Alvarez-Aguilera M, Jimenez-Rodriguez RM. Watch and wait in locally advance rectal cancer: Past, present and future. World J Meta-Anal 2021; 9(4): 327-332 [DOI: 10.13105/wjma.v9.i4.327]
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Reader Comments:
It contains a strategic part to consider the appropriate treatment by distinguishing the clinical benefit from various approaches for the treatment of rectal cancer patients, such as surgery, neoadjuvant chemotherapy, and radiotherapy.
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September 26, 2021, 22:31
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Reader Comments:
Autors show a wide knowledge about the organ preservation in rectal cancer. They made an historical review of that important issue and presented chronologically the most important works made by experts in this field. This editorial will help the working group interested in rectal cancer with the intention of increase the knowledge about the management of cancer. They emphazise the importance of neoadjuvant treatment wit chemo/radiotherapy with different schedules with interest in maximize the complete response rate and minimize the recurrent rate. Examples of important trials are PROSPECT, OPRA and so on. Is an excellent work.
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Reader Comments:
The authors have covered this very timely and appropriate issue well. Filling in the background gap excels it. For instance, William Coley (of Memorial Hospital, NY, USA, belatedly named "Father of Immunotherapy") never had any modern radiotherapy (RT) nor chemotherapy (CHT); yet, he still treated successfully hundreds of inoperable sarcomas by bacterial toxins (late 19th century). Currently, the pivotal phenomenon of ICD [immunogenic cell death, duly highlighted by Lorenzo Galluzzi et al for approximately 10 years by now, as induced by signals from dying cancer cells rendered by some CHT (notably metronomic CHT) and RT courses purposely shortened] would induce a very robust innate immunity similar to that of Coley's toxins. It may well be very useful for organ preservation trials, including that on rectal cancers. Despite authors' concern, fibrosis is usually much more belated; whereas very active debris clearance may toughen tumors akin to edema of chronic inflammation. Logistically, short RT courses (e.g., of only 2 weeks) allowing much shorter time to permit debris clearance naturally require longer post-RT observations, lest unfair conclusions ensue. Perhaps a separate discussion is appropriate.
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Are the research objectives achieved by the experiments used in this study?
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Reader Comments:
The study demonstrates management of the locally advance rectal cancer. It is a nice article.
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Thank you very much for your comments.