Value of Intraoperative Radiotherapy in Locally Advanced Rectal Cancer

Ferenschild, Floris T. J.; Vermaas, Maarten; Nuyttens, J.; Graveland, Wilfried J.; Marinelli, A.; Sijp, J. R. van der; Wiggers, Theo; Verhoef, Cornelis; Eggermont, Alexander; Wilt, Johannes H. W. de

doi:10.1007/s10350-006-0651-x

Cited by 62 publications

(50 citation statements)

References 43 publications

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“…A recent German trial has demonstrated the benefits of preoperative CRT with improved compliance, reduced toxicity, and increased local control. 13 In many European centers, radiotherapy only was used as neoadjuvant treatment for locally advanced rectal cancer, 14 but the addition of chemotherapy has recently been demonstrated to improve local control in two large randomized trials. 15,16 Addition of 5-FU and leucovorin to preoperative radiation slightly increased the amount of acute toxicity in T3 to T4 resectable rectal cancer patients.…”

Section: Preoperative Treatmentmentioning

confidence: 99%

Management of Locally Advanced Primary and Recurrent Rectal Cancer

Wilt

Vermaas

Ferenschild

et al. 2007

Clinics in Colon and Rectal Surgery

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Treatment for patients with locally advanced and recurrent rectal cancer differs significantly from patients with rectal cancer restricted to the mesorectum. Adequate preoperative imaging of the pelvis is therefore important to identify those patients who are candidates for multimodality treatment, including preoperative chemoradiation protocols, intraoperative radiotherapy, and extended surgical resections. Much effort should be made to select patients with these advanced tumors for treatment in specialized referral centers. This has been shown to reduce morbidity and mortality and improve long-term survival rates. In this article, we review the best treatment options for patients with locally advanced and recurrent rectal cancer. We also emphasize the necessity of a multidisciplinary team, including a radiologist, radiation oncologist, urologist, surgical oncologist, plastic surgeon, and gynecologist in the diagnosis and treatment of patients with these pelvic tumors.

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Section: Preoperative Treatmentmentioning

confidence: 99%

Management of Locally Advanced Primary and Recurrent Rectal Cancer

Wilt

Vermaas

Ferenschild

et al. 2007

Clinics in Colon and Rectal Surgery

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“…But these patients were all R1 or R2 resections. Therefore, it can be performed as a palliative procedure [12]. In contradiction to that, Dubois et al published their data from a multi-institutional trial with 142 patients receiving IORT for rectal cancer.…”

Section: Perioperative Treatmentmentioning

confidence: 97%

Surgical options for locally recurrent rectal cancer—review and update

Troja

El-Sourani

Abdou

et al. 2015

Int J Colorectal Dis

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Locally recurrent rectal tumours in the pelvis are found in about 6% following treatment for rectal cancer. This type of tumour can cause serious local complications and symptoms. The aim of modern surgical oncology is to offer a curative treatment option embedded in an interdisciplinary network of specialities to the patient. Due to advancements in surgical techniques and procedures, especially regarding surgical reconstruction, the possibilities of a curative treatment regarding recurrent cancers have been expanded and established. To aim for a curative treatment one must introduce a multimodal therapy including radio- and chemotherapy, and a radical oncological surgery with en bloc resection of the tumour and affected surrounding organs to achieve a R0-resection.

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“…Addition of intraoperative therapy for patients with narrow or microscopic incomplete resection seems to overrule the unfavorable prognostic histological finding. A study from The Netherlands reported 5-year local control of 58% and overall survival of 38% for patients with R1/R2 resections [27] .…”

Section: Management Of Fixed Unresectable Tumorsmentioning

confidence: 99%

Neoadjuvant Radiochemotherapy for Rectal Cancer

Vini

2007

Dig Dis

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During the past few decades, significant progress has been achieved in the management of rectal cancer with the introduction of total mesorectal excision. The role of radiotherapy in improving local control and survival has been investigated extensively. Randomized trials of preoperative radiotherapy reported statistically significant lower local recurrence rates with either short regimens (25 Gy in 5 fractions) or conventionally fractionated regimens (45–50 Gy in 25 fractions) and some also showed a survival improvement. Preoperative radiotherapy appears more effective in terms of local control and toxicity compared to postoperative therapy. Several recent studies show that 5-FU-based chemotherapy enhances tumor response to radiotherapy and preoperative chemoradiotherapy is being increasingly used for stage II and III disease.

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Value of Intraoperative Radiotherapy in Locally Advanced Rectal Cancer

Cited by 62 publications

References 43 publications

Management of Locally Advanced Primary and Recurrent Rectal Cancer

Management of Locally Advanced Primary and Recurrent Rectal Cancer

Surgical options for locally recurrent rectal cancer—review and update

Neoadjuvant Radiochemotherapy for Rectal Cancer

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