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  1. Article ; Online: Emerging trends in the treatment of rectal cancer.

    Minsky, Bruce D

    Acta oncologica (Stockholm, Sweden)

    2019  Volume 58, Issue 10, Page(s) 1343–1351

    Abstract: The conventional treatment for cT3-T4 or node-positive clinically resectable rectal cancer is long course preoperative chemoradiation followed by surgery and postoperative adjuvant chemotherapy. Disadvantages of this approach include possible ... ...

    Abstract The conventional treatment for cT3-T4 or node-positive clinically resectable rectal cancer is long course preoperative chemoradiation followed by surgery and postoperative adjuvant chemotherapy. Disadvantages of this approach include possible overtreatment of patients, 6 weeks of daily radiation treatment, and undetected metastatic disease. There are a number of emerging trends which are changing this approach to treatment. Selected topics included in this manuscript include the selective use of pelvic radiation, the role of radiation for a positive radial margin, the interval between radiation and surgery, non-operative management, new chemoradiation regimens, short vs. long course radiation, and the role of postoperative adjuvant chemotherapy.
    MeSH term(s) Chemoradiotherapy/methods ; Chemotherapy, Adjuvant/methods ; Clinical Trials, Phase III as Topic ; Disease-Free Survival ; Humans ; Neoadjuvant Therapy/methods ; Neoplasm Staging ; Patient Selection ; Proctectomy ; Radiotherapy Dosage ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy ; Time Factors
    Language English
    Publishing date 2019-07-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 896449-x
    ISSN 1651-226X ; 0349-652X ; 0284-186X ; 1100-1704
    ISSN (online) 1651-226X
    ISSN 0349-652X ; 0284-186X ; 1100-1704
    DOI 10.1080/0284186X.2019.1629009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Neoadjuvant Treatment Strategies: Advanced Radiation Alternatives.

    Minsky, Bruce D

    Clinics in colon and rectal surgery

    2017  Volume 30, Issue 5, Page(s) 377–382

    Abstract: Long-course chemoradiation therapy (CRT) has been the standard approach for locally advanced rectal tumors. Neoadjuvant CRT is associated to improved local disease control, with less toxicity when compared with adjuvant CRT, as well as the chance for ... ...

    Abstract Long-course chemoradiation therapy (CRT) has been the standard approach for locally advanced rectal tumors. Neoadjuvant CRT is associated to improved local disease control, with less toxicity when compared with adjuvant CRT, as well as the chance for pathologic complete response. The CRT regimens have improved over the past years. This article will examine selected controversies, including novel chemoradiation regimens, duration of radiation (short vs. long course), and radiation techniques such as intensity-modulated radiation therapy (IMRT).
    Language English
    Publishing date 2017-11-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2048635-2
    ISSN 1531-0043
    ISSN 1531-0043
    DOI 10.1055/s-0037-1606115
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: New Paradigms in Rectal Cancer Multidisciplinary Care: Special Issue Introduction.

    Ashman, Jonathan B / Ma, Brigette / Minsky, Bruce D

    Clinical colorectal cancer

    2022  Volume 21, Issue 1, Page(s) 1–2

    MeSH term(s) Humans ; Rectal Neoplasms/diagnosis ; Rectal Neoplasms/therapy ; Rectum
    Language English
    Publishing date 2022-01-31
    Publishing country United States
    Document type Editorial
    ZDB-ID 2112638-0
    ISSN 1938-0674 ; 1533-0028
    ISSN (online) 1938-0674
    ISSN 1533-0028
    DOI 10.1016/j.clcc.2022.01.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Neoadjuvant Treatment Strategies: Advanced Radiation Alternatives

    Minsky, Bruce D.

    Clinics in Colon and Rectal Surgery

    (New Horizons in Rectal Cancer Management)

    2017  Volume 30, Issue 05, Page(s) 377–382

    Abstract: Long-course chemoradiation therapy (CRT) has been the standard approach for locally advanced rectal tumors. Neoadjuvant CRT is associated to improved local disease control, with less toxicity when compared with adjuvant CRT, as well as the chance for ... ...

    Series title New Horizons in Rectal Cancer Management
    Abstract Long-course chemoradiation therapy (CRT) has been the standard approach for locally advanced rectal tumors. Neoadjuvant CRT is associated to improved local disease control, with less toxicity when compared with adjuvant CRT, as well as the chance for pathologic complete response. The CRT regimens have improved over the past years. This article will examine selected controversies, including novel chemoradiation regimens, duration of radiation (short vs. long course), and radiation techniques such as intensity-modulated radiation therapy (IMRT).
    Keywords rectal cancer ; chemoradiation therapy ; short course ; long course ; IMRT
    Language English
    Publishing date 2017-11-01
    Publisher Thieme Medical Publishers
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2072321-0
    ISSN 1530-9681 ; 1531-0043
    ISSN (online) 1530-9681
    ISSN 1531-0043
    DOI 10.1055/s-0037-1606115
    Database Thieme publisher's database

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  5. Article ; Online: Future of therapy for rectal cancer.

