A multicentre retrospective review of SABR reirradiation in rectal cancer recurrence

Johnstone, Philippa; Okonta, Leroy; Aitken, K.; Holmes, Jane; Harrison, Mark; Harji, Deena; O’Cathail, Séan M.; Taylor, Claire; Tsang, Y.; Wing, Mark S.; Muirhead, R.

doi:10.1016/j.radonc.2021.06.030

Cited by 11 publications

(12 citation statements)

References 23 publications

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“…In patients who choose not to pursue or are not eligible for surgery, stereotactic body radiotherapy combined with systematic chemotherapy, although not curative, may achieve durable disease control for some. 7…”

Section: Locally Advanced and Recurrent Rectal Cancermentioning

confidence: 99%

“…In 2024, pelvic exenteration is considered the standard of care for selected patients with locally advanced and recurrent rectal cancer. In patients who choose not to pursue or are not eligible for surgery, stereotactic body radiotherapy combined with systematic chemotherapy, although not curative, may achieve durable disease control for some 7 …”

Section: Locally Advanced and Recurrent Rectal Cancermentioning

confidence: 99%

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Contemporary management of advanced colorectal cancer: the Australian experience

Brown,

Ansari,

Solomon

2024

Medical Journal of Australia

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Section: Locally Advanced and Recurrent Rectal Cancermentioning

confidence: 99%

Section: Locally Advanced and Recurrent Rectal Cancermentioning

confidence: 99%

Contemporary management of advanced colorectal cancer: the Australian experience

Brown,

Ansari,

Solomon

2024

Medical Journal of Australia

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“…For locally advanced or advanced rectal cancer, distant metastasis is the most common cause of death, and the lung is the most likely site, followed by the liver (13,14). However, if local recurrence occurs without surgery, the 5-year overall survival is about 4% (15)(16)(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Clinical study on risk factors related to postoperative recurrence or metastasis of rectal cancer: a retrospective cohort study

Wang¹,

Hong²,

Niu³

et al. 2022

J Gastrointest Oncol

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Background: Rectal cancer is usually treated by surgery, but recurrence or metastasis seriously affect the quality of life and survival of patients. Identifying the risk factors for postoperative recurrence or metastasis of rectal cancer has important guiding value for the treatment of rectal cancer. However, the research on risk factors of postoperative recurrence or metastasis of rectal cancer has not been unified. Methods:The data of all patients undergoing rectal cancer surgery in The Fifth People's Hospital of Shanghai, Fudan University, from 2016 to 2020 were collected and analyzed. A total of 185 patients were included for statistical analysis and were divided into a recurrence or metastasis group and a non-recurrence or metastasis group. Patients were followed up according to National Comprehensive Cancer Network (NCCN) guidelines by enhanced CT or MRI, and colonoscopy. The cut-off of the research was recurrence, metastasis, or death. Logistic regression analysis and Cox regression analysis were used to analyze the risk factors related to postoperative recurrence or metastasis of rectal cancer, and the survival curve was drawn.Results: Multiple logistic regression analysis showed involvement of the mesorectal fascia (MRF) [OR (odds ratio) =2.9, 95% confidence interval (CI): 1.16-7.29, P=0.023], nerve and vascular invasion (OR =1.7, 95% CI: 1.08-2.59, P=0.022), intraoperative blood transfusion (OR =3.7, 95% CI: 1.45-9.40, P=0.006), and Dukes staging (OR =2.3, 95% CI: 1.26-4.35, P=0.007) were independent risk factors for postoperative recurrence or metastasis of rectal cancer. Involvement of mesenteric fascia infiltration (OR =11.5, 95% CI: 1.49-88.79, P=0.019) and Dukes stage (OR =3.0, 95% CI: 1.46-6.26, P=0.003) were independent risk factors for liver metastasis, while nerve and vascular invasion (OR =2.4, 95% CI: 1.19-5.00, P=0.015) was an independent risk factor for pulmonary metastasis.Conclusions: Postoperative recurrence or metastasis of rectal cancer is related to many factors. These findings have clinical guiding value and significance for the follow up and prognosis of patients with rectal cancer after surgery. Large-scale prospective clinical studies are needed.

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“…The RAPIDO trial shows that SCRT can signi cantly reduce the rate of distant metastasis (19.8% vs. 26.6%) and increase the pCR rate (27.7% vs. 13.8%) compared with the standard LCRT [20]. Besides, more recently studies show that re-irradiation with stereotactic ablative radiotherapy (SABR, 30 Gy/5 Fx) is well tolerated and achieved high local control rates, the 2-year LC rate was 68.2-69.0% and 0-3% of patients developed grade 3 toxicities [21][22][23][24]. Thus, hypofractionated radiation in 5 fractions is a potential treatment option for LRRC.…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated radiotherapy combined with chemotherapy and Toripalimab for locally recurrent rectal cancer: a single-arm, phase II trial (TORCH-R)

Shen

Zhang

et al. 2023

Preprint

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Background For patients with locally recurrent rectal cancer (LRRC), R0 resection of pelvic recurrent tumour is most important prognostic factor influencing survival. However, only approximately 40% of patients with recurrent rectal cancer can undergo R0 resection. Recent studies have shown promising synergistic effects of the combination of immunotherapy (PD-1/PD-L1 antibodies) and neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC). Thus, for LRRC patients, addition of immunotherapy to preoperative CRT is likely to further improve the rate R0 resection and prognosis. Methods TORCH-R is a prospective, single-center, single-arm phase II trial of preoperative hypofractionated radiotherapy, chemotherapy and immunotherapy in LRRC. A total of 75 locally recurrent rectal cancer (LRRC) patients will be recruited and receive 25-40Gy/5Fx irradiation or 15-25Gy/5Fx reirradiation, 6 cycles of CAPOX and toripalimab, followed by multidisciplinary team (MDT) for decision: radical surgery, sustained treatment until resectable or exit. The primary endpoint is the R0 resection rate of pelvic recurrent tumour. The secondary endpoints include the overall response rate (ORR), progression-free survival (PFS), overall survival (OS), safety and tolerability. Discussion TORCH-R will investigate whether hypofractionated radiotherapy combined with chemotherapy and Toripalimab can achieve better R0 resection rates, good tolerance and prognosis in LRRC patients. This is the first clinical trial to induce immunotherapy and consolidative chemoradiotherapy in LRRC patients. Trial registration: Trial Registration Number and Date of Registration: ClinicalTrials.gov NCT05628038, November 17, 2022.

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A multicentre retrospective review of SABR reirradiation in rectal cancer recurrence

Cited by 11 publications

References 23 publications

Contemporary management of advanced colorectal cancer: the Australian experience

Contemporary management of advanced colorectal cancer: the Australian experience

Clinical study on risk factors related to postoperative recurrence or metastasis of rectal cancer: a retrospective cohort study

Hypofractionated radiotherapy combined with chemotherapy and Toripalimab for locally recurrent rectal cancer: a single-arm, phase II trial (TORCH-R)

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