Intraoperative radiation therapy for curatively resected rectal cancer

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Locally advanced rectal cancer requires effective local control strategies.
• Intraoperative radiotherapy (IORT) is a technique explored for enhancing local tumor control.

Purpose of the Study:

• To evaluate the efficacy of intraoperative radiotherapy in patients with curatively resected rectal cancer.
• To assess the impact of IORT on survival, disease-free survival, and local recurrence rates.

Main Methods:

• A retrospective comparison of 78 patients receiving IORT with curative resection versus 248 patients treated with surgery alone.
• IORT involved electron beam administration to the pelvic dissected surface, with 62 patients also receiving preoperative radiotherapy.
• Patient groups were compared for survival, disease-free survival, local recurrence, and distant metastasis rates.

Main Results:

• The intraoperative radiotherapy group demonstrated significantly better survival, disease-free survival, and local recurrence-free survival (P=0.01, P=0.04, P=0.02).
• Local failure rates were significantly lower in the IORT group (2.6%) compared to the non-IORT group (11.3%, P=0.02).
• Improved survival was noted in Stage II patients, while local recurrence reduction was observed in Stage II and III patients. Wound infections were more frequent but not serious.

Conclusions:

• Intraoperative radiotherapy, applied to the dissected pelvic surface, effectively reduces local recurrence in Stage II and III rectal adenocarcinoma.
• IORT demonstrated an improvement in survival outcomes, particularly for Stage II rectal cancer patients.
• This rectal cancer treatment strategy offers a valuable option for improving local control and survival in select patient populations.