Hindawi Journal of Oncology Volume 2022, Article ID 8675587, 7 pages https://doi.org/10.1155/2022/8675587 Research Article Efficacy Analysis of Combining Sintilimab with Neoadjuvant Chemotherapy in Treating Middle and Advanced Rectal Cancer Based on Big Data 1 1 1 1 2 1 Yifei Wang, Jiandong Fei, Yanan Zheng, Ping Li, Xiaodong Ren, and Yongzhu An Department of Gastrointestinal Surgery, The First Aﬃliated Hospital of Hebei North University, Zhangjiakou, 075000 Hebei, China Central Laboratory, The First Aﬃliated Hospital of Hebei North University, Zhangjiakou, 075000 Hebei, China Correspondence should be addressed to Yongzhu An; firstname.lastname@example.org Received 27 June 2022; Revised 9 August 2022; Accepted 25 August 2022; Published 16 September 2022 Academic Editor: Alamgeer Yuchi Copyright © 2022 Yifei Wang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To analyze the eﬃcacy of combining sintilimab with neoadjuvant chemotherapy in treating middle and advanced rectal cancer based on big data. Methods. According to the inclusion and exclusion criteria, 43 patients with middle and advanced rectal cancer, who were treated with sintilimab and neoadjuvant chemotherapy in General Surgery of the hospitals of Zhangjiakou city from January 2020 to January 2022, were selected for the retrospective study. The patients’ short-term eﬃcacy was scientiﬁcally evaluated, and the factors aﬀecting eﬃcacy and the correlation were analyzed. Results. Among the 43 enrolled patients, 30 of them had regional lymphatic metastasis but none had distant metastasis; most patients were at Broders II and TNM III, and all of them had adenocarcinoma; the total response rate was 69.77% (30 cases), with no grade IV and V adverse reactions; the patients were divided into the eﬀective group and the ineﬀective group after treatment based on the evaluation results of short- term eﬃcacy, and analysis of the relevant factors exposed in both groups revealed signiﬁcant diﬀerences in age, tumor size, CEA, NLR value, PLR value, TNM stage, and presence of combined lymphatic metastasis between the two groups (P <0:05); univariate analysis showed that tumor size, CEA, TNM stage, and combined lymphatic metastasis were the independent risk factors aﬀecting the eﬃcacy in patients with middle to advanced rectal cancer (P <0:05); and through the Spearman correlation analysis of the above independent risk factors, it was further conﬁrmed that tumor size, CEA, TNM stage, and combined lymphatic metastasis were negatively correlative with the eﬃcacy of combining sintilimab with neoadjuvant chemotherapy in treating middle to advanced rectal cancer (P <0:05). Conclusion. Combining sintilimab with neoadjuvant chemotherapy has good eﬃcacy and safety proﬁle, which is conducive to subsequent surgery; in contrast, larger tumor diameter, higher CEA level, higher TNM stage, and more serious lymphatic metastasis are all independent risk factors aﬀecting treatment sensitivity and can lead to poor eﬃcacy. 1. Introduction tralia, and New Zealand and 392,000 new cases in China in 2018. Its early symptoms are not obvious, and the incidence is relatively high in men aged 40-80 years. At present, surgi- Rectal cancer is one of the most common malignant tumors of the digestive tract. According to the 2020 global epidemi- cal treatment is in the central position in rectal cancer treat- ment, because it provides patients at the early stage with ological statistics on cancer published by the International Agency for Research on Cancer (IARC), rectal cancer has long-term survival and those who can only receive limited treatment if they have local recurrence or distant metastasis become the 3rd most prevalent malignant tumor in men with better survival in combination with chemoradiotherapy and the 2nd in women worldwide, with the highest inci- dence