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Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy with Intra-Operative Radiotherapy for Patients
Vincent C J van de Vlasakker1, Teun B M van den Heuvel1, Anouk Rijken1
1Department of Surgery, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands.
Cancers
|February 11, 2023
Summary
This study shows that combining radical surgery, intra-operative radiotherapy (IORT), and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is a safe and effective treatment option for advanced rectal cancer with peritoneal metastases.
Area of Science:
- Oncology
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Locally advanced rectal cancer (LARC) and locally recurrent rectal carcinoma (LRRC) with peritoneal metastases (PM) present significant treatment challenges.
- Multimodality treatment strategies are crucial for improving outcomes in these complex cases.
Purpose of the Study:
- To evaluate the safety and long-term efficacy of a combined treatment regimen involving radical surgery, intra-operative radiotherapy (IORT), and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).
- To assess outcomes for patients with LARC or LRRC and PM undergoing this integrated therapeutic approach.
Main Methods:
- A single-center cohort study included consecutive patients with LARC, LRRC, and PM undergoing the multimodality treatment.
- Outcomes assessed included postoperative complications, intensive care unit (ICU) stay, re-admission rates, disease-free survival (DFS), and overall survival (OS).
Main Results:
- The study included 14 LARC and 16 LRRC patients with PM.
- Median ICU stay was 1 day, with 57% experiencing severe postoperative complications; no 90-day mortality was recorded.
- Median DFS was 10.0 months and median OS was 31.0 months.
Conclusions:
- The observed postoperative complications and survival rates are comparable to those of established treatments for LARC or LRRC and PM as separate procedures.
- Combined IORT and CRS-HIPEC is a viable treatment option for carefully selected patients with LARC or LRRC and peritoneal metastases in specialized tertiary referral centers.
