Analysis of long-term efficacy of second-course radiotherapy for pelvic recurrence of rectal cancer
10.3760/cma.j.cn113030-20241022-00409
- VernacularTitle:直肠癌盆腔复发患者二程放疗的长期疗效分析
- Author:
Yunsong JI
1
;
Lei WANG
;
Xuemin LI
;
Hao WANG
;
Ran PENG
Author Information
1. 北京大学第三医院肿瘤放疗科，北京 100191
- Publication Type:Journal Article
- Keywords:
Rectal neoplasms, recurrent;
Re-irradiation;
Pelvic recurrence;
Local recurrence-free survival
- From:
Chinese Journal of Radiation Oncology
2025;34(7):671-676
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the long-term efficacy of second-course radiotherapy for patients with locally recurrent rectal cancer (LRRC) following pelvic radiotherapy.Methods:Data of 34 patients with in-field pelvic recurrence of rectal cancer that could not be resected with R0 surgery admitted to Peking University Third Hospital from October 2012 to April 2024 were retrospectively analyzed. All patients received second-course intensity-modulated radiotherapy and the median radiation dose for the first course was 50 Gy (range 45-66 Gy), and for the second course, the median dose was 45 Gy (range 10-60.4 Gy). Regular follow-up visits and imaging examination were performed during follow-up. The recurrence of all patients was analyzed. According to the site of recurrence, all patients were divided into the presacral, pelvic wall and central recurrence groups. Local recurrence-free survival (LRFS) and overall survival (OS) rates were estimated using the Kaplan-Meier method. The survival among groups was compared by two-sided log-rank test.Results:The median follow-up period was 22 months. Among 34 patients, recurrence was observed in 38 sites, primarily at the central region (24 sites, 63%) and 23 patients (68%) had initial recurrence. The median OS was 47 months, and the median LRFS was 19 months. The 1-, 2-, 3- and 5-year OS rates were 93.1%, 75.3%, 69.1% and 38.4%, respectively. The 1- and 2-year LRFS rates were 69.8% and 27.2%. There were no significant differences in OS among the presacral, pelvic wall and central recurrence groups ( P=0.616). Conclusions:For patients with locally recurrent rectal cancer that cannot be resected with R0 margins, second-course radiotherapy offers higher clinical efficacy compared with alternative therapeutic options previously reported.