in developed countries such as North America, Aus- . For patients with locally advanced rectal cancer, 2 Journal of Oncology less than 3 months; (6) concurrent acute infection, such as neoadjuvant chemotherapy can lower the tumor stage, and some reports have conﬁrmed that the application of neoad- lung infection and urinary system infection; (7) pregnant juvant chemotherapy before total mesorectal excision or lactating women; and (8) low compliance with treatment (TME) is the “gold standard” for the treatment of patients and lost to follow-up. with stage II and III rectal cancer [2, 3]. In addition, some 2.3. Patient Screening. According to the inclusion and exclu- published works and reports also state that neoadjuvant che- sion criteria, 43 patients with middle and advanced rectal motherapy has the potential to reduce local recurrence. In cancer, who were treated with sintilimab and neoadjuvant recent years, the studies of immune checkpoint inhibitors chemotherapy in General Surgery of the hospitals of Zhang- (ICIs) in various tumors are growing vigorously, and the jiakou city from January 2020 to January 2022, were selected results have shown that ICIs have good therapeutic eﬀect. for the retrospective study; the study plan met the code of Immunotherapy is claimed to signiﬁcantly improve the ethics and was reviewed and approved by the ethics commit- prognosis of colorectal cancer patients, and ICIs have also tees of the hospitals of Zhangjiakou city. been recommended as a ﬁrst-line option for advanced rectal cancer [4–7]. Related studies suggest that ICIs show good 2.4. Methods eﬀects in the neoadjuvant treatment of resectable rectal can- cer; meanwhile, ICI drugs also have a great potential in the 2.4.1. Sintilimab. Patients were treated with third-line and comprehensive treatment decision-making of locally above anti-PD-1 mAb monotherapy or in combination with advanced and early rectal cancer. In 2022, sindilizumab as other agents, the single dosage of sintilimab injection an innovative PD-1 inhibitor drug was successfully included (Tyvyt®) (speciﬁcation: 100 mg; manufacturer: Innovent in the CSCO guidelines for the clinical use of ICIs, achieving Biologics (Suzhou) Co., Ltd.; NMPA approval no. the breakthrough that all ﬁrst-line therapies for ﬁve major S20180016) was 200 mg, and it was administered once every tumors were included in the CSCO guidelines [8–10]. The 3 weeks until the downstaging eﬀect and surgical resection use of immunotherapy in neoadjuvant treatment is mostly indicators were met, so as to improve the rate of radical dependent on the safety and eﬃcacy of the treatment, and resection (R0 resection). it is still in the stage of active exploration from relevant data at home and abroad, with few clinical studies reported. 2.4.2. Neoadjuvant Chemotherapy. XELOX scheme: from Therefore, this article mainly collected middle and advanced day 1 to day 14, 1000 mg/m of capecitabine was given twice rectal cancer patients treated with sindilizumab plus neoad- daily; and at day 1, 130 mg/m of oxaliplatin was given. If a juvant chemotherapy in the General Surgery of the hospitals second course of chemotherapy was implemented, it should to carry out a retrospective study and to inquire about the be started at day 22 of radiotherapy. clinicopathological factors related to the treatment eﬃcacy, avoiding ineﬀectiveness or overtreatment, which is also ben- 2.5. Observation Indicators. Clinical characteristics: the eﬁcial to guide the preoperative treatment regimen and enrolled patients’ clinical information including age (with achieve the individualized treatment of middle and 55 years old as the critical value), gender, smoking, Broders advanced rectal cancer. classiﬁcation, ECOG score, and TNM stage was recorded. Short-term eﬃcacy: patients received reexamination