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Rectal Cancer

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Re-Irradiation: New Frontiers

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

Reirradiation combined with chemotherapy for patients developing recurrent rectal cancer after radiation or chemoradiation is feasible and provides high chances for cure and palliation. Nearly one-half of patients with resected disease achieve long-term control of pelvic disease, and up to 65 % of them can have long-term (5-year) survival. Even in unresected patients, long-term control can be achieved in about 20 % of cases with one out of five patients surviving after 5 years.

Acute and late toxicity are not prohibitive if proper attention is paid to both radiation technique and surgical technique. The use of small radiation fields, exclusion of the bowel and bladder, and the use of hyperfractionated radiation doses up to 40 Gy are recommended.

Since most of treatment failures occur within the radiation treatment field, future studies should investigate methods to further improve local control. In view of the fact that about one-half of surviving patients will develop distant metastases, innovative strategies for reduction of distant metastases should also be explored.

The original version of this chapter was revised. An erratum to this chapter can be found at 10.1007/978-3-319-41825-4_78.

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  1. Radiation Oncology Department – Gemelli ART, Università Cattolica del Sacro Cuore, Rome, Italy

    Mariangela Massaccesi & Vincenzo Valentini

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Correspondence to Vincenzo Valentini .

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  1. Department of Oncology, University of Tromso and Nordland Hospital, Bodo, Norway

    Carsten Nieder

  2. University Medical Center Groningen, Groningen, The Netherlands

    Johannes Langendijk

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Massaccesi, M., Valentini, V. (2016). Rectal Cancer. In: Nieder, C., Langendijk, J. (eds) Re-Irradiation: New Frontiers. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2016_67

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