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Stereotactic body radiotherapy (SBRT) reirradiation for pelvic recurrence from colorectal cancer
Author(s) -
Dagoglu Nergiz,
Mahadevan Anand,
Nedea Elena,
Poylin Vitaly,
Nagle Deborah
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23858
Subject(s) - medicine , cyberknife , radiosurgery , colorectal cancer , pelvis , radiology , radiation therapy , fiducial marker , surgery , cancer
Background and Objectives When surgery is not adequate or feasible, stereotactic body radiotherapy (SBRT) reirradiation has been used for recurrent cancers. We report the outcomes of a series of patients with pelvic recurrences from colorectal cancer reirradiated with SBRT. Methods The Cyberknife TM Robotic Stereotactic Radiosurgery system with fiducial based real time tracking was used. Patients were followed with imaging of the pelvis. Results Four women and 14 men with 22 lesions were included. The mean dose was 25 Gy in median of five fractions. The mean prescription isodose was 77%, with a median maximum dose of 32.87 Gy. There were two local failures, with a crude local control rate of 89%. The median overall survival was 43 months. One patient had small bowel perforation and required surgery (Grade IV), two patients had symptomatic neuropathy (1 Grade III) and one patient developed hydronephrosis from ureteric fibrosis requiring a stent (Grade III). Conclusions Local recurrence in the pelvis after modern combined modality treatment for colorectal cancer is rare. However it presents a therapeutic dilemma when it occurs; often symptomatic and eventually life threatening. SBRT can be a useful non‐surgical modality to control pelvic recurrences after prior radiation for colorectal cancer. J. Surg. Oncol. 2015 111:478–482 . © 2015 Wiley Periodicals, Inc.