after 4 weeks of treatment and were evaluated according to 2. Materials and Methods the WHO criteria for short-term objective response evalua- 2.1. Inclusion Criteria. (1) All patients were diagnosed with tion in solid tumors . Complete disappearance of tumor middle and advanced rectal cancer after CT, MRI, and path- lesions and maintenance for ≥4 weeks were considered com- plete remission (CR); ≥30% reduction in volume of tumor ological examination; (2) the TNM stages of the patients were IIc and III; (3) the ECOG score was less than 3 points; lesions compared with that before treatment and mainte- (4) the patients had basically normal routine blood test nance for ≥4 weeks represented partial remission (PR); result, ECG, coagulation function, and liver and kidney <30% reduction in volume of tumor lesions compared with function; (5) the patients failed in ﬁrst-line oxaliplatin+tar- that before treatment or <20% increase represented stable disease (SD); and ≥20% increase in volume of tumor lesions geted therapy chemotherapy and had not receive other PD-1 immunotherapy; (6) the patients did not have contra- compared with that before treatment or appearance of new indications of sindilizumab and chemotherapy; (7) the lesions represented progressive disease (PD), with total patients received TME after neoadjuvant chemotherapy; response = CR + PR. and (8) the patients and their family members understood Adverse reactions: according to the Common Terminol- ogy Criteria for Adverse Events (CTCAE) v4.0 of the the study and signed the treatment consent and study consent. National Cancer Institute (NCI) , the adverse reactions were divided into grades I to V (grade I: mild adverse reac- 2.2. Exclusion Criteria. Exclusion criteria are as follows: (1) tion, asymptomatic or mild symptoms, intervention not complicated with other malignant tumors; (2) complicated indicated; grade II: moderate adverse reactions, clinical with heart disease, severe hypertension, and other diseases symptoms that require intervention and may aﬀect body of the cardiovascular system; (3) complicated with hemato- function, but daily life will not be aﬀected; grade III: severe logical system diseases and severe internal medicine diseases; adverse reactions, complicated symptoms that require active (4) central nervous system metastases; (5) estimated survival intervention and treatment; grade IV: life-threatening Journal of Oncology 3 2.6. Statistical Processing. In this study, the data processing Table 1: Clinical characteristics of 43 patients (n =43). software was SPSS 22.0, which was mainly used to calculate Clinical data Number of cases Proportion (%) the between-group diﬀerences of data; the picture drawing Age software was GraphPad Prism 7 (GraphPad Software, San Diego, USA); the items included were enumeration data ≤55 years 20 46.51 and measurement data, which were expressed by ½nð%Þ >55 years 23 53.49 and (x ± s), examined by the X test and t-test, and met nor- Gender mal distribution; and diﬀerences were considered statisti- Male 28 65.12 cally signiﬁcant when P <0:05. Female 15 34.88 Smoking 3. Results Yes 24 55.81 3.1. Clinical Characteristics. Among the 43 enrolled patients No 19 44.19 (aged 42 to 74 years) of the study, there were 28 males and Broders grade 15 females, 30 patients had regional lymphatic metastasis, I 4 9.30 and none had distant metastasis; most patients were at Bro- II 31 72.09 ders II and TMN III stage, all of them had adenocarcinoma. III 8 18.60 See Table 1 for statistical data. ECOG score 3.2. Short-Term Eﬃcacy. All 43 patients ﬁnished sintilimab 0-1 point 26 60.47 treatment, neoadjuvant chemotherapy, and surgical treat- 2 points 17 39.53 ment and completed clinical eﬃcacy evaluation. There were TNM stage 10 CR cases, 20 PR cases, 8 SD cases, and 5 PD cases and a IIc 13 30.23 total of 30 eﬀective cases. See Figure 1. III 30 69.77 3.3. Adverse Reactions. After recording patients’ adverse reactions, it was found that patients did not have grade IV 69.77% and V adverse reactions, and the incidence rate of vomiting and nausea was the highest, followed by granulocytopenia and mucocutaneous damage. See Table 2. 