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Related Concept Videos

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

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5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

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Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates...
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Related Experiment Video

Updated: Jun 5, 2025

Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
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Neoadjuvant Chemoradiotherapy in Locally Advanced and Locally Recurrent Colon Cancer.

R A F Agas1, M Fahey2, R R Gosavi3

  • 1Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.

Clinical Oncology (Royal College of Radiologists (Great Britain))
|December 11, 2024
PubMed
Summary

Neoadjuvant radiotherapy shows promise for high-risk colon cancer, improving R0 resection rates in locally advanced primary and recurrent cases. Further research into chemoradiation and systemic therapy is essential for optimizing local treatment strategies.

Keywords:
Chemoradiation: radiotherapycolorectal cancerneoadjuvantpreoperative

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Radiation Oncology

Background:

  • Systemic treatment for high-risk colon cancer is established, but local management advances are slow.
  • Local control remains a challenge, particularly for locally advanced primary colon (LAPC) and locally recurrent colon (LRC) cancers.
  • Identifying patients who could benefit from intensified local treatment, such as radiotherapy, is crucial to minimize R1 resection risks.

Purpose of the Study:

  • To identify a subset of high-risk colon cancer patients where local management is challenging.
  • To evaluate the potential benefit of intensifying local treatment with radiotherapy to reduce R1 resection rates.
  • To assess the outcomes of neoadjuvant radiotherapy in LAPC and LRC patients.

Main Methods:

  • Retrospective analysis of 88 patients (40 LAPC, 48 LRC) with locally advanced or recurrent colon adenocarcinomas treated with neoadjuvant radiotherapy (45-50.4 Gy).
  • Median follow-up was 8.1 years for LAPC and 6.3 years for LRC.
  • Surgical resection and oncologic outcomes were analyzed.

Main Results:

  • In the LAPC group, 90% underwent surgery with 81% R0 resection and 66.7% pathologic downstaging.
  • In the LRC group, 79.2% underwent surgery with 65.8% R0 resection.
  • Local failure rates were 13% for LAPC and 35% for LRC (5-year survival 53%). Disease progression occurred in 38% of LAPC and 61% of LRC patients.

Conclusions:

  • Local management of high-risk colon cancer presents ongoing challenges.
  • Neoadjuvant radiotherapy can improve resection rates and downstaging in select LAPC and LRC patients.
  • Future research should focus on neoadjuvant chemoradiation, systemic therapies, and improved staging to identify high-risk populations.