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OBJECTIVE Treatment results for locally recurrent rectal cancers are poor. This is a result of the fact that surgery is hampered due to the severance of the anatomical planes during the primary procedure and that radiotherapy is limited by normal tissue tolerance, especially after previous irradiation. This paper describes the results of a combined treatment modality in this patient group. METHODS From 1994 to 1998, 37 patients with locally recurrent rectal cancer, but without distant metastatic disease, received a combined treatment consisting of 50.4 Gy preoperative irradiation or, in case of previous radiotherapy, 30 Gy reirradiation or no irradiation, followed by radical surgery and intraoperative electron beam radiotherapy boost. RESULTS Fifteen patients received a radical resection (R0), eight a microscopic irradical resection (R1), and 14 a macroscopic irradical resection (R2). The overall 3-year local control (LC), disease-free survival (DFS), and overall survival rates were 60%, 32%, and 58% respectively. Radicality of resection (R0/R1 vs. R2) turned out to be the significant factor for improved survival (p < 0.05), DFS (p = 0.0008), and LC (p = 0.01). Preoperative (re-)irradiation is the other significant factor in survival (p = 0.005) and DFS (p = 0.001) and was almost significant for LC (p = 0.08). After external beam radiation therapy (EBRT) a significantly higher resection rate was obtained (R0/R1 vs. R2 p = 0.001). Symptomatic peripheral local recurrences have a significantly worse prognosis and higher rate of R2-resection (p = 0.0005). CONCLUSIONS Centralization of locally recurrent rectal cancer patients enabled the development of an aggressive multimodality treatment, which in turn led to promising results. Distant failure is still a drawback.
G H Mannaerts, and
H Martijn, and
M A Crommelin, and
G N Stultiëns, and
W Dries, and
O J van Driel, and
H J Rutten
March 1991,
Cancer,
G H Mannaerts, and
H Martijn, and
M A Crommelin, and
G N Stultiëns, and
W Dries, and
O J van Driel, and
H J Rutten
May 1991,
Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
G H Mannaerts, and
H Martijn, and
M A Crommelin, and
G N Stultiëns, and
W Dries, and
O J van Driel, and
H J Rutten
December 2012,
BMC cancer,
G H Mannaerts, and
H Martijn, and
M A Crommelin, and
G N Stultiëns, and
W Dries, and
O J van Driel, and
H J Rutten
October 1980,
Diseases of the colon and rectum,
G H Mannaerts, and
H Martijn, and
M A Crommelin, and
G N Stultiëns, and
W Dries, and
O J van Driel, and
H J Rutten
November 1998,
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology,
G H Mannaerts, and
H Martijn, and
M A Crommelin, and
G N Stultiëns, and
W Dries, and
O J van Driel, and
H J Rutten
October 1995,
Journal of surgical oncology,
G H Mannaerts, and
H Martijn, and
M A Crommelin, and
G N Stultiëns, and
W Dries, and
O J van Driel, and
H J Rutten
January 2001,
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology,
G H Mannaerts, and
H Martijn, and
M A Crommelin, and
G N Stultiëns, and
W Dries, and
O J van Driel, and
H J Rutten
December 2013,
Radiation oncology (London, England),
G H Mannaerts, and
H Martijn, and
M A Crommelin, and
G N Stultiëns, and
W Dries, and
O J van Driel, and
H J Rutten
July 2021,
International journal of radiation oncology, biology, physics,
G H Mannaerts, and
H Martijn, and
M A Crommelin, and
G N Stultiëns, and
W Dries, and
O J van Driel, and
H J Rutten
January 1992,
International journal of radiation oncology, biology, physics,