46.51% 3.4. Analysis of Factors Related to Treatment Eﬀectiveness. 23.26% The patients were divided into the eﬀective group (n =30) 18.60% and the ineﬀective group (n =30) after treatment based on 11.63% the evaluation results of short-term eﬃcacy, and analysis of the relevant factors exposed in both groups revealed signiﬁ- CR PR SD PD Total efficac y cant diﬀerences in age, tumor size, CEA, NLR value, PLR value, TNM stage, and presence of combined lymphatic Figure 1: Evaluation results of patients’ short-term eﬃcacy. metastasis between the two groups (P <0:05). See Table 3. 3.5. Logistic Regression Analysis. After including the single adverse reactions that may lead to disability and even organ factors into logistic regression analysis, it was showed that damage or dysfunction; grade V: death). tumor size, CEA, TNM stage, and lymphatic metastasis were Fasting venous blood was taken from all patients after independent risk factors aﬀecting the eﬃcacy of combining treatment and tested for white blood cell count (normal sintilimab with neoadjuvant chemotherapy in treating mid- range: 4:0 – 10:0×10 /L), neutrophils (normal range: 1:80 dle and advanced rectal cancer (P <0:05). See Table 4. 9 9 – 6:30 × 10 /L), lymphocytes (normal range: 0:8 – 4× 10 / L), platelets (normal range: 100 – 300 × 10 /L), CEA (normal 3.6. Correlation Analysis. After performing Spearman corre- range: 3.5–5.0 ng/mL), CA199 (normal range: <37 IU/mL), lation analysis of the above independent risk factors, it was NLR (normal range: 1–3), and PLR (normal range: 63.0– further conﬁrmed that tumor size, CEA, TNM stage, and 182.6). combined lymphatic metastasis were negatively correlated The related factors, such as age (>55 years old), tumor with the eﬃcacy of combining sintilimab with neoadjuvant size (≥3 cm), gender (male), distance between tumor and chemotherapy in treating middle and advanced rectal cancer anal verge (≥5 cm), concurrent chemotherapy cycle (≥3 (P <0:05). See Table 5. weeks), neoadjuvant chemotherapy cycle (≥2 weeks), white blood cell count, neutrophil, lymphocyte, platelet, CEA, 4. Discussion CA199, NLR value, PLR value, TNM stage, and lymph node metastasis, were included in the single variate analysis of In recent years, neoadjuvant chemoradiotherapy has gradu- treatment eﬀectiveness, and then, logistic regression analysis ally walked into the popular ﬁeld, and numerous previous and Spearman correlation analysis were performed. studies have shown that the comprehensive treatment mode (%) 4 Journal of Oncology Table 2: Evaluation results of patients’ adverse reactions. Adverse reactions Grade I Grade II Grade III Grade IV Grade V Total incidence rate½ n% ðÞ Nausea 17 2 0 0 0 19 (44.19) Vomiting 15 3 1 0 0 19 (44.19) Diarrhea 6 5 0 0 0 11 (25.58) Leukopenia 8 4 0 0 0 12 (27.91) Granulocytopenia 11 4 2 0 0 17 (39.53) Thrombocytopenia 3 3 0 0 0 6 (13.95) Mucocutaneous damage 10 4 1 0 0 15 (34.88) Neurotoxicity 9 2 0 0 0 11 (25.58) Peripheral phlebitis 4 1 0 0 0 5 (11.63) Table 3: Analysis of factors related to treatment eﬀectiveness. Related factors Ineﬀective group (n =13)Eﬀective group (n =30) X /t P Age (>55 years) 10 (72.92) 13 (43.33) 4.113 0.043 Gender (male) 7 (53.85) 21 (70.00) 1.042 0.307 Tumor size (≥3 cm) 8 (61.54) 8 (26.67) 4.721 0.030 Distance between tumor and anal verge (≥5 cm) 7 (53.85) 16 (53.33) 1.042 0.307 Concurrent chemotherapy cycle (≥3 weeks) 6 (46.15) 11 (36.67) 0.342 0.559 Neoadjuvant chemotherapy cycle (≥2 weeks) 8 (61.54) 16 (53.33) 0.248 