    Minsky, Bruce D

    Chinese clinical oncology

    2013  Volume 2, Issue 2, Page(s) 19

    Abstract: Since 2004, the standard of care for patients with cT3 and/or N+ rectal cancer has been preoperative chemoradiation followed by surgery and postoperative adjuvant chemotherapy. A number of advances have occurred and are defining the future of rectal ... ...

    Abstract Since 2004, the standard of care for patients with cT3 and/or N+ rectal cancer has been preoperative chemoradiation followed by surgery and postoperative adjuvant chemotherapy. A number of advances have occurred and are defining the future of rectal cancer therapy. Among these are short course radiation, the impact of postoperative adjuvant chemotherapy, selective radiation and selective surgery, and new chemoradiation regimens with novel agents. This review will examine these developments and assess their impact on the future therapy of rectal cancer.
    Language English
    Publishing date 2013-06
    Publishing country China
    Document type Journal Article
    ZDB-ID 2828547-5
    ISSN 2304-3873 ; 2304-3865
    ISSN (online) 2304-3873
    ISSN 2304-3865
    DOI 10.3978/j.issn.2304-3865.2013.03.01
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Rectal cancer: is 'watch and wait' a safe option for rectal cancer?

    Minsky, Bruce D

    Nature reviews. Gastroenterology & hepatology

    2013  Volume 10, Issue 12, Page(s) 698–700

    MeSH term(s) Humans ; Rectal Neoplasms
    Language English
    Publishing date 2013-10-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2493722-8
    ISSN 1759-5053 ; 1759-5045
    ISSN (online) 1759-5053
    ISSN 1759-5045
    DOI 10.1038/nrgastro.2013.201
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Short-course radiation versus long-course chemoradiation for rectal cancer: making progress.

    Minsky, Bruce D

    Journal of clinical oncology : official journal of the American Society of Clinical Oncology

    2012  Volume 30, Issue 31, Page(s) 3777–3778

    MeSH term(s) Adenocarcinoma/drug therapy ; Adenocarcinoma/radiotherapy ; Female ; Humans ; Male ; Neoplasm Recurrence, Local/pathology ; Rectal Neoplasms/drug therapy ; Rectal Neoplasms/radiotherapy
    Language English
    Publishing date 2012-11-01
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 604914-x
    ISSN 1527-7755 ; 0732-183X
    ISSN (online) 1527-7755
    ISSN 0732-183X
    DOI 10.1200/JCO.2012.45.0551
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Long-Term Patient-Reported Dyspareunia After Definitive Chemoradiation for Anal Cancer: Using the Anterior Vaginal Wall as an Organ-at-Risk to Define an Actionable Dosimetric Goal.

    Rooney, Michael K / Niedzielski, Joshua S / Salazar, Ramon M / Arzola, Angelica / Das, Prajnan / Koay, Eugene J / Koong, Albert / Ludmir, Ethan B / Minsky, Bruce D / Noticewala, Sonal / Smith, Grace L / Taniguchi, Cullen / Holliday, Emma B

    Advances in radiation oncology

    2024  Volume 9, Issue 5, Page(s) 101449

    Abstract: Purpose: Chemoradiation therapy (CRT) is the standard treatment for squamous cell carcinoma of the anus (SCCA). This study aimed to investigate the relationship between vaginal dosimetry and long-term patient-reported dyspareunia after treatment. We ... ...

