Stereotactic Body Radiation Therapy in Patients with Pelvic Recurrence from Rectal Carcinoma

Abstract

Objective: To investigate the clinical applications of stereotactic body radiation therapy (SBRT) using the CyberKnife system for pelvic recurrence from rectal cancer with a focus on survival and toxicity. Methods: Between 2002 and 2006, 23 patients with recurrent rectal cancer were treated with SBRT at our institution. The median follow-up was 31 months. Sites of recurrence were presacral in seven patients and the pelvic wall in 16. SBRT doses ranged from 30 to 51 Gy (median 39 Gy) and were delivered in three fractions. Response to treatment was assessed by computed tomography. Overall and local progression-free survival and toxicities were recorded. Results: Four-year overall survival and local control rates were 24.9 and 74.3%, respectively. No prognostic factor was found to affect patient survival or local progression. One patient developed a severe radiation-related toxicity, but recovered completely after treatment. Conclusions: SBRT for pelvic recurrence was found to be comparable with other modalities with respect to overall survival and complication rates. Further studies are needed to confirm these preliminary results.

Is Stereotactic Body Radiotherapy (SBRT) in lymph node oligometastatic patients feasible and effective?

“…Out of 7 review articles, only 1 is dedicated exclusively to the lymph node SBRT, 8 and 2 describe treatment options for lymph node recurrence including SBRT. 11,12 Thirty one clinical series reporting treatment outcome (in the series of 1-69 cases of lymph node recurrence) were divided in those including patients treated with SBRT only for lymph node recurrent cancer (12 articles) [32][33][34][35][36][37][38][39][40][41][42][43] and those on the patients treated for any oligometastatic cancer to any sites including lymph nodes (19 articles). [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] The first article of this series was published in 2005.…”

Is stereotactic body radiotherapy a treatment option for pelvic recurrences?

“…21 rektal kanseri olan olgu çalışması bildirmiştir ancak hastaların sadece dokuzu SBRT öncesinde EBRT almıştı. [45] Dört yıllık kontrol oranı %74.3'tü ve grade IV toksisite görül-memişti. Dewas ve ark.…”

Stereotactic body radiation therapy (SBRT) for pancreatic and non-hepatobiliary gastrointestinal (GI) malignancies

“…Kim et al also described treatment of 23 patients with recurrent rectal cancer via SBRT [16]. Seven patients had presacral recurrences, while 16 had recurrence in the pelvic side wall.…”