0.619 3:82 ± 0:55 4:03 ± 0:68 White blood cell count (×10 /L) 0.981 0.332 Neutrophil (×10 /L) 3:04 ± 1:01 3:10 ± 1:04 0.175 0.862 0:90 ± 0:54 0:92 ± 0:49 Lymphocyte (×10 /L) 0.119 0.906 Platelet (×10 /L) 216:94 ± 60:16 218:33 ± 68:73 0.063 0.950 5:24 ± 1:48 2:64 ± 1:28 CEA (ng/mL) 5.836 <0.001 CA199 (IU/mL) 30:31 ± 12:16 23:85 ± 11:95 1.575 0.123 4:16 ± 0:62 3:61 ± 0:85 NLR value 2.098 0.042 PLR value 284:03 ± 13:85 270:11 ± 13:74 3.044 0.004 TNM stage 4.488 0.034 IIc 1 (7.69) 12 (40.00) III 12 (92.31) 18 (60.00) Lymphatic metastasis 12 (92.31) 18 (60.00) 4.488 0.034 Table 4: Multivariate logistic regression analysis. Variable B S.E. Wals df Sig. Exp (B) 95% C.I. of Exp (B) Tumor size -1.482 0.704 4.431 1 0.035 0.227 0.057-0.903 CEA (ng/mL) -1.240 0.376 10.904 1 0.001 3.457 1.656-7.218 TNM stage -2.079 1.106 3.538 1 0.006 0.125 0.014-1.091 Lymphatic metastasis -2.079 1.106 3.538 1 0.006 0.125 0.014-1.091 of neoadjuvant therapy combined with radical surgery has a chance of recurrence in some patients; in addition, it can relatively good eﬀect on reducing the pathological stage of reduce the total number and positive rate of lymph nodes middle and advanced rectal cancer, lowering the rate of local in postoperative specimens, which is beneﬁcial to the recurrence, prolonging survival time, and improving the rate improvement of the curative resection rate; and ﬁnally, neo- of anal conserving and the quality of life [13, 14]. Through adjuvant therapy reduces the tumor volume, increases the preoperative neoadjuvant chemoradiotherapy, it is able to distance between the lower edge of the tumor and the anal achieve postoperative pathological outcome as CR with low verge, and increases the success rate of anal-conserving Journal of Oncology 5 was not low but was within an acceptable range from the Table 5: Spearman correlation analysis. point of view of clinical treatment. The patients were divided Variable N Correlative coeﬃcient Signiﬁcance into the eﬀective group and the ineﬀective group after treat- Tumor size 43 -0.331 0.030 ment based on the evaluation results of short-term eﬃcacy, ∗∗ and analysis of the relevant factors exposed in both groups -0.664 CEA (ng/mL) 43 <0.001 revealed signiﬁcant diﬀerences in age, tumor size, CEA, -0.323 TNM stage 43 0.035 NLR value, PLR value, TNM stage, and presence of com- -0.323 Lymphatic metastasis 43 0.035 bined lymphatic metastasis between the two groups (P <0:05); after including the single factors into logistic Note: ∗ indicated signiﬁcant correlation at the 0.05 level (two-sided); ∗∗ indicated a signiﬁcant correlation at the 0.01 level (two-sided). regression analysis, it was showed that tumor size, CEA, TNM stage, and combined lymphatic metastasis were the surgery. Meanwhile, concomitant with the continuous devel- independent risk factors aﬀecting the eﬃcacy of combining opment of medical treatment, ICIs represented by anti-PD-1 sintilimab with neoadjuvant chemotherapy in treating mid- dle and advanced rectal cancer (P <0:05); and after per- mAb have become a research hotspot for cancer therapy, and a pan-tumor clinical trial study found that patients with forming Spearman correlation analysis of the above mismatch repair dysfunction and high microsatellite insta- independent risk factors, it was further conﬁrmed that bility might beneﬁt from anti-PD-1 mAb therapy, but there tumor size, CEA, TNM stage, and combined lymphatic is still insuﬃcient evidence, and immunotherapy strategies metastasis were negatively correlative with the eﬃcacy of combining sintilimab with neoadjuvant chemotherapy in for rectal cancer are under continuous exploration. The advent of sindilizumab marks the entry of antitumor immu- treating middle and advanced rectal cancer (P <0:05). In notherapy in China into the innovation era. It is character- terms of TNM studies