Would you offer palliative re-irradiation to the sacrum for a patient with a prior history of RT for rectal cancer?
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 cancer 5 years ago, and is already having numbness/paresthesias from recurrence.
If you would re-treat, what would be your preferred dose/fractionation scheme, and why?
Answer from: Radiation Oncologist at Academic Institution
I agree with @Zhaohui Jin. Multidisciplinary discussion for such a clinical scenario is key. If the patient is determined to be unresectable following the multidisciplinary review, I would offer palliative re-irradiation. I would favor a dose of 30 Gy in 5 fractions, sparing bowel, bladder, cauda eq...
Comments
Radiation Oncologist at Wellspan Sechler Family Cancer Center
Thank you.
Thank you.
Answer from: Radiation Oncologist at Academic Institution
Yes. The prior RT was 5 years ago, and additional RT can usually be done safely. If this is the only site of disease, then an aggressive dose with concurrent drug might be optimal, with consideration of surgery to follow RT/CT. But, the neurological symptoms suggest infiltration of the sacrum so res...
Comments
Radiation Oncologist at Wellspan Sechler Family Cancer Center
Thank you! That is very helpful!
Thank you! That is very helpful!
Radiation Oncologist
See articles below:
Grønlie Guren et al., PMID 25613395
Youssef et al., PMID 28740875
Comments
Radiation Oncologist at Wellspan Sechler Family Cancer Center
Thank you! Very helpful!
Thank you! Very helpful!
Thank you.