Rectal Cancer   

Questions discussed in this category



Do you find that starting with chemoradiation increases the risk of complete obstruction secondary to transient tumor inflammation, or do you favor st...

Intravesical therapy was delivered two years prior, and last cystoscopy was negative. One-third of the bladder would otherwise be included in the plan...

For example, if mass is ulcerated and cannot be excised with polypectomy? Would you ever consider radiation and chemotherapy?

Especially as the study was done before the adoption of total neoadjuvant therapy

Consider a patient who prioritizes fertility preservation, for whom one of three suspicious nodes approaches the CRM, and is <1 mm from the mesorec...

Would you treat both at the same time? Does one need to be prioritized over the other? Does Xeloda have any efficacy against Merkel cell cancer? How...

With trials like PROSPECT and FOWARC showing no statistically significant improvement in locoregional control and survival outcomes when comparing rad...

Especially consider a situation where surgical excision alone is not appropriate. What if the radiation was LDR or HDR brachytherapy?

How are you approaching patients with rectal cancer who meet PROSPECT criteria but have other higher risk features, such as >4 lymph nodes with sus...

Do you have a preference in ordering MRI, endoscopy, CT scan (chest, abdomen, pelvis), EUS, or other testing before starting any treatment, for re-sta...

Since there is no overlap between chemo regimens for these cancers, how would you sequence treatment? 

What systemic therapy is most appropriate, how would you sequence, and what RT dose fractionation would you use?

Would the location of the tumor (i.e. ultralow), symptoms (bleeding), or patient resistance to surgery play into this decision?

How would you sequence therapy, and what dose and volumes would you use for radiation? Prostate cancer is localized, Gleason 4+3, PSA 65.

Is concurrent chemoradiation reasonable or excessive in a patient with life expectancy <5 yrs? Should the standard be 5 Gy x 5, and will this provi...

Given the published results of the PRODIGE 23 trial where FOLFORINOX was used neoadjuvantly with FOLFOX post-op

Dose-escalation RT trials have had mixed results in the past for advanced rectal cancer, while in the early rectal stage there is a tendency towards a...

How do you weigh definitive chemoRT vs minimally invasive surgical approach with neoadjuvant chemo followed by transanal excision, in light of results...

If records have been destroyed, how do you factor prior pelvic radiation for prostate cancer into your decision?

How does your counseling about side-effects change when offering short vs long course radiation?

If the patient is amenable to adjuvant chemotherapy alone, but is worried about chronic diarrhea/urgency after radiation, how would you counsel them?

I.E., can a patient with a questionable 5 mm node (MRI T2N1) which is negative on pathology after short course radiation be staged T2N0 and receive no...

The patient has disease in the S2/S3 region with an anterior soft tissue mass. The patient previously received 50.4 Gy with treatment for rectal canc...

Are there clinical scenarios in which you have found chemotherapy first has been beneficial?  (i.e., advanced T stage, extra-mesorectal LN, anat...

Do you worry about fluoropyrimidine resistance with concurrent chemoRT? Is there any role for neoadjuvant immunotherapy?

Colleagues in surgery have raised concerns about post radiation effects in the pelvis with the ordering of short course RT->chemo ->surgery.

When using short course RT, the NCCN guidelines currently recommend short course RT followed by chemotherapy, followed by surgery. Many surgeons are h...

Would you consider treating 3-5mm lesions with SBRT or wait until they are a certain size? I am concerned I will not be able to see them adequately on...

Does it ever differ from a standard rectal field? For example, do you always treat the entire rectum, mesorectum, and entire length of internal iliac ...

Is MRI being considered the primary mode of imaging in multidisciplinary tumor boards, especially in light of the results of the MERCURY trial (JCO 20...

Would taking the drug at a specific time point prior to their radiation appointment time to maximize blood levels of the drug be clinically beneficial...


