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Rectal Cancer

  • Mariangela Massaccesi
  • Vincenzo Valentini
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Reirradiation combined with chemotherapy for patients developing recurrent rectal cancer after radiation or chemoradiation is feasible and provides high chances for cure and palliation. Nearly one-half of patients with resected disease achieve long-term control of pelvic disease, and up to 65 % of them can have long-term (5-year) survival. Even in unresected patients, long-term control can be achieved in about 20 % of cases with one out of five patients surviving after 5 years.

Acute and late toxicity are not prohibitive if proper attention is paid to both radiation technique and surgical technique. The use of small radiation fields, exclusion of the bowel and bladder, and the use of hyperfractionated radiation doses up to 40 Gy are recommended.

Since most of treatment failures occur within the radiation treatment field, future studies should investigate methods to further improve local control. In view of the fact that about one-half of surviving patients will develop distant metastases, innovative strategies for reduction of distant metastases should also be explored.

Keywords

Rectal Cancer Small Bowel Obstruction Late Toxicity Circumferential Resection Margin Stereotactic Radiation Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Abusaris H, Hoogeman M, Nuyttens JJ (2012) Re-irradiation: outcome, cumulative dose and toxicity in patients retreated with stereotactic radiotherapy in the abdominal or pelvic region. Technol Cancer Res Treat 11(6):591–597CrossRefPubMedPubMedCentralGoogle Scholar
  2. Alberda WJ, Verhoef C, Nuyttens JJ, Rothbarth J, van Meerten E, de Wilt JH, Burger JW (2014) Outcome in patients with resectable locally recurrent rectal cancer after total mesorectal excision with and without previous neoadjuvant radiotherapy for the primary rectal tumor. Ann Surg Oncol 21(2):520–526. doi: 10.1245/s10434-013-3306-x CrossRefPubMedGoogle Scholar
  3. Alberda WJ, Verhoef C, Schipper ME, Nuyttens JJ, Rothbarth J, de Wilt JH, Burger JW (2015) The importance of a minimal tumor-free resection margin in locally recurrent rectal cancer. Dis Colon Rectum 58(7):677–685CrossRefPubMedGoogle Scholar
  4. Beyond TME Collaborative (2013) Consensus statement on the multidisciplinary management of patients with recurrent and primary rectal cancer beyond total mesorectal excision planes. Br J Surg 100(8):E1–E33. doi: 10.1002/bjs.9192 CrossRefGoogle Scholar
  5. Bhangu A, Ali SM, Brown G, Nicholls RJ, Tekkis P (2014) Indications and outcome of pelvic exenteration for locally advanced primary and recurrent rectal cancer. Ann Surg 259(2):315e–322eCrossRefGoogle Scholar
  6. Bishop AJ, Gupta S, Cunningham MG, Tao R, Berner PA, Korpela SG et al (2015) Interstitial brachytherapy for the treatment of locally recurrent anorectal cancer. Ann Surg Oncol 22(Suppl 3):596–602CrossRefGoogle Scholar
  7. Bosman SJ, Holman FA, Nieuwenhuijzen GA, Martijn H, Creemers GJ, Rutten HJ (2014) Feasibility of reirradiation in the treatment of locally recurrent rectal cancer. Br J Surg 101(10):1280–1289CrossRefPubMedGoogle Scholar
  8. Chan CL, Bokey EL, Chapuis PH, Renwick AA, Dent OF (2006) Local recurrence after curative resection for rectal cancer is associated with anterior position of the tumour. Br J Surg 93(1):105–112CrossRefPubMedGoogle Scholar
  9. Coco C, Valentini V, Manno A, Mattana C, Verbo A, Cellini N et al (2006) Long-term results after neoadjuvant radiochemotherapy for locally advanced resectable extraperitoneal rectal cancer. Dis Colon Rectum 49:311–318CrossRefPubMedGoogle Scholar
  10. Combs SE, Kieser M, Habermehl D, Weitz J, Jäger D, Fossati P et al (2012) Phase I/II trial evaluating carbon ion radiotherapy for the treatment of recurrent rectal cancer: the PANDORA-01 trial. BMC Cancer 12:137CrossRefPubMedPubMedCentralGoogle Scholar
  11. Dagoglu N, Mahadevan A, Nedea E, Poylin V, Nagle D (2015) Stereotactic body radiotherapy (SBRT) reirradiation for pelvic recurrence from colorectal cancer. J Surg Oncol 111(4):478–482CrossRefPubMedGoogle Scholar
  12. Das P, Delclos ME, Skibber JM, Rodriguez-Bigas MA, Feig BW, Chang GJ et al (2010) Hyperfractionated accelerated radiotherapy for rectal cancer in patients with prior pelvic irradiation. Int J Radