Outcome of intraoperative brachytherapy as a salvage treatment for locally recurrent rectal cancer

• DOI: 10.1007/s00066-024-02271-1
• Publication Date: 2024-08-08T13:03:40Z
• Authors: Raluca Stoian; Hannes P. Neeff; Mark Gainey; Michael Kollefrath; Simon Kirste; Constantinos Zamb...; Jan Philipp Haral...; Dimos Baltas; Stefan Fichtner F...; Anca-Ligia Grosu; Tanja Sprave
• Keywords: Chemoradiotherapy

Abstract Background Locally advanced recurrent rectal cancer (RRC) requires a multimodal approach. Intraoperative high-dose-rate brachytherapy (HDR-BT) may reduce the risk of local recurrence. However, optimal therapeutic regimen remains unclear. The aim this retrospective monocentric study was to evaluate toxicity HDR-BT after resection RRC. Methods Between 2018 and 2022, 17 patients with RRC received HDR-BT. delivered alone or as an anticipated boost median dose 13 Gy (range 10–13 Gy) using 192 iridium microSelectron HDR remote afterloader (Elekta AB, Stockholm, Sweden). All participants were followed for assessment acute late adverse events Common Terminology Criteria Adverse Events version 5.0 modified Late Effects in Normal Tissues criteria (subjective, objective, management, analytic; LENT-SOMA) at 3‑ 6‑month intervals. Results A total treated by Gy). Most (47%) had tumor stage cT3‑4 N0. At time diagnosis, 7 (41.2%) visceral metastases (hepatic, pulmonary, peritoneal) sense oligometastatic disease. interval between primary diagnosis months 1–65 months). In addition HDR-BT, 2 long-course chemoradiotherapy (CRT; up 50.4 1.8-Gy fractions) short-course CRT 36 2‑Gy fractions. For concomitant CRT, all 5‑fluorouracil (5-FU) capecitabine. Median follow-up 1–54). most common grade 1–2 toxicities pain (41.2%), wound healing disorder 3 (17.6%), lymphedema (11.8%). Chronic similar: incontinence No patient experienced ≥3 event. Conclusion Reirradiation is well tolerated low toxicity. An individualized multimodality approach setting should be evaluated prospective multi-institutional studies.