Papers discussed in this category


International journal of radiation oncology, biology, physics, 2012-04-01

Lancet Oncol., 2015 Dec 16

Lancet,

Gastrointestinal cancer research : GCR, 2007-03

Journal of the National Comprehensive Cancer Network : JNCCN, 2014-04

Cancer medicine, 2016-12

Int. J. Radiat. Oncol. Biol. Phys., 1988-05-01

Int J Radiat Oncol Biol Phys, 2016 Jul 15

Journal of geriatric oncology, 2018-03

International journal of radiation oncology, biology, physics, 2001-01-01

Lancet Gastroenterol Hepatol, 2017-07-01

Dis. Colon Rectum, 2017-10-01

Ann. Oncol., 2016-05-01

International journal of radiation oncology, biology, physics, 2017-10-01

Clinics in colon and rectal surgery, 2012-06

Eur J Gastroenterol Hepatol,

The Lancet. Oncology, 2015-08

Radiother Oncol, 2020 Mar 30

Ann. Surg., 2020 Mar 20

Lancet Oncol., 2017-03-01

Adv Radiat Oncol, 2020 Apr 22

Lancet Oncol, 2020 Dec 07

Ann Oncol,

Lancet Oncol, 2021 Apr 13

N Engl J Med, 2018 Mar 29

J. Clin. Oncol., 2019 Oct 08

Lancet Oncol., 2016-06-01

The Lancet. Oncology, 2019-04

J Natl Cancer Inst,

Lancet Oncol, 2021 May 04

Int J Radiat Oncol Biol Phys, 2019 Dec 1

Pract Radiat Oncol, 2020 Oct 21

International journal of radiation oncology, biology, physics, 1988-02

Lancet Oncol,

World J Gastroenterol,

JAMA oncology, 2018-06-14

British journal of cancer, 2017-06-06

Ann Surg,

Lancet Oncol., 2011 May 17

International journal of radiation oncology, biology, physics, 1999-02-01

J Clin Oncol,

N Engl J Med, 2022 Jun 05

Diseases of the colon and rectum, 2014-01

Adv Radiat Oncol, 2020 Aug 07

Int J Radiat Oncol Biol Phys, 2001 Jul 15

Advances in radiation oncology, 2016

Radiother Oncol, 2014 Nov 26

J Clin Oncol, 2022 Apr 28

N Engl J Med, 2022 Nov 03

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2004-05-15

Lancet Gastroenterol Hepatol, 2023 Feb 16

Clinical cancer research : an official journal of the American Association for Cancer Research, 2018-05-01

Asia-Pacific journal of clinical oncology, 2020 Aug 05

Annals of surgical oncology, 2020 May 13

Diseases of the colon and rectum, 2019 Jun

J Clin Oncol, 2022 Aug 18

JAMA Surg, 2019 Jan 01

The Lancet. Oncology, 2015-11

Int J Radiat Oncol Biol Phys, 2012 Jul 03

Oncology, 2022 Oct 28

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-11-01

Ann Surg, 2023 Jan 20

Radiother Oncol, 2004 Jul

JAMA Surg, 2019 Sep 18

J Clin Oncol, 2019 Sep 26

Ann Oncol, 2022 Oct 25

J Clin Oncol, 2023 Jun 04

N Engl J Med, 2023 Jun 04

N. Engl. J. Med., 2004-10-21

Ann Surg, 2020 Mar

Lancet Oncol, 2023 Jun 02

N. Engl. J. Med.,

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2017-01

Am J Clin Oncol,

Frontiers in oncology, 2023 Jun 29

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 2021 Dec 20

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2010 Oct

Cancer medicine, 2018-12

Oncology (Williston Park, N.Y.), 2018-01-15

Frontiers in oncology, 2023 Jun 08

Cancers, 2022 Jul 28

International journal of radiation oncology, biology, physics, 2019 Aug 30

The American surgeon, 2015 May

Lancet (London, England), 2009-03-07

Ann Surg, 2011 Apr

JAMA Oncol, 2019 Jul 01

J Clin Oncol, 2023 Jun 19

JAMA oncology, 2023 Dec 21

International journal of radiation oncology, biology, physics, 2024 Jan 05

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2022 Mar 09

Seminars in oncology, 2006-12

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-01-20

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2002-04-01