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Once‐daily reirradiation for rectal cancer in patients who have received previous pelvic radiotherapy
Author(s) -
Ng Michael K Y,
Leong Trevor,
Heriot Alexander G,
Ngan Samuel Y K
Publication year - 2013
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12057
Subject(s) - medicine , radiation therapy , hyperfractionation , dose fractionation , colorectal cancer , surgery , cancer
The purpose of this study is to assess the efficacy and toxicity using once‐daily reirradiation for patients with rectal cancer having received previous pelvic radiotherapy. Method Between J une 1997 and J une 2008, 56 patients were identified having received previous pelvic radiotherapy and received reirradiation for rectal cancer. Reirradiation intent was palliative in 43 patients, and preoperative/postoperative in 13 patients. Eighty per cent of patients received concurrent chemotherapy ( n = 45). Results The median dose‐fractionation reirradiation schedule was 39.6 Gy in 22 fractions once daily (range 20–39.6 Gy ), and the median cumulative radiation dose was 87.3 Gy . Seven patients experienced a grade 3 acute toxicity, with no grade 4 event. Fifty‐one patients (91%) completed the treatment and five patients required a treatment break. The overall symptomatic response rate was 88% at three months post‐reirradiation. There was one late effect of skin ulceration among patients reirradiated palliatively. Median overall survival was 39 months in patients undergoing radical surgery versus 15 months in patients reirradiated palliatively ( P < 0.001). Conclusion Once‐daily reirradiation to a total dose of ≤39.6 Gy is relatively safe in the treatment of patients with rectal cancer after previous pelvic radiotherapy. It is effective in symptom control and provides an additional option in management of local recurrence.