How would you treat a T4 rectal cancer invading the uterus that is causing rectal and vaginal bleeding?
What is your preferred combination and order of therapy for a T4 rectal tumor invading the uterus leading to both rectal and vaginal bleeding?
Would you recommend upfront neoadjuvant chemoradiation, TNT with initial multi-agent chemotherapy followed by chemoradiation, or an alternative approach? This would be in the setting of the patient and disease allowing for surgical resection.
1 Answer
Mednet MemberInvited Expert
Radiation Oncology · Montefiore Medical Center
Answered on
In this T4b locally advanced rectal cancer, I would recommend neoadjuvant chemoradiation (RT dose 45 Gy to the pelvis +/- boost to 54 Gy to the gross tumor), followed by surgery (including a hysterectomy). The bleeding should stop in the first 2 weeks of neoadjuvant therapy. You do, however, have to...
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