- 作者：Prajnan Das ; Marc E. Delclos ; John M. Skibber ; Miguel A. Rodriguez-Bigas ; Barry W. Feig ; George J. Chang ; Cathy Eng ; Manpreet Bedi ; Sunil Krishnan ; Christopher H. Crane
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2010
- 出版时间：1 May 2010
- 年：2010
- 卷：77
- 期：1
- 页码：60-65
- 全文大小：109 K
Purpose
To retrospectively determine rates of toxicity, freedom from local progression, and survival in rectal cancer patients treated with reirradiation.Methods and Materials
Between February 2001 and February 2005, 50 patients with a history of pelvic radiotherapy were treated with hyperfractionated accelerated radiotherapy for primary (n = 2 patients) or recurrent (n = 48 patients) rectal adenocarcinoma. Patients were treated with 150-cGy fractions twice daily, with a total dose of 39 Gy (n = 47 patients) if the retreatment interval was ≥1 year or 30 Gy (n = 3) if the retreatment interval was <1 year. Concurrent chemotherapy was administered to 48 (96 % ) patients. Eighteen (36 % ) patients underwent surgical resection following radiotherapy.
Results
Two patients had grade 3 acute toxicity and 13 patients had grade 3 to 4 late toxicity. The 3-year rate of grade 3 to 4 late toxicity was 35 % . The 3-year rate of freedom from local progression was 33 % . The 3-year freedom from local progression rate was 47 % in patients undergoing surgery and 21 % in those not undergoing surgery (p = 0.057). The 3-year overall survival rate was 39 % . The 3-year overall survival rate was 66 % in patients undergoing surgery and 27 % in those not undergoing surgery (p = 0.003). The 3-year overall survival rate was 53 % in patients with a retreatment interval of >2 years and 21 % in those with a retreatment interval of ≤2 years (p = 0.001).
Conclusions
Hyperfractionated, accelerated reirradiation was well tolerated, with low rates of acute toxicity and moderate rates of late toxicity. Reirradiation may help improve pelvic control in rectal cancer patients with a history of pelvic radiotherapy.