in malignant tumors, reports have ized by high aﬃnity, long-lasting, stability and high target conﬁrmed that the later the T stage of the tumor, the poorer occupancy, and the objective response rate and disease con- the eﬃcacy [19–21]. As the course of the disease progresses, the depth of tumor inﬁltration trol rate of immunotherapy using this drug for relapsed and increases, the blood supply is refractory Hodgkin lymphoma are as good as those of inno- relatively insuﬃcient, and the tumor cells suﬀer from poor vative drugs of the international class [15, 16]. At present, nutrition and hypoxia, which reduce the treatment radiotherapy combined with immunotherapy is the research sensitivity. hotspot of tumor regression, and the systemic immune The sensitivity of mAb therapy and chemotherapy is response induced before surgery can make the body produce dependent not only on the biological characteristics of immune memory, while after surgery, patients cannot pro- the tumor itself but also on the microenvironment in duce immune-mediated sustained antitumor eﬀects due to which it resides. In vivo studies have found that tumor tumor resection, so neoadjuvant chemotherapy combined cells dying after chemoradiotherapy are able to present with immunotherapy is also rational to a certain extent. tumor associated antigens to host immune cells, activating Based on this, the eﬃcacy of combining sindilizumab with the body tumor response. Therefore, hematological indices neoadjuvant chemotherapy in treating middle and advanced can also be an inﬂuential factor in the evaluation of recur- rectal cancer was explored herein, and the related factors rence and prognosis. The results of available studies sug- aﬀecting eﬃcacy were analyzed based on data. gest that neutrophils, NLR, lymphocytes, platelets, and The evaluation of clinical results of 43 patients revealed CEA have some correlation with the eﬃcacy and clinico- that there were 10 CR cases, 20 PR cases, 8 SD cases, and 5 pathological characteristics of neoadjuvant chemoradio- PD cases, and the overall response rate of treatment was therapy and are somewhat valuable in judging the 69.77% (30 cases), which was higher compared with the pre- prognosis [22, 23]. CEA is widely used to predict the eﬃ- vious results. On the one hand, the study result aﬃrmed the cacy of neoadjuvant chemoradiotherapy for rectal cancer, eﬃcacy of sindilizumab combined with neoadjuvant chemo- with demonstrated eﬃcacy predictive value. The changes therapy in patients with medium and advanced rectal can- in NLR and PLR, novel systemic immune response indica- cer; on the other hand, because sindilizumab injection was tors, are caused by the synergistic eﬀect of neutrophils, oﬃcially marketed in mainland China only in 2019 and the platelets, and lymphocytes. Relevant studies have shown duration of its clinical use for rectal cancer treatment is rel- that preoperative NLR levels and tumor volume size in atively short, so there are relatively few clinical cases. In cancer patients have signiﬁcant associations [24, 25]. In addition, based on the study criteria, most of the enrolled this study, in logistic regression analysis and correlation patients were TNM stage III patients, some of them had analysis, the diﬀerence of NLR and PLR was not found, regional lymph node metastasis, and none had distant so the reference and guidance value of their level changes metastasis, and therefore, the speciﬁcity of case screening for the treatment of rectal cancer with the combination of may have some inﬂuence on the overall eﬃcacy statistics. sindilizumab and neoadjuvant chemotherapy should be Based on the statistics of adverse reactions in patients, no conﬁrmed with large-sample and multicenter studies. grade IV and V adverse reactions occurred in all patients, In conclusion, combining