P-321 - Impact of re-irradiation on patients with locally relapse rectal cancer

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Surgical oncology
Colon and Rectal Cancer
Therapy
Radiation oncology
Presenter E. Kozma
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors E. Kozma, A. Sallaku
  • University Hospital Mother Theresa, Tirana/AL

Abstract

Introduction

Rectal cancer in Albania constitutes 3.2% of all malignant tumors. Every year are diagnosed average 107 new cases, and a consider number of them are diagnosed in locally advanced stages. Despite treatment with radical purpose still many rectal cancer patients develop local relapse. Re-irradiation is an option of treatment especially for cases which cannot be treated surgically. The purpose of this study is to show the feasibility of re-irradiation, its toxicity and impact on clinical outcome.

Methods

During 2012-2014 we have re-irradiated 15 locally relapsed rectal cancer patients. All patients had a performance status of 70-100% and had received 50.4 Gy from the first pelvic radiation in adjuvant or neoadjuvant setting. All relapsed cases were considered initially inoperable. We irradiated them using hyperfractionation 1.2 or 1.25 Gy twice daily, not less than 6 hours between fractions to a total dose of 38.4 - 40 Gy concomitantly with chemotherapy. Time of re-irradiation was more than 12 months from the first treatment.

Results

All patients completed the treatment in time without interruption. The follow up ranged between 4-27 months. Total dose to the gross tumor volume was 50.4 Gy from the first irradiation and 38.4 - 40 Gy from re-irradiation. Median survival was 15 months, and symptoms relief was shown in 93% of re-irradiated patients. Acute toxicities were tolerable with diarrhea and cystitis in 25% of patients and only one patient demonstrated signs of subocclusion 3 months after re-irradiation but without need for surgery.

Conclusion

Re-irradiation of locally relapsed rectal cancer patients using hyperfractionation is a feasible treatment. It shows improvements of quality of life with acceptable toxicity and increase of survival in some patients.