For patients with peritoneal carcinomatosis and minimal response to neoadjuvant chemotherapy, is there a benefit to palliative cytoreductive surgery followed by whole abdominal radiotherapy?

Topics: Radiation Oncology • Gastrointestinal Cancers • General Radiation Oncology

Do your recommendations differ between appendiceal, colorectal, and gastric cancer? If radiation is offered, would you boost the unresectable/gross residual disease? Would a young person in good performance status change your recommendation?

Answer from: Radiation Oncologist at Community Practice

The prognosis for individuals with peritoneal carcinomatosis is generally bleak. Administering radiation therapy to manage gastric, colon, or appendiceal cancer is exceptionally challenging due to the imperative to safeguard the delicate large and small intestine. One potential exception arises when...

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Radiation Oncologist at Washington University School of Medicine
Please clarify this answer for me. We have two lo...

Answer from: Radiation Oncologist at Academic Institution

I cannot think of a scenario I would ever recommend whole abdominal radiotherapy in any GI primary with peritoneal disease.Appendiceal carcinoma generally would be a consideration for surgery + HIPEC. Post-debulking HIPEC is being investigated in other GI primaries (and ovarian/primary peritoneal) a...

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