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Abstract about adjuvant chemo after neoadjuvant chemoradiation

SandiaBuddy's picture
SandiaBuddy
Posts: 1029
Joined: Apr 2017

https://www.ncbi.nlm.nih.gov/pubmed/31996583

This is not my situation, but the abstract may be interesting to those affected:

In stage 2/3 rectal cancer treated with chemoradiotherapy and surgery, the addition of adjuvant chemotherapy was not associated with decreased recurrence-free survival in the entire cohort or in any subgroup, while tumor response to chemoradiotherapy is closely associated with disease recurrence. These findings have important consequences for treatment and surveillance decisions for rectal cancer patients. Pre-surgical efforts that maximize tumor downstaging, such as total neoadjuvant therapy, may produce better oncologic outcomes than traditional adjuvant chemotherapy.

SnapDragon2's picture
SnapDragon2
Posts: 243
Joined: Nov 2019

Thanks for posting this info.  My pathology report stated neoadjuvant tumor regression score of 2, which I think is a partial response not a total response.  For me, I think I ned the adjuvant chemo.  I am going to print this and take with me to onc apt on Wed.  Again, thank you!

SandiaBuddy's picture
SandiaBuddy
Posts: 1029
Joined: Apr 2017

No doubt, everyone's situation is different.  But I believe it always helps to be aware of some of the issues.

SnapDragon2's picture
SnapDragon2
Posts: 243
Joined: Nov 2019

Mhmmm...absolutely!

zx10guy
Posts: 247
Joined: Dec 2013

I heard some discussion of using adjuvent chemo prior to surgery for colon cancer as well.  When you think about it, it makes sense.  

lhduffer
Posts: 79
Joined: Oct 2015

My situation was different as I was stage 4a rectal cancer with a large and very low tumor.  I was diagnosed in July 2015 and was not considered a candidate for surgery.  In an effort to shrink the tumor and give me a chance at surgery, they started me with neoadjuvant chemotherapy, 4 rounds of capecitabine and oxaliplatin.  This was followed by chemo and radiation for 28 days.  My scan after this course of treatment showed no evidence of the original tumor nor the enlarged nodes.  Due to my good response to treatment, I was able to have the surgery.  They did follow this up with 2 rounds of adjuvant chemo, which they "saved" from my neoadjuvant treatment.  I did drop the oxaliplatin on the final dose as I was concerned about permanent neuropathy.

Although this was the only option available to me, my radiation oncologist told me at that time that she felt that neoadjuvant treatment would be the way of the future.  One reason she felt it could be more effective was that we are able to tolerate the neoadjuvant treatment better than adjuvant due to the tremendous trauma and stress placed on the body due to surgery.  She said many people never complete their course of adjuvant treatment following surgery as they are unable to tolerate the side effects.

Thanks for continuing to share these articles.  They are extremely interesting and provide additional knowledge which we all need in making our decisions.

 

suzycruise76's picture
suzycruise76
Posts: 121
Joined: Mar 2019

Ihduffer for sharing your experience and opinion. I had neoadjuvant treatment with good response, followed by surgery,and after getting pathology results all negative,and having discussion with my surgeon,radiology and oncology doctors I decided NOT to go through adjuvant treatment (which they offered me but did not insisted I needed it). I am extremely happy having both my CT scans and colonoscopy with NED results! And of course I do hope and believe it is going to stay this wayLaughing.

By the way- it all happened during the year 2019.

Suzy

 

lhduffer
Posts: 79
Joined: Oct 2015

You're welcome and congrats on the NED!  May it forever stay that way!  I just had my 3 year follow up colonoscopy and got a 5 year pass!  So excited.  Now I just need to get through my scanxiety due to my upcoming CT in March.  Praying it is good and that I continue NED as well.

suzycruise76's picture
suzycruise76
Posts: 121
Joined: Mar 2019

That's great! Now just keep your scanxiety under control and believe it is going to be NED again!

Wish you good luck now and always,

Suzy

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