Pattern of care for re-irradiation in locally recurrent rectal cancer: a national survey on behalf of the AIRO gastrointestinal tumors study group.

Autor: Mantello G; Radiotherapy Department, Azienda Ospedaliero Universitaria delle Marche, Via Conca 71, 60126, Ancona, Italy., Galofaro E; Radiotherapy Department, Azienda Ospedaliero Universitaria delle Marche, Via Conca 71, 60126, Ancona, Italy. elena.galofaro@ospedaliriuniti.marche.it., Caravatta L; Department of Radiation Oncology, SS Annunziata Hospital, Chieti, Italy., Di Carlo C; Radiotherapy Department, Azienda Ospedaliero Universitaria delle Marche, Via Conca 71, 60126, Ancona, Italy., Montrone S; Department of Radiotherapy, Pisa University, Pisa, Italy., Arpa D; IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Radiotherapy Unit, Meldola, Italy., Chiloiro G; Departments of Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., De Paoli A; Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy., Donato V; Radiation Oncology Division, Oncology and Speciality Medicine Department, San Camillo-Forlanini Hospital, Rome, Italy., Gambacorta MA; Departments of Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Genovesi D; Department of Radiation Oncology, SS Annunziata Hospital, Chieti, Italy., Lupattelli M; Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy., Macchia G; Radiotherapy Unit, Gemelli Molise Hospital, Catholic University of Sacred Heart, Campobasso, Italy., Montesi G; Radiotherapy Unit, ULSS5, Rovigo, Italy., Niespolo RM; Radiotherapy Unit, Azienda Ospedaliera San Gerardo, Monza, Italy., Palazzari E; Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy., Pontoriero A; Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy., Scricciolo M; UOC di Radioterapia Oncologica Mestre, Ospedale dell'Angelo, Venice, Mestre, Italy., Valvo F; Fondazione CNAO, National Center of Oncological Hadrontherapy, Pavia, Italy., Franco P; Department of Translational Medicine, Department of Radiation Oncology, Maggiore Della Carità University Hospital, University of Eastern Piedmont, Novara, Italy.
Jazyk: angličtina
Zdroj: La Radiologia medica [Radiol Med] 2023 Jul; Vol. 128 (7), pp. 869-876. Date of Electronic Publication: 2023 Jun 26.
DOI: 10.1007/s11547-023-01652-3
Abstrakt: Purpose: Radical resection (R0) represents the best curative treatment for local recurrence (LR) rectal cancer. Re-irradiation (re-RT) can increase the rate of R0 resection. Currently, there is a lack of guidelines on Re-RT for LR rectal cancer. The Italian Association of Radiation and clinical oncology for gastrointestinal tumors (AIRO-GI) study group released a national survey to investigate the current clinical practice of external beam radiation therapy in these patients.
Material and Methods: In February 2021, the survey was designed and distributed to members of the GI working group. The questionnaire consisted of 40 questions regarding center characteristics, clinical indications, doses, and treatment techniques of re-RT for LR rectal cancer.
Results: A total of 37 questionnaires were collected. Re-RT was reported as an option for neoadjuvant treatment in resectable and unresectable disease by 55% and 75% of respondents, respectively. Long-course treatment with 30-40 Gy (1.8-2 Gy/die, 1.2 Gy bid) and hypofractionated regimen of 30-35 Gy in 5 fractions were used in most centers. A total dose of 90-100 Gy as EqD2 dose (α/β = 5 Gy) was delivered by 46% of the respondents considering the previous treatment. Modern conformal techniques and daily image-guided radiation therapy protocols were used in 94% of centers.
Conclusion: Our survey showed that re-RT treatment is performed with advanced technology that allow a good management of LR rectal cancer. Significant variations were observed in terms of dose and fractionation, highlighting the need for a consensus on a common treatment strategy that could be validated in prospective studies.
(© 2023. The Author(s).)
Databáze: MEDLINE
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