Ini J Radiat Oncol Biol Phys 1997 37(2) 289-295. 

Marsh RD, Chu NM, Vauthey JN, et al. Preoperative treatment of patients with locally advanced unresectable rectal adenocarcinoma utilizing continuous chronobiologically shaped 5-fluorouracil infusion and radiation therapy. Cancer 1996 78(2) 217-225. 

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