Stereotactic radiation therapy in recurrent rectal cancer treatment
Abstract
Analysis of the last data shows that there is a steady rise in colorectal morbidity not only in Russian Federation, but also in other developed countries. In rectal cancer treatment there are no standarts by the moment. Last years all over the world there are tendencies to use multicomponent complex modalities of treatment wich include not only surgery, but also radiation therapy and chemotherapy.
Recurrent cancer is considered as radioresistent, and local treatment with high doses of radiation is frequently limited by normal tissues’ tolerance and by dose received in previous course. Reirradiation is always a risk because of cumulative radiation dose to organs at risk and normal tissues. Highly precise techniques of radiation therapy, such as IMRT, brachytherapy, IORT, stereotactic radiation therapy can be used in reccurent cancer treatment because of toxicity decrease and sparing of normal tissues.
Some data shows that usage of modern technologies is effective when using CyberKnife. Stereotactic radiation theapy (SBRT) is a variant of aggressive treatment which is able to provide good local control with minimal toxicity. Innovative approach in reirradiation for patients with recurrent cancer is proton therapy and carbon ion therapy. Dose distribution in proton therapy with its practically no exit dose clears the way to new abilities in reirradiation, leads to dose decrease in tissues outside irradiated volume, and it’s very important in patients who got virtually maximal dose while treating initial disease.
About the Authors
V. V. GLEBOVSKAYA
FSBSC «Russian Cancer Scientific Center named after N. N. Blokhin»
Russian Federation
Moscow
Russian Federation
Moscow
S. I. TKACHEV
FSBSC «Russian Cancer Scientific Center named after N. N. Blokhin»
Russian Federation
Moscow
Russian Federation
Moscow
A. V. NAZARENKO
FSBSC «Russian Cancer Scientific Center named after N. N. Blokhin»
Russian Federation
Moscow
Russian Federation
Moscow
O. P. TROFIMOVA
FSBSC «Russian Cancer Scientific Center named after N. N. Blokhin»
Russian Federation
Moscow
Russian Federation
Moscow
References
1. Juffermans JH, Hanssens PE (2003) Reirradiation and hyperthermia in rectal carcinoma: a retrospective study on palliative effect. Cancer 98:1759–1766.
2. Schaffer M et al (2003) Feasibility and morbidity of combined hyperthermia and radiochemotherapy in recurrent rectal cancer – preliminary results. Onkologie 26:120–124.
3. Milani V et al (2008) Radiochemotherapy in combination with regional hyperthermia in preirradiated patients with recurrent rectal cancer. StrahlentherOncol 184:163–168.
4. Abigail T., Berman MD; Stefan Both, PhD; Tiffany Sharkoski, BA et al. Proton Reirradiation of Recurrent Rectal Cancer: Dosimetric Comparison, Toxicities, and Preliminary Outcomes. International Journal of Particle Therapy, Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA, 2014.
5. Roels S, Duthoy W, Haustermans K et al (2006) Definition and delineation of the clinical target volume for rectal cancer. Int J RadiatOncolBiolPhys 65: 1129–1142.
6. Syk E, Torkzad MR, Blomqvist L et al (2008) Local recurrence in rectal cancer: anatomic localization and effect on radiation target. Int J RadiatOncolBiolPhys 72: 658–664.
7. Kusters M, Marijnen CAM, van de Velde CJH (2010) Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial. Eur J SurgOncol 36: 470–476.
8. Mangan CE, Rubin SC, Rabin DS et al (1986) Lymph node nomenclature in the gynecologic oncology. GynecolOncol 23:222–226.
9. Steup WH, Mariya Y, van de Velde CJH (2002) Patterns of lymphatic spread in rectal cancer. A topographical analysis on lymph node metastases.Eur J Cancer 38:911–918.
10. Myerson RJ, Garofalo MC, EI Naqa Iet al (2009) Elective clinical target volumes for conformal therapy in anorectal cancer: a radiation therapy oncology group consensus panel contouring atlas. Int J RadiatOncolBiolPhys 74:824–830.
11. Yu TK et al (2008) Patterns of locoregional recurrence after surgery and radiotherapy of chemoradiation for rectal cancer.Int J RadiatOncolBiolPhys 71:1175–1180.
12. Haddock MG, Miller RC, Nelson H et al (2011) Combined modality therapy including intraoperative electron irradiation for locally recurrent colorectal cancer. Int J RadiatOncolBiolPhys 79: 143–150.
13. Guerrero Urbano MT, Henrys AJ (2006) IMRT in patients with locally advanced rectal cancer reduces volume of bowel treated to high dose levels. IntJRadiatOncolBiolPhys 65:907–916.
14. Arbea L, Ramos LI, Martinez-Monge R et al (2010) IMRT vs 3D CRT in locally advanced rectal cancer (LARC): dosimetric comparison and clinical implications. RadiatOncol 5.
15. Duthoy W, De Gersem W, Vergote K et al (2004) Clinical implementation of VMAT for rectal cancer. Int J RadiatOncolByol Phis 60:794–806.
16. van Herk M et al (2000) The probability of correct target dosage: dose-population histograms for deriving treatment margins in radiotherapy. . Int J RadiatOncolByol Phis 47:1121–1135.
17. Roels S, Duthoy W, Hausermans K et al (2006) Definition and delineation of the clinical target volume for rectal cancer. Int J RadiatOncolByol Phis 65:1129–1142.
18. Samuelian JM et al (2011) Reduced acute bowel toxicity in patients treated with IMRT for rectal cancer. . Int J RadiatOncolByol Phisdoi: 10.1016.j.ijrobp.2011.01.051.
19. De Ridder M, Tournel K, Van Nieuwenhove Y et al (2008) Phase II study of preoperative helicaltomotherapy for rectal cancer. . IntJRadiatOncolByolPhis 70:728–734.
20. Seierstad T et al (2009) MR – guided SIB in preoperative radiotherapy of locally advanced rectal cancer following neoadjuvant chemotherapy. RadiotherOncol 93:279–284.
21. Valentini V, et al (2008) Evidence and research in rectal cancer. RadiotherOncol 87:449–474.
22. Robotic image-guided reirradiation of lateral pelvis recurrences: preliminary results. Sylvain Dewas, Jean Emmanuel Bibault et al. 2011/ Department Universitaire de Radiotherapy CyberKnife Nord-Quest; Centre Oscar Lambret CLCC, France.
Review
For citations:
GLEBOVSKAYA V.V., TKACHEV S.I., NAZARENKO A.V., TROFIMOVA O.P. Stereotactic radiation therapy in recurrent rectal cancer treatment. Malignant tumours. 2015;(4s2):82-87. (In Russ.)
Views:
938
Email this article 