sintilimab with neoadjuvant and the incidence of nausea and vomiting was the highest, chemotherapy has signiﬁcant eﬃcacy in treating middle followed by granulocytopenia and mucocutaneous damage, and advanced rectal cancer and is safer, which is conducive which was close to most of the previous similar reported to the subsequent surgery; and larger tumor diameter, higher data [17, 18]. The overall incidence of adverse reactions CEA level, higher TNM stage, and more serious lymphatic 6 Journal of Oncology metastasis are all independent risk factors aﬀecting treat- tion in locally advanced rectal cancer with high risk of recur- rence - a phase II study,” Anticancer Research: International ment sensitivity and can lead to poor eﬃcacy. Journal of Cancer Research and Treatment, vol. 37, no. 5, pp. 2683–2691, 2017. Data Availability  A. Bohlok, A. Hendlisz, F. Bouazza et al., “The potential beneﬁt of adjuvant chemotherapy in locally advanced rectal cancer Data to support the ﬁndings of this study is available on rea- treated with neoadjuvant chemoradiotherapy is not predicted sonable request from the corresponding author. by tumor regression grade,” International Journal of Colorectal Disease, vol. 33, no. 10, pp. 1383–1391, 2018. Conflicts of Interest  T. Conroy, J.-F. Bosset, P.-L. Etienne et al., “Neoadjuvant che- motherapy with FOLFIRINOX and preoperative chemoradio- The authors do not have conﬂicts of interest to declare. therapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, References open-label, phase 3 trial,” The Lancet Oncology, vol. 22, no. 5, pp. 702–715, 2021.  X. Yang, T. Hu, C. Gu et al., “The prognostic signiﬁcance of isolated tumor cells detected within lateral lymph nodes in rec-  Y. Sun, Z. Huang, Y. Zhang et al., “Is early initiation of adju- tal cancer patients after laparoscopic lateral lymph node dis- vant chemotherapy beneﬁcial for locally advanced rectal can- section,” Journal of Laparoendoscopic & Advanced Surgical cer following neoadjuvant chemoradiotherapy and radical Techniques, vol. 29, no. 11, pp. 1462–1468, 2019. surgery?,” World Journal of Surgery, vol. 44, no. 9, pp. 3149– 3157, 2020.  A. Nishie, Y. Asayama, K. Ishigami et al., “Amide proton transfer imaging to predict tumor response to neoadjuvant  K. Y. Hu, M. T. Simpson, J. J. Blank et al., “Use of neoadjuvant chemotherapy in locally advanced rectal cancer,” Journal of chemotherapy in the treatment of locally advanced rectal can- Gastroenterology and Hepatology, vol. 34, no. 1, pp. 140–146, cer,” Journal of Surgical Research: Clinical and Laboratory Investigation, vol. 243, pp. 447–452, 2019.  S. P. Ng, J. Chu, S. Chander et al., “Results of phase II trial of  F. Sclafani, G. Brown, D. Cunningham et al., “PAN-EX: a intensiﬁed neoadjuvant treatment with interdigitating radio- pooled analysis of two trials of neoadjuvant chemotherapy therapy and chemotherapy with oxaliplatin, 5-ﬂuorouracil followed by chemoradiotherapy in MRI-deﬁned, locally and folinic acid in patients with locally advanced rectal cancer advanced rectal cancer,” Annals of Oncology, vol. 27, no. 8, (PROARCT trial),” Radiotherapy and Oncology, vol. 155, pp. 1557–1565, 2016. pp. 27–32, 2021.  Q. Xu, Y. Xu, H. Sun et al., “Quantitative intravoxel incoherent  S. Lichthardt, L. Zenorini, J. Wagner et al., “Impact of adjuvant motion parameters derived from whole-tumor volume for chemotherapy after neoadjuvant radio- or radiochemotherapy assessing pathological complete response to neoadjuvant che- for patients with locally advanced rectal cancer,” Journal of motherapy in locally advanced rectal cancer,” Journal of Mag- Cancer Research and Clinical Oncology, vol. 143, no. 11, netic Resonance Imaging, vol. 48, no. 1, pp. 248–258, 2018. pp. 2363–2373, 2017.  