Long‐term results of reirradiation for patients with recurrent rectal carcinoma

Mohiuddin, Mohammed; Marks, Gerald; Marks, John W.

doi:10.1002/cncr.10799

Cited by 188 publications

(149 citation statements)

References 66 publications

Supporting

Mentioning

136

Contrasting

Unclassified

Order By: Relevance

“…Hyperfractionated radiation has been considered to improve locoregional control rates without increasing late toxicity in head and neck cancer (17). In patients with recurrent rectal carcinoma, high doses of hyperfractionated radiation may be delivered with acceptable risk, without prohibitive long-term side effects (18). Hyperfractionated re-irradiation has also been used to successfully manage locally recurrent lung cancer (19) and head and neck cancers (20).…”

Section: Discussionmentioning

confidence: 99%

Re-irradiation of locoregional esophageal cancer recurrence following definitive chemoradiotherapy: A report of 6 cases

Katano

Yamashita

Nakagawa

2017

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. There is currently no consensus on salvage therapy for recurrent esophageal cancer. Salvage surgery is a well-established option for attaining long-term survival; however, it is associated with a high risk of perioperative morbidity and mortality. A total of 6 patients who underwent re-irradiation for recurrence of locoregional esophageal cancer following definitive chemoradiotherapy were investigated. The median interval between initial radiotherapy and re-irradiation was 17.4 months (range, 6.4-59.2 months). Re-irradiation salvage therapy was mostly administered with concurrent chemotherapy, which consisted of several cycles of nedaplatin on day 1 and oral S-1 administration on days 1-14. The median survival after re-irradiation was 13.6 months (range, 1.9-33.3 months). A total of 3 patients who completed hyperfractionated radiation therapy survived for >1 year. One patient has had no signs of recurrence or late radiation toxicity for >2 years. Severe acute hematological adverse events (AEs) occurred in 3 patients, including 1 case of grade 4 leukopenia. One severe late AE occurred in 1 patient, who developed grade 3 dysphagia and became permanently dependent on percutaneous endoscopic gastrostomy tube feeding. Salvage radiotherapy is considered to be a good treatment option for inoperable locoregional recurrent esophageal cancer. The results of the present study demonstrated that re-irradiation, with or without chemotherapy, for recurrent esophageal carcinoma after definitive chemoradiotherapy was tolerable and yielded reasonably satisfactory results.

show abstract

Section: Discussionmentioning

confidence: 99%

Re-irradiation of locoregional esophageal cancer recurrence following definitive chemoradiotherapy: A report of 6 cases

Katano

Yamashita

Nakagawa

2017

Molecular and Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…Therefore, employing a hyperfractionated radiotherapy schedule where lower doses per fraction are delivered twice a day, i.e., 1.2 Gy bidaily, compared to a larger fraction size once a day, i.e., 2 Gy daily, would allow preferential sparing of normal tissue while allowing the same tumoricidal dose to be delivered to the target volume. This strategy has been successfully employed in reirradiation of pelvic malignancies 23,24 and could potentially be exploited in the setting where reconstructive surgery is anticipated.…”

Section: Discussionmentioning

confidence: 99%

Urological reconstruction after pelvic oncological surgery: A single institution experience

Tan

et al. 2017

Asian Journal of Surgery

View full text Add to dashboard Cite

Summary Background: In locally advanced pelvic malignancies, there is often involvement of urological organs, necessitating resection and reconstruction, which can be associated with significant complications. Methods: We retrospectively reviewed 20 patients undergoing urological reconstructions during pelvic oncological surgeries from January 2004 to December 2013. All patients had imagingproven involvement of at least one urological organ preoperatively. Primary outcome was urological complication rate. Secondary outcomes were nonurological complication, recurrence rate, and overall survival. Results: Median age of presentation was 51 years. Six and 14 patients underwent resections for primary and secondary tumors, respectively. Colorectal tumors were the most common, followed by gynecological cancers. The ureter was the most common urological organ involved, followed by the bladder, prostate, and seminal vesicles. Reconstructive procedures included ileal and sigmoid conduits, ureteroneocystostomies, Boari flap, transureteroureterostomies (TUUs) and direct ureteroureterostomies. Six patients developed major urological complications, requiring endoscopic and surgical reinterventions. The follow-up time was 34 months. Thirteen patients developed recurrence, associated with higher tumor grade and lymphovascular invasion, and occurred at a median time of 10 months. These patients had an overall survival of 20 months, compared to 45 months in patients without recurrence. Conclusion: Careful patient selection in pelvic oncological surgeries can significantly prolong survival. Recurrent tumors and greater intraoperative blood loss are associated with higher urological complications. A limited pelvic exenteration and lower radiation doses can reduce

show abstract

“…43 Subsequent toxicity in re-irradiated patients is accaptable and resulted tumor shrinkage could be followed by surgical salvage and long-term survival in selected patients (Table 2). 41,[44][45][46][47][48] The irradiated volume usually encompasses recurrent tumor with a 2-4 cm margin. As the late intestinal therapy should be an essential component of these aggressive treatment approaches.…”

Section: Discussionmentioning

confidence: 99%