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Image-guided high-dose-rate interstitial brachytherapy for recurrent rectal cancer after salvage surgery: a case report.
J Contemp Brachytherapy 2019; 11(4):343-348JC

Abstract

Treatment options for patients with recurrent rectal cancer in pelvis represent a significant challenge because the balance of efficiency and toxicity needs to be pursued. This case report illustrates a treatment effect of image-guided high-dose-rate interstitial brachytherapy (HDR-ISBT) for locally relapsed rectal cancer after salvage surgery. A 61-year-old male who underwent laparoscopic high anterior resection (LAP-HAR) with D3 lymph node dissection as a primary treatment for rectal cancer (pT3N0M0, well-differentiated adenocarcinoma) had relapsed locally 8 months after initial surgery, for which he underwent salvage abdominal perineal resection (APR), followed by adjuvant 8 cycles of XELOX (capecitabine and oxaliplatin) chemotherapy. He developed pelvic recurrence 1 year after the second surgery. Image-guided HDR-ISBT was performed (30 Gy/5 fractions/3 days) followed by external beam radiation therapy with 39.6 Gy in 22 fractions. There were no severe complications related to salvage radiotherapy. CEA was decreased from 24.5 ng/ml to 0.7 ng/ml, 4 months after the salvage radiotherapy. Complete response was noted on follow-up MRIs done on 2, 5, 8, and 14 months after the treatment. Hence, HDR-ISBT appears to be effective for locally recurrent rectal cancer even after salvage surgery.

Authors+Show Affiliations

Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan. Department of Radiation Oncology, Lihuili Hospital, Ningbo Medical Center, China.Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31523235

Citation

Yanping, Bei, et al. "Image-guided High-dose-rate Interstitial Brachytherapy for Recurrent Rectal Cancer After Salvage Surgery: a Case Report." Journal of Contemporary Brachytherapy, vol. 11, no. 4, 2019, pp. 343-348.
Yanping B, Murakami N, Shima S, et al. Image-guided high-dose-rate interstitial brachytherapy for recurrent rectal cancer after salvage surgery: a case report. J Contemp Brachytherapy. 2019;11(4):343-348.
Yanping, B., Murakami, N., Shima, S., Takahashi, K., Inaba, K., Okuma, K., ... Itami, J. (2019). Image-guided high-dose-rate interstitial brachytherapy for recurrent rectal cancer after salvage surgery: a case report. Journal of Contemporary Brachytherapy, 11(4), pp. 343-348. doi:10.5114/jcb.2019.87000.
Yanping B, et al. Image-guided High-dose-rate Interstitial Brachytherapy for Recurrent Rectal Cancer After Salvage Surgery: a Case Report. J Contemp Brachytherapy. 2019;11(4):343-348. PubMed PMID: 31523235.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Image-guided high-dose-rate interstitial brachytherapy for recurrent rectal cancer after salvage surgery: a case report. AU - Yanping,Bei, AU - Murakami,Naoya, AU - Shima,Satoshi, AU - Takahashi,Kana, AU - Inaba,Koji, AU - Okuma,Kae, AU - Igaki,Hiroshi, AU - Nakayama,Yuko, AU - Itami,Jun, Y1 - 2019/08/29/ PY - 2019/01/23/received PY - 2019/06/11/accepted PY - 2019/9/17/entrez PY - 2019/9/17/pubmed PY - 2019/9/17/medline KW - image-guided high-dose-rate interstitial brachytherapy KW - local recurrence KW - rectal cancer SP - 343 EP - 348 JF - Journal of contemporary brachytherapy JO - J Contemp Brachytherapy VL - 11 IS - 4 N2 - Treatment options for patients with recurrent rectal cancer in pelvis represent a significant challenge because the balance of efficiency and toxicity needs to be pursued. This case report illustrates a treatment effect of image-guided high-dose-rate interstitial brachytherapy (HDR-ISBT) for locally relapsed rectal cancer after salvage surgery. A 61-year-old male who underwent laparoscopic high anterior resection (LAP-HAR) with D3 lymph node dissection as a primary treatment for rectal cancer (pT3N0M0, well-differentiated adenocarcinoma) had relapsed locally 8 months after initial surgery, for which he underwent salvage abdominal perineal resection (APR), followed by adjuvant 8 cycles of XELOX (capecitabine and oxaliplatin) chemotherapy. He developed pelvic recurrence 1 year after the second surgery. Image-guided HDR-ISBT was performed (30 Gy/5 fractions/3 days) followed by external beam radiation therapy with 39.6 Gy in 22 fractions. There were no severe complications related to salvage radiotherapy. CEA was decreased from 24.5 ng/ml to 0.7 ng/ml, 4 months after the salvage radiotherapy. Complete response was noted on follow-up MRIs done on 2, 5, 8, and 14 months after the treatment. Hence, HDR-ISBT appears to be effective for locally recurrent rectal cancer even after salvage surgery. SN - 1689-832X UR - https://www.unboundmedicine.com/medline/citation/31523235/Image-guided_high-dose-rate_interstitial_brachytherapy_for_recurrent_rectal_cancer_after_salvage_surgery:_a_case_report L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31523235/ DB - PRIME DP - Unbound Medicine ER -