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Colon Cancer

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Gastrointestinal Malignancies

Part of the book series: Practical Guides in Radiation Oncology ((PGRO))

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Abstract

Colon cancer is a common malignancy, currently ranked as the third most prevalent cancer and the third leading cause of cancer death in the United States. The primary treatment modality for colon cancer is surgery, with extent determined by tumor location, patient anatomy, and clinical considerations. Adjuvant chemotherapy is the standard of care for lymph node positive (stage III) disease, given established survival benefit. IORT is used to decrease risk of recurrence in locally invasive tumors, particularly with close or involved margins. Adjuvant or neoadjuvant radiation therapy is used for T4 tumors, as the risk of local recurrence is significant in certain clinical scenarios. Adjuvant radiation therapy is delivered by external beam radiotherapy (EBRT) to the tumor bed (as defined by preoperative imaging, surgical findings, and strategically placed surgical clips) with margin; coverage of nodal basins is considered given clinical findings. Typically, a dose of 45 Gy in 1.8 Gy fractions is delivered with optional 5.4 Gy boost to areas at highest risk of recurrence and consideration of dose escalation in select situations. 3D-CRT technique (three or four field preferred) is typically used, although normal tissue constraints (kidney, small bowel, etc.) may dictate more sophisticated advanced planning techniques, including IMRT and VMAT.

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Author information

Authors and Affiliations

  1. Duke University Medical Center, Durham, NC, USA

    Fumiko Chino M.D., Christopher Willett M.D., Manisha Palta M.D. & Brian Czito M.D.

Authors
  1. Fumiko Chino M.D.
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  2. Christopher Willett M.D.
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  3. Manisha Palta M.D.
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  4. Brian Czito M.D.
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Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, Case Western Reserve University, Cleveland, Ohio, USA

    Suzanne Russo

  2. Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA

    Sarah Hoffe

  3. Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington, USA

    Edward Kim

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© 2018 Springer International Publishing AG

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Chino, F., Willett, C., Palta, M., Czito, B. (2018). Colon Cancer. In: Russo, S., Hoffe, S., Kim, E. (eds) Gastrointestinal Malignancies. Practical Guides in Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-64900-9_10

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  • DOI: https://doi.org/10.1007/978-3-319-64900-9_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64899-6

  • Online ISBN: 978-3-319-64900-9

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