A. Ogura, K. Uehara, T. Aiba et al., “Indications for neoadju-  F. Sclafani, G. Brown, D. Cunningham et al., “Systemic chemo- vant treatment based on risk factors for poor prognosis before therapy as salvage treatment for locally advanced rectal cancer and after neoadjuvant chemotherapy alone in patients with patients who fail to respond to standard neoadjuvant chemo- locally advanced rectal cancer,” European Journal of Surgical radiotherapy,” The Oncologist, vol. 22, no. 6, pp. 728–736, Oncology, vol. 47, no. 5, pp. 1005–1011, 2021.  A. Patel, P. Spychalski, G. Corrao et al., “Neoadjuvant short-  J. Zhang, M. Huang, Y. Cai et al., “Neoadjuvant chemotherapy course radiotherapy with consolidation chemotherapy for with mFOLFOXIRI without routine use of radiotherapy for locally advanced rectal cancer: a systematic review and meta- locally advanced rectal cancer,” Clinical Colorectal Cancer, analysis,” Acta Oncologica, vol. 60, no. 10, pp. 1308–1316, vol. 18, no. 4, pp. 238–244, 2019.  S. Hasegawa, S. Goto, T. Matsumoto et al., “A multicenter  T. Mukai, K. Uehara, T. Aiba et al., “Importance of the neoad- phase 2 study on the feasibility and eﬃcacy of neoadjuvant juvant rectal (NAR) score to the outcome of neoadjuvant che- chemotherapy without radiotherapy for locally advanced rec- motherapy alone for locally advanced rectal cancer,” Surgery tal cancer,” Annals of Surgical Oncology, vol. 24, no. 12, Today, vol. 50, no. 8, pp. 912–919, 2020. pp. 3587–3595, 2017.  H. Hu and H. Jiang, “Prediction of neoadjuvant radiotherapy  S. Feng, P. Yan, Q. Zhang et al., “Induction chemotherapy and chemotherapy for locally advanced rectal cancer based followed by neoadjuvant chemoradiotherapy and surgery for on 3.0T MRI intravoxel incoherent motion diﬀusion patients with locally advanced rectal cancer: a systematic weighted-imaging with Fe3O4nanocontrast agent,” review and meta-analysis,” International Journal of Colorectal Nanoscience and Nanotechnology Letters, vol. 11, no. 12, Disease, vol. 35, no. 8, pp. 1355–1369, 2020. pp. 1676–1684, 2019.  K. Toritani, J. Watanabe, Y. Suwa et al., “A prospective, single-  K. M. Hardiman, A. G. Antunez, A. Kanters, A. D. Schuman, arm, multicenter trial of neoadjuvant chemotherapy with and S. E. Regenbogen, “Clinical and pathological outcomes mFOLFOX6 plus panitumumab without radiotherapy for of induction chemotherapy before neoadjuvant radiotherapy locally advanced rectal cancer,” International journal of colo- in locally-advanced rectal cancer,” Journal of Surgical Oncol- rectal disease., vol. 35, no. 12, pp. 2197–2204, 2020. ogy, vol. 120, no. 2, pp. 308–315, 2019.  W. Eisterer, G. Piringer, A. De Vries et al., “Neoadjuvant che-  L. Guo, P. Song, X. Xue et al., “Variation of programmed death motherapy with capecitabine, oxaliplatin and bevacizumab ligand 1 expression after platinum-based neoadjuvant followed by concomitant chemoradiation and surgical resec- Journal of Oncology 7 chemotherapy in lung cancer,” Journal of Immunotherapy, vol. 42, no. 6, pp. 215–220, 2019.  C. Jiangxia, C. Siying, K. Dong et al., “Eﬃcacy and safety of cindilimab in patients with advanced colorectal cancer,” China pharmacovigilance, vol. 19, no. 2, pp. 164–168, 2022.  B. Yue, S. Daqiang, Z. Xun, Z. Gongjian, L. Lili, and C. Qun, “Application of PD-1 monoclonal antibody combined with chemotherapy in preoperative neoadjuvant therapy of stage III a non-small cell lung cancer,” Chinese Journal of Thoracic and Cardiovascular Surgery, vol. 38, no. 2, pp. 96–101, 2022.  G. Chijiang, C. Ke, and D. Jinlin, “Changes and clinical signif- icance of vascular endothelial growth factor after bevacizumab combined with radiotherapy and chemotherapy in the neoad- juvant treatment of locally advanced rectal cancer,” China Chronic Disease Prevention and Control, vol. 25, no. 5, pp. 372–375, 2017.
Journal of Oncology
– Hindawi Publishing Corporation
Published: Sep 16, 2022