Modern Techniques in Re-Irradiation for Locally Recurrent Rectal Cancer: A Systematic Review

Mantello, Giovanna; Galofaro, Elena; Bisello, Silvia; Chiloiro, Giuditta; Romano, Angela; Caravatta, Luciana; Gambacorta, Maria Antonietta

doi:10.3390/cancers15194838

Cited by 4 publications

(2 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, the outcome of second-time surgery for the patients with LRRC was superior to those of reirradiation [ 12 , 14–16 ]. However, there might have been a selection bias of the patients with LRRC in treatment decisions.…”

Section: Discussionmentioning

confidence: 99%

“…An optimal method of reirradiation for LRRC patients has not yet been established, although numerous studies of reirradiation with photon therapy for LRRC patients have been published [ 4–11 ]. Recently, a systematic review of reirradiation for LRRC was published [ 12 ]. In the systematic review, the study of carbon ion radiotherapy (CIRT), intensity-modulated radiotherapy and stereotactic ablative radiotherapy (SABR) were included.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Proton beam reirradiation for locally recurrent rectal cancer patients with prior pelvic irradiation

Takagawa,

Suzuki,

Seto

et al. 2024

Journal of Radiation Research

View full text Add to dashboard Cite

The aim of the present study was to report the feasibility of proton beam reirradiation for patients with locally recurrent rectal cancer (LRRC) with prior pelvic irradiation. The study population included patients who were treated with proton beam therapy (PBT) for LRRC between 2008 and December 2019 in our institution. Those who had a history of distant metastases of LRRC, with or without treatment, before reirradiation, were excluded. Overall survival (OS), progression-free survival (PFS) and local control (LC) were estimated using the Kaplan–Meier method. Ten patients were included in the present study. The median follow-up period was 28.7 months, and the median total dose of prior radiotherapy (RT) was 50 Gy (range, 30 Gy–74.8 Gy). The median time from prior RT to reirradiation was 31.5 months (range, 8.1–96.6 months), and the median reirradiation dose was 72 Gy (relative biological effectiveness) (range, 56–77 Gy). The 1-year/2-year OS, PFS and LC rates were 100%/60.0%, 20.0%/10.0% and 70.0%/58.3%, respectively, with a median survival time of 26.0 months. Seven patients developed a Grade 1 acute radiation dermatitis, and no Grade ≥ 2 acute toxicity was recorded. Grade ≥ 3 late toxicity was recorded in only one patient, who had developed a colostomy due to radiation-related intestinal bleeding. Reirradiation using PBT for LRRC patients who had previously undergone pelvic irradiation was feasible. However, the indications for PBT reirradiation for LRRC patients need to be considered carefully due to the risk of severe late GI toxicity.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Proton beam reirradiation for locally recurrent rectal cancer patients with prior pelvic irradiation

Takagawa,

Suzuki,

Seto

et al. 2024

Journal of Radiation Research

View full text Add to dashboard Cite

show abstract

Comment on “Analysis of re-recurrent rectal cancer after curative treatment of locally recurrent rectal cancer”

Zhang

2025

Radiotherapy and Oncology

View full text Add to dashboard Cite

Radiotherapy & total neoadjuvant therapy for recurrent rectal cancer in previously irradiated patients, (RETRY): a multicenter prospective observational study

Gambacorta,

Romano,

Caravatta

et al. 2024

Radiat Oncol

View full text Add to dashboard Cite

Background Local recurrence of rectal cancer (LRRC) previously treated with radiotherapy is associated with a poor prognosis. Historically, the integration of radiotherapy (RT) with surgery has improved the likelihood of complete resections (R0) and, consequently, enhanced survival. Unfortunately, many LRRC cases are not amenable to surgical intervention. The inclusion of chemotherapy (CHT) alongside advanced RT techniques including proton and carbon ion RT (CIRT) and stereotactic body radiation therapy (SBRT), has generated new treatment options. Therefore, there is a need for improved stratification of LRRC patients to enhance treatment outcomes. The RETRY is an integrated trial with the primary aim to explore if combining CHT with RT in all available modalities can enhance local control (LC) in LRRC patients, consequently improving survival. Methods Experts from Italian centers specializing in rectal cancer and LRRC management collaborated to design a prospective multicenter observational study within the AIRO group for gastrointestinal malignancies. Eligible participants are adult LRRC patients who previously had pelvic RT, meet specific criteria, and are affiliated with the participating Italian centers. Specific criteria must be met for CIRT referral. A total of 88 patients will be enrolled over three years. The primary objective is to determine the 3-year LC rate. Secondary outcomes include assessing survival, quality of life, and R0 resection rates in surgery cases. A minimum dose of 40 Gy, conventional fractionation with concomitant fluoropyrimidine—with/without oxaliplatin-based CHT (CRT) is prescribed in neoadjuvant setting. Alternatively, the dose will vary from 35 to 40 Gy in 5 fractions based on clinical judgment, by SBRT. Both proton and photon therapies will be evaluated in these approaches. Surgery will be considered if deemed operable. In inoperable cases, CIRT with a dose of 40–60 Gy relative biological effectiveness (RBE) will be administered with a daily dose fraction ranging between 3 and 4.8 Gy RBE. Discussion The RETRY trial aims to investigate the combined effects of RT and CHT and when feasible the addition of surgery, to determine whether this comprehensive approach can result in improved survival and quality of life for LRRC patients. Trial registration number ClinicalTrials.gov (No. NCT05984576).

show abstract

Modern Techniques in Re-Irradiation for Locally Recurrent Rectal Cancer: A Systematic Review

Cited by 4 publications

References 33 publications

Proton beam reirradiation for locally recurrent rectal cancer patients with prior pelvic irradiation

Proton beam reirradiation for locally recurrent rectal cancer patients with prior pelvic irradiation

Comment on “Analysis of re-recurrent rectal cancer after curative treatment of locally recurrent rectal cancer”

Radiotherapy & total neoadjuvant therapy for recurrent rectal cancer in previously irradiated patients, (RETRY): a multicenter prospective observational study

Contact Info

Product

Resources

About