How would you treat a T4 rectal cancer invading the uterus that is causing rectal and vaginal bleeding?

Topics: Radiation Oncology • Gastrointestinal Cancers

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.

Answer from: Radiation Oncologist at Academic Institution

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...

Comments

Radiation Oncologist at Center for Neurosciences
Is there a particular reason why TNT would not be ...

Radiation Oncologist at Lake Huron Medical Center
I was wondering the same thing. I know some data s...

Related Questions