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| 1 | Neoadjuvant radiotherapy dose escalation for locally advanced rectal cancers in the new era of radiotherapy:A review of literature显示文摘BACKGROUND The standard treatment of locally advanced rectal cancers(LARC)consists on neoadjuvant chemoradiotherapy followed by total mesorectal excision.Different data in literature showed a benefit on tumor downstaging and pathological complete response(pCR)rate using radiotherapy dose escalation,however there is shortage of studies regarding dose escalation using the innovative techniques for LARC(T3-4 or N1-2).AIM To analyze the role of neoadjuvant radiotherapy dose escalation for LARC using innovative radiotherapy techniques.METHODS In December 2020,we conducted a comprehensive literature search of the following electronic databases:PubMed,Web of Science,Scopus and Cochrane library.The limit period of research included articles published from January 2009 to December 2020.Screening by title and abstract was carried out to identify only studies using radiation doses equivalent dose 2 Gy fraction(EQD2)≥54 Gy and Volumetric Modulated Arc Therapy(VMAT),intensity-modulated radiotherapy or image-guided radiotherapy(IGRT)techniques.The authors’searches generated a total of 2287 results and,according to PRISMA Group(2009)screening process,21 publications fulfil selection criteria and were included for the review.RESULTS The main radiotherapy technique used consisted in VMAT and IGRT modality.The mainly dose prescription was 55 Gy to high risk volume and 45 Gy as prophylactic volume in 25 fractions given with simultaneous integrated boosts technique(42.85%).The mean pCR was 28.2%with no correlation between dose prescribed and response rates(P value≥0.5).The R0 margins and sphincter preservation rates were 98.88%and 76.03%,respectively.After a mean follow-up of 35 months local control was 92.29%.G3 or higher toxicity was 11.06%with no correlation between dose prescription and toxicities.Patients receiving EQD2 dose>58.9 Gy and BED>70.7 Gy had higher surgical complications rates compared to other group(P value=0.047).CONCLUSION Dose escalation neoadjuvant radiotherapy using innovative techniques is safe for LARC achieving higher rates of pCR.EQD2 doses>58.9 Gy is associated with higher rate of surgical complications. | Durim Delishaj Ilaria Costanza Fumagalli Stefano Ursino Agostino Cristaudo Francesco Colangelo Antonio Stefanelli Alessandro Alghisi Giuseppe De Nobili Romerai D’Amico Alessandra Cocchi Antonio Ardizzoia Carlo Pietro | 2021 | World Journal of Clinical Cases2021，9，30： | 2 |
| 2 | Neuroendocrine control of growth hormone secretion显示文摘 | Muller EE Locatelli V Cocchi D | 1999 | Physiological Reviews1999，79，： | 1 |
| 3 | Human neutrophil alpha-defensin 4 inhibits HIV-1 infection in vitro显示文摘 | Wu Z Cocchi F Gentles D | 2005 | FEBS Lett2005，579，1： | 1 |
| 4 | Mixing of exci- mer and exciplex emission: a new way to improve white light emitting organic electrophosphorescent diodes 显示文摘 | Kalimonwski J Cocchi M Virgili D | 2007 | Adv Mater2007，19，： | 1 |
| 5 | Magnetic field effects on emission and current in Alq3-based lectroluminescent diodes 显示文摘 | Kalinowski J Cocchi M Virgili D P | 2003 | Chem Phys Leg2003，380，56： | 1 |
| 6 | Magnetic field effects on organic electr ophosphorescence 显示文摘 | Kalinowski J Cocchi M Virgili D P | 2004 | Phys Rev B2004，70，20： | 1 |
| 7 | Neuroendocrine control of growth hormone secretion显示文摘 | MULLERr E E LOCATELL V COCCHI D | 1999 | Physiological Reviews1999，79，2： | 1 |
| 8 | The soluble ectodomain of herpes simplex virus gD contains a membrane-proximal pro-fusion domain and suffices to mediate virus entry显示文摘 | Cocchi F Fusco D Menotti L | 2004 | Proc Natl Acad Sci USA2004，101，： | 1 |
| 9 | Leu-enkephalinstimulated growth normone and prolactin release in the rat:comparison with the effect of morphine显示文摘 | Cocchi D Santagostino A Gil Ad I | 1977 | Life Sci1977，20，12： | 1 |
| 10 | Human neutrophil a-defensin 4 inhibits HIV-1 infection in vitro 显示文摘 | Wu Z Cocchi F Gentles D | 2005 | FEBS Lett2005，579，1： | 1 |
| 11 | The influence of sex and gonadectomy on the growth hormone and corticosterone response to hexarelin in the rat显示文摘 | Sibilia V Cocchi D Pagani F | 2000 | Life Sci2000，68，3： | 1 |
| 12 | Determination of carboxylic acids in vinegars and in Aceto Balsamico Tradizionale di Modena by HPLC and GC methods显示文摘 | Cocchi M Lambertini P Manzini D | 2002 | Agricultural and Food Chemistry2002，50，19： | 1 |
| 13 | Optical excitations and field enhancement in short graphene nanoribbons显示文摘 | Cocchi C Prezzi D Ruini A | 2012 | J Phys Chem Lett2012，3，7： | 1 |
| 14 | Efficient exciplex emitting organic electroluminescent devices显示文摘 | Cocchi M Virgili D Giro G Fattori V Marco P D Kalinowski J Shirota | 2002 | Applied Physics Letters2002，80，13： | 1 |
| 15 | Towards a routine appli-cation of vibrational spectroscopy to the detection of bone fragments infeedingstuffs:Use and validation of a NIR scanning microscopy method显示文摘 | PAVINO D SQUADRONE S COCCHI M | 2010 | Food Chemistry2010，121，： | 1 |
| 16 | Pricing in computer networks:motivation,formulation,and example显示文摘 | Cocchi R Estrin D Shenker S | 1993 | IEEE/ACM Transactions on Networking1993，1，6： | 1 |
| 17 | Organic electroluminescence from singlet and triplet exciplexes:exciplex electrophosphorescent diode显示文摘 | Cocchi M Virgili D Sabatini C Kalinowski J | 2006 | Chemical Physics Letters2006，421，46： | 1 |
| 18 | Pricing in computer networks:motivation,formulation and example显示文摘 | Cocchi R Shenker S Estrin D | 1933 | IEEE/ACM Transactions on Networking1933，1，6： | 1 |
| 19 | Pricing in computer networks: Motivation,formulation and example显示文摘 | Cocchi R Shenker S Estrin D | 1993 | IEEE AMC Trans on Networking1993，1，6： | 1 |
| 20 | Determina- tion of earboxylic acids in vinegars and in Aceto Balsamico Tradizionale di Modena by HPLC and GC methods 显示文摘 | Cocchi M LambertiniL P Manzini D | 2002 | Journal of Agricultural and Food Chemistry2002，50，19： | 1 |
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