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Reirradiation to the pelvis for recurrent rectal cancer

 Woong Sub Koom  ;  Yunseon Choi  ;  Su Jung Shim  ;  Jihye Cha  ;  Jinsil Seong  ;  Nam Kyu Kim  ;  Ki Chang Nam  ;  Ki Chang Keum 
 Journal of Surgical Oncology, Vol.105(7) : 637-642, 2012 
Journal Title
 Journal of Surgical Oncology 
Issue Date
Adult ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/radiotherapy* ; Pelvis/radiation effects* ; Radiotherapy/adverse effects ; Rectal Neoplasms/mortality ; Rectal Neoplasms/radiotherapy* ; Survival Rate
acute toxicity ; infield control ; late toxicity ; recurrent rectal cancer ; reirradiation
OBJECTIVES: This study investigated late toxicity and infield progression-free survival in patients with locally recurrent rectal cancer (LRRC) who had previously received irradiation to the pelvis. METHODS: Twenty-two patients were treated by reirradiation to the pelvis between January 2000 and August 2007. All patients received curative surgery with preoperative or postoperative chemoradiotherapy as an initial treatment. Five patients (23%) underwent surgical resection after reirradiation. The median follow-up duration was 20 months (range, 7-91 months). RESULTS: Two patients (9%) had grade-3 acute toxicity and eight patients (36%) had grade-3 to -4 late toxicity. The incidence of grade-3 to -4 late toxicity in the gastrointestinal and urinary system was 18% and 27%, respectively. Recurrent tumor location (axial or anterior) and surgical resection after reirradiation significantly influenced severe late toxicity (P = 0.024 and P = 0.039, respectively). In the 17 patients not undergoing surgery after reirradiation, median infield progression-free survival was 16 months. Reirradiation doses exceeding 50 Gy(αβ10) (equivalent dose in 2 Gy fractions) significantly increased the infield progression-free survival (P = 0.005). CONCLUSIONS: Tumor location (axial or anterior) and surgery after reirradiation may increase severe late toxicity. In addition, an EQD2 exceeding 50 Gy(αβ10) may improve infield control.
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1. College of Medicine (의과대학) > Dept. of Medical Engineering (의학공학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Nam, Ki Chang(남기창)
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Cha, Ji Hye(차지혜)
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