    Abstract Purpose: Chemoradiation therapy (CRT) is the standard treatment for squamous cell carcinoma of the anus (SCCA). This study aimed to investigate the relationship between vaginal dosimetry and long-term patient-reported dyspareunia after treatment. We further aimed to use the anterior vaginal wall (AVW) as an organ at risk to define an actionable dosimetric clinical goal to decrease the risk of patient-reported dyspareunia.
    Methods and materials: Women with SCCA treated with intensity modulated radiation therapy-based CRT were surveyed at least 2 years after successfully completing therapy. A Female Sexual Function Index (FSFI) pain subscore ≤4 was used to define dyspareunia. Dosimetric parameters were calculated for both the full vaginal canal and AVW. Multivariable linear regression models were created to identify predictors of FSFI pain subscore using backward selection to identify final variables include in the models. An actionable dosimetric predictor for dyspareunia was established using the Youden index method for cutoff optimization.
    Results: Of 184 women who were contacted, 90 (49%) returned completed surveys. Of those who completed surveys, 51 (56.7%) reported being sexually active, and 47 had dosimetric data available for review. Of sexually active respondents, 32 (68%) had an FSFI pain subscore ≤4. Multiple regression models were generated using the full vaginal canal and AVW as organs at risk, and both models showed similar predictive relationships with volumetric dose parameters emerging as the best dosimetric predictors for dysparenuia. Age over 65 years was also associated with higher FSFI pain subscores (eg, less pain with intercourse) in both models. AVW V35 Gy < 60% was identified as the optimal cutoff to reduce the risk of patient-reported dyspareunia.
    Conclusions: Increased dose to the vaginal canal is significantly associated with worse patient-reported dyspareunia following CRT for SCCA. Minimizing dose to the AVW to V35 Gy < 60% may reduce the risk of this quality of life-limiting toxicity. Further prospective evaluation is needed to validate these findings.
    Language English
    Publishing date 2024-02-02
    Publishing country United States
    Document type Journal Article
    ISSN 2452-1094
    ISSN 2452-1094
    DOI 10.1016/j.adro.2024.101449
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Counterpoint: long-course chemoradiation is preferable in the neoadjuvant treatment of rectal cancer.

    Minsky, Bruce D

    Seminars in radiation oncology

    2011  Volume 21, Issue 3, Page(s) 228–233

    Abstract: There are 2 approaches to preoperative therapy. Short-course (25 Gy in 5 fractions) radiation and long-course (50.4 Gy in 28 fractions) radiation combined with chemotherapy (CMT). Although short-course radiation therapy is used in some European countries, ...

    Abstract There are 2 approaches to preoperative therapy. Short-course (25 Gy in 5 fractions) radiation and long-course (50.4 Gy in 28 fractions) radiation combined with chemotherapy (CMT). Although short-course radiation therapy is used in some European countries, it is not favored in all European countries or North America. Unlike long-course CMT, it cannot be safely combined with adequate doses of systemic concurrent chemotherapy, and, as currently designed, it does not increase sphincter preservation. Long-course CMT remains the preferred regimen for cT3 and/or node-positive disease. With parallel advances in staging, surgery, systemic therapy, and molecular markers, more selective approaches are being investigated.
    MeSH term(s) Chemotherapy, Adjuvant ; Dose Fractionation ; Evidence-Based Medicine ; Humans ; Lymphatic Metastasis ; Neoadjuvant Therapy/standards ; Neoplasm Staging ; Preoperative Care/standards ; Radiotherapy Dosage ; Randomized Controlled Trials as Topic ; Rectal Neoplasms/drug therapy ; Rectal Neoplasms/radiotherapy ; Rectal Neoplasms/surgery ; Survival Rate ; Time Factors
    Language English
    Publishing date 2011-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1146999-7
    ISSN 1532-9461 ; 1053-4296
    ISSN (online) 1532-9461
    ISSN 1053-4296
    DOI 10.1016/j.semradonc.2011.02.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Unique considerations in the patient with rectal cancer.

    Minsky, Bruce D

    Seminars in oncology

    2011  Volume 38, Issue 4, Page(s) 542–551

    Abstract: In the past two decades, substantial progress has been made in the adjuvant management of colorectal cancer. Chemotherapy has improved overall survival in patients with node-positive (N+) disease. In contrast with colon cancer, which has a low incidence ... ...

    Abstract In the past two decades, substantial progress has been made in the adjuvant management of colorectal cancer. Chemotherapy has improved overall survival in patients with node-positive (N+) disease. In contrast with colon cancer, which has a low incidence of local recurrence, patients with rectal cancer have a higher incidence requiring the addition of pelvic radiation therapy (chemoradiation). Patients with rectal cancer have a number of unique management considerations: for example, the role of short-course radiation, whether postoperative adjuvant chemotherapy is necessary for all patients, and if the type of surgery following chemoradiation should be based on the response rate. More accurate imaging techniques and/or molecular markers may help identify patients with positive pelvic nodes to reduce the chance of overtreatment with preoperative therapy. Will more effective systemic agents both improve the results of radiation as well as modify the need for pelvic radiation? This review will address these and other controversies specific to patients with rectal cancer.
    MeSH term(s) Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Carcinoma/therapy ; Combined Modality Therapy/methods ; Combined Modality Therapy/trends ; Dissent and Disputes ; Humans ; Postoperative Period ; Preoperative Period ; Radiotherapy, Adjuvant/methods ; Rectal Neoplasms/therapy
    Language English
    Publishing date 2011-08
    Publishing country United States
    Document type Evaluation Studies ; Journal Article ; Review
    ZDB-ID 189220-4
    ISSN 1532-8708 ; 0093-7754
    ISSN (online) 1532-8708
    ISSN 0093-7754
    DOI 10.1053/j.seminoncol.2011.05.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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