Patterns of Failure and Local Control After Intraoperative Electron Boost Radiotherapy to the Presacral Space in Combination with Total Mesorectal Excision in Patients with Locally Advanced Rectal Cancer

Journal Article · Sun Apr 01 04:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.11.039· OSTI ID:20951581

Roeder, Falk ^[1]; Treiber, Martina ^[1]; Oertel, Susanne ^[1]; Dinkel, Julien ^[1]; Timke, Carmen ^[1]; Funk, Angela ^[1]; Garcia-Huttenlocher, Helena ^[1]; Bischof, Marc ^[1]; Weitz, Juergen ^[2]; Harms, Wolfgang ^[1]; Hensley, Frank W ^[1]; Buchler, Markus W ^[2]; Debus, Juergen ^[1]; Krempien, Robert ^[1]

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1. Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)
2. Department of Surgery, University of Heidelberg, Heidelberg (Germany)

Purpose: To evaluate local control and patterns of failure in patients treated with intraoperative electron beam radiotherapy (IOERT) after total mesorectal excision (TME), to appraise the effectiveness of intraoperative target definition. Methods and Materials: We analyzed the outcome of 243 patients with rectal cancer treated with IOERT (median dose, 10 Gy) after TME. Eighty-eight patients received neoadjuvant and 122 patients adjuvant external beam radiotherapy (EBRT) (median dose, 41.4 Gy), and in 88% simultaneous chemotherapy was applied. Median follow-up was 59 months. Results: Local failure was observed in 17 patients (7%), resulting in a 5-year local control rate of 92%. Only complete resection and absence of nodal involvement correlated positively with local control. Considering IOERT fields, seven infield recurrences were seen in the presacral space, resulting in a 5-year local control rate of 97%. The remaining local relapses were located as follows: retrovesical/retroprostatic (5), anastomotic site (2), promontorium (1), ileocecal (1), and perineal (1). Conclusion: Intraoperative electron beam radiotherapy as part of a multimodal treatment approach including TME is a highly effective regimen to prevent local failure. The presacral space remains the site of highest risk for local failure, but IOERT can decrease the percentage of relapses in this area.

• OSTI ID: 20951581
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 67; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
ELECTRON BEAMS
FAILURES
HEALTH HAZARDS
PATIENTS
RADIATION DOSES
RADIOTHERAPY
RECTUM