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Radiation Therapy for Gastrointestinal Cancers pp 171–180Cite as

Rectal and Colon Cancer: Radiation Therapy Planning

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Locally advanced colorectal cancer is typically treated with trimodality therapy. In the United States, preoperative chemoradiation followed by surgery and adjuvant chemotherapy remains the standard of care. Data regarding short-course versus long-course radiation therapy yield no significant differences in outcomes; however, there remain concerns regarding potential late toxicity. The role of intensity-modulated radiation therapy (IMRT) and proton therapy for the treatment of colorectal cancer remains unclear, with further investigation needed. Different technologies or techniques including SBRT or hyperfractionation may be options in the treatment for local recurrences, while IORT is a good option for those who are found to have unresectable disease or predicted to have positive margins at the time of surgery. Newer technologies may provide increased conformality of the target and decreased toxicity in the treatment of colorectal cancer, thus ultimately eliminating disease safely without adversely affecting quality of life.

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References

  1. Sauer R, Fietkau R, Wittekind C, et al. Adjuvant versus neoadjuvant radiochemotherapy for locally advanced rectal cancer. Strahlenther Onkol. 2001;177:173–81.

    Article  CAS  PubMed  Google Scholar 

  2. Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351(17):1731–40.

    Article  CAS  PubMed  Google Scholar 

  3. Bujko K, Nowacki MP, Nasierowska-Guttmejer A, Michalski W, Bebenek M, Kryj M. Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg. 2006;93(10):1215–23.

    Article  CAS  PubMed  Google Scholar 

  4. Ngan SY, Burmeister B, Fisher RJ, et al. Randomized trial of short-course radiotherapy versus long-course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer: Trans-Tasman Radiation Oncology Group Trial 01.04. J Clin Oncol. 2012;30(31):3827–33.

    Article  PubMed  Google Scholar 

  5. van Gijn W, Marijnen CA, Nagtegaal ID, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol. 2011;12(6):575–82.

    Article  PubMed  Google Scholar 

  6. Nijkamp J, Kusters M, Beets-Tan RGH, et al. Three-dimensional analysis of recurrence patterns in rectal cancer: the cranial border in hypofractionated preoperative radiotherapy can be lowered. Int J Radiat Oncol Biol Phys. 2001;80(1):103–10.

    Article  Google Scholar 

  7. Folkesson J, Birgisson H, Pahlman L, Cedermark B, Glimelius B, Gunnarsson U. Swedish rectal cancer trial: long lasting benefits from radiotherapy on survival and local recurrence rate. J Clin Oncol. 2005;23(24):5644–50.

    Article  PubMed  Google Scholar 

  8. Syk E, Torkzad MR, Blomqvist L, Nilsson PJ, Glimelius B. Local recurrence in rectal cancer: anatomic localization and effect on radiation target. Int J Radiat Oncol Biol Phys. 2008;72(3):658–64.

    Article  PubMed  Google Scholar 

  9. Letschert JG, Lebesque JV, de Boer RW, Hart AA, Bartelink H. Dose-volume correlation in radiation-related late small-bowel complications: a clinical study. Radiother Oncol. 1990;18(4):307–20.

    Article  CAS  PubMed  Google Scholar 

  10. Baglan KL, Frazier RC, Yan D, Huang RR, Martinez AA, Robertson JM. The dose-volume relationship of acute small bowel toxicity from concurrent 5-FU-based chemotherapy and radiation therapy for rectal cancer. Int J Radiat Oncol Biol Phys. 2002;52(1):176–83.

    Article  PubMed  Google Scholar 

  11. Guerrero Urbano MT, Henrys AJ, Adams EJ, et al. Intensity-modulated radiotherapy in patients with locally advanced rectal cancer reduces volume of bowel treated to high dose levels. Int J Radiat Oncol Biol Phys. 2006;65(3):907–16.

    Article  PubMed  Google Scholar 

  12. Hong TS, Moughan J, Garofalo MC, et al. NRG oncology radiation therapy oncology group 0822: a phase 2 study of preoperative chemoradiation therapy using intensity modulated radiation therapy in combination with capecitabine and oxaliplatin for patients with locally advanced rectal cancer. Int J Radiat Oncol Biol Phys. 2015;93(1):29–36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Wong SK, Winter K, Meropol NJ, et al. RTOG 0247: a randomized phase II study of neoadjuvant capecitabine and irinotecan or capecitabine and oxaliplatin with concurrent radiation therapy for patients with locally advanced rectal cancer. Int J Radiat Oncol Biol Phys. 2012;82(4):1367–75.

    Article  CAS  PubMed  Google Scholar 

  14. Aschele C, Cionini L, Lonardi S, et al. Primary tumor response to preoperative chemoradiation with or without oxaliplatin in locally advanced rectal cancer: Pathologic results of the STAR-01 randomized phase III trial. J Clin Oncol. 2011;29(20):2773–80.

    Article  CAS  PubMed  Google Scholar 

  15. O'Connell MJ, Colangelo LH, Beart RW, et al. Capecitabine and oxaliplatin in the preoperative multimodality treatment of rectal cancer: surgical end points from national surgical adjuvant breast and bowel project trial R-04. J Clin Oncol. 2014;32(18):1927–34.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Myerson RJ, Garofalo MC, El Naqa I, Abrams RA, et al. Elective clinical target volumes for conformal therapy in anorectal cancer: a radiation therapy oncology group consensus panel contouring atlas. Int J Radiat Oncol Biol Phys. 2009;74(3):824–30.

    Article  PubMed  Google Scholar 

  17. Colaco RJ, Nichols RC, Huh S, et al. Protons offer reduced bone marrow, small bowel, and urinary bladder exposure for patients receiving neoadjuvant radiotherapy for resectable rectal cancer. J Gastrointest Oncol. 2014;5(1):3–8.

    PubMed  PubMed Central  Google Scholar 

  18. Sauer R, Liersch T, Merkel S, et al. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the german CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol. 2012;30(16):1926–33.

    Article  CAS  PubMed  Google Scholar 

  19. Dagoglu N, Mahadevan A, Nedea E, Poylin V, Nagle D. Stereotactic body radiotherapy (SBRT) reirradiation for pelvic recurrence from colorectal cancer. J Surg Oncol. 2015;111(4):478–82.

    Article  PubMed  Google Scholar 

  20. Abusaris H, Hoogeman M, Nuyttens JJ. Re-irradiation: outcome, cumulative dose and toxicity in patients retreated with stereotactic radiotherapy in the abdominal or pelvic region. Technol Cancer Res Treat. 2012;11(6):591–7.

    PubMed  PubMed Central  Google Scholar 

  21. Kim MS, Choi C, Yoo S, et al. Stereotactic body radiation therapy in patients with pelvic recurrence from rectal carcinoma. Jpn J Clin Oncol. 2008;38(10):695–700.

    Article  PubMed  Google Scholar 

  22. Valentini V, Morganti AG, Gambacorta MA, et al. Preoperative hyperfractionated chemoradiation for locally recurrent rectal cancer in patients previously irradiated to the pelvis: a multicentric phase II study. Int J Radiat Oncol Biol Phys. 2006;64(4):1129–39.

    Article  PubMed  Google Scholar 

  23. Das P, Delclos ME, Skibber JM, et al. Hyperfractionated accelerated radiotherapy for rectal cancer in patients with prior pelvic irradiation. Int J Radiat Oncol Biol Phys. 2010;77(1):60–5.

    Article  PubMed  Google Scholar 

  24. Nakfoor BM, Willett CG, Shellito PC, Kaufman DS, Daly WJ. The impact of 5-fluorouracil and intraoperative electron beam radiation therapy on the outcome of patients with locally advanced primary rectal and rectosigmoid cancer. Ann Surg. 1998;228(2):194–200.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Mathis KL, Nelson H, Pemberton JH, Haddock MG, Gunderson LL. Unresectable colorectal cancer can be cured with multimodality therapy. Ann Surg. 2008;248(4):592–8.

    PubMed  Google Scholar 

  26. Krempien R, Roeder F, Oertel S, et al. Long-term results of intraoperative presacral electron boost radiotherapy (IOERT) in combination with total mesorectal excision (TME) and chemoradiation in patients with locally advanced rectal cancer. Int J Radiat Oncol Biol Phys. 2006;66(4):1143–51.

    Article  PubMed  Google Scholar 

  27. Hyngstrom JR, Tzeng CW, Beddar S, et al. Intraoperative radiation therapy for locally advanced primary and recurrent colorectal cancer: ten-year institutional experience. J Surg Oncol. 2014;109(7):652–8.

    Article  PubMed  Google Scholar 

  28. Tan J, Heriot AG, Mackay J, et al. Prospective single-arm study of intraoperative radiotherapy for locally advanced or recurrent rectal cancer. J Med Imaging Radiat Oncol. 2013;57(5):617–25.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Harvard Radiation Oncology Program, Boston, MA, USA

    Sophia C. Kamran MD

  2. Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA

    Harvey J. Mamon MD, PhD

  3. Massachusetts General Hospital, Boston, MA, USA

    Jennifer Y. Wo MD

Authors
  1. Sophia C. Kamran MD
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  2. Harvey J. Mamon MD, PhD
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  3. Jennifer Y. Wo MD
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Corresponding author

Correspondence to Jennifer Y. Wo MD .

Editor information

Editors and Affiliations

  1. Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA

    Theodore Hong

  2. The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Prajnan Das

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© 2017 Springer International Publishing AG

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Kamran, S.C., Mamon, H.J., Wo, J.Y. (2017). Rectal and Colon Cancer: Radiation Therapy Planning. In: Hong, T., Das, P. (eds) Radiation Therapy for Gastrointestinal Cancers. Springer, Cham. https://doi.org/10.1007/978-3-319-43115-4_14

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  • DOI: https://doi.org/10.1007/978-3-319-43115-4_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43113-0

  • Online ISBN: 978-3-319-43115-4

  • eBook Packages: MedicineMedicine (R0)

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