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Brachytherapy. 2013 Sep-Oct;12(5):457-62. doi: 10.1016/j.brachy.2012.11.003. Epub 2013 May 23.

High-dose-rate endorectal brachytherapy for locally advanced rectal cancer in previously irradiated patients.

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  • 1Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL.

Abstract

PURPOSE:

Preoperative high-dose-rate (HDR) endorectal brachytherapy is well tolerated among patients with locally advanced rectal cancer. However, these studies excluded patients who previously received pelvic radiation therapy (RT). Because a favorable toxicity profile has been published for HDR endorectal brachytherapy, we evaluated this technique in patients who have previously received pelvic irradiation.

METHODS AND MATERIALS:

We included patients who had received pelvic irradiation for a previous pelvic malignancy and later received preoperative HDR endorectal brachytherapy for rectal cancer. Brachytherapy was delivered to a total dose of 26 Gy in 4 consecutive daily 6.5 Gy fractions.

RESULTS:

We evaluated 10 patients who previously received pelvic external beam radiation therapy (EBRT) alone (n=6), EBRT and brachytherapy (n=2), or brachytherapy alone (n=2). The median interval between the initial course of RT and endorectal brachytherapy was approximately 11 years (range, 1-19 years). Two patients experienced a complete pathologic response while 1 patient had a near complete pathologic response. No acute grade ≥3 toxicity was observed. No intraoperative or postoperative surgical complications were observed.

CONCLUSIONS:

Preoperative HDR endorectal brachytherapy is an alternative to EBRT for patients with locally advanced rectal cancer who have previously received pelvic RT.

KEYWORDS:

Endorectal brachytherapy; High-dose-rate; Rectal cancer; Reirradiation

PMID:
23707855
DOI:
10.1016/j.brachy.2012.11.003
[PubMed - indexed for MEDLINE]
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