Skip to main content

What Is the Contribution of Intraoperative Radiotherapy (IORT) in Tailoring Local Therapy in Primary or Recurrent Rectal Cancer?

  • Chapter
  • First Online:
  • 975 Accesses

Abstract

Combined modality therapy, preferably preoperative chemoradiation and radical surgery, is the standard of care for local treatment in patients with locally advanced rectal cancer. Local control is expected superior to 85% at 5 years. Intraoperative radiotherapy (IORT) is a high-quality radiation-boosting technique for dose-escalation purposes in limited anatomic regions evaluated and considered at risk at the time of surgical resection. In-field IORT recurrence rates are inferior to 5% in primary disease. The experience available using IORT as a component of treatment, both in primary and localized recurrent disease, is reviewed. Factors associated to topographic (in-field control/recurrence) pelvic results are discussed to potentially guide a tailored use of IORT according to local risk estimations.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Kusters M, Marijnen CA, Van de Velde CJ et al (2010) Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial. Eur J Surg Oncol 36:470–476

    Article  PubMed  CAS  Google Scholar 

  2. Kusters M, van de Velde CJ, Beets-Tan RG et al (2009) Patterns of local recurrence in rectal cancer: a single-center experience. Ann Surg Oncol 16:289–296

    Article  PubMed  CAS  Google Scholar 

  3. Kusters M, Wallner C, Lange MM et al (2010) Origin of presacral local recurrence after rectal cancer treatment. Br J Surg 97:1582–1587

    Article  PubMed  CAS  Google Scholar 

  4. Yu TK, Bhosale PR, Crane CH, Yyier RB et al (2008) Patterns of locoregional recurrence after surgery and radiotherapy or chemoradiation for rectal cancer. Int J Radiat Oncol Biol Phys 71:1175–1180

    Article  PubMed  Google Scholar 

  5. Cantero-Muñoz P, Urién MA, Ruano-Ravina A (2011) Efficacy and safety of intraoperative radiotherapy in colorectal cancer: a systematic review. Cancer Lett 306:121–133

    Article  PubMed  Google Scholar 

  6. Dubois JB, Bussieres E, Richaud P et al (2011) Intra-operative radiotherapy of rectal cancer: results of the French multi-institutional randomized study. Radiother Oncol 98:298–303

    Article  PubMed  Google Scholar 

  7. Roeder F, Treiber M, Oertel S et al (2007) Patterns of failure and local control after intraoperative electron boost radiotherapy to the presacral space in combination with total mesorectal excision in patients with locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 67:1381

    Article  PubMed  Google Scholar 

  8. Kusters M, Holman FA, Martijn H et al (2009) Patterns of local recurrence in locally advanced rectal cancer after intra-operative radiotherapy containing multimodality treatment. Radiother Oncol 92:221–225

    Article  PubMed  Google Scholar 

  9. Díaz-Gonzalez JA, Calvo FA et al (2006) Prognostic factors for disease-free survival in patients with T3–4 or N + rectal cancer treated with preoperative chemoradiation therapy, surgery, and intraoperative irradiation. Int J Radiat Oncol Biol Phys 64:1122–1128

    Article  PubMed  Google Scholar 

  10. Calvo F, Serrano J, Lozano MA et al (2011) Presacral evolutive events after post-neoadjuvant intraoperative presacral radiation boost for rectal cancer. Radiother Oncol 99(suppl 1):S18

    Article  Google Scholar 

  11. Haddock MG, Miller RC, Nelson H et al (2011) Combined modality therapy including intraoperative electron irradiation for locally recurrent colorectal cancer. Int J Radiat Oncol Biol Phys 79:143–150

    Article  PubMed  Google Scholar 

  12. Kusters M, Dresen RC, Martin H et al (2009) Radicality of resection and survival after multimodality treatment is influenced by subsite of locally ­recurrent rectal cancer. Int J Radiat Oncol Biol Phys 75:1444–1449

    Article  PubMed  Google Scholar 

  13. Kusters M, Valentini V, Calvo FA et al (2010) Results of European pooled analysis of IORT-containing multimodality treatment for locally advanced rectal cancer: adjuvant chemotherapy prevents local recurrence rather than distant metastases. Ann Oncol 21:1279–1284

    Article  PubMed  CAS  Google Scholar 

  14. Valentini V, Coco C, Rizzo G et al (2009) Outcomes of clinical T4M0 extra-peritoneal rectal cancer treated with preoperative radiochemotherapy and surgery: a prospective evaluation of a single institutional experience. Surgery 145:486–494

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Felipe A. Calvo .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Calvo, F.A. (2012). What Is the Contribution of Intraoperative Radiotherapy (IORT) in Tailoring Local Therapy in Primary or Recurrent Rectal Cancer?. In: Valentini, V., Schmoll, HJ., van de Velde, C. (eds) Multidisciplinary Management of Rectal Cancer. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25005-7_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-25005-7_16

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-25004-0

  • Online ISBN: 978-3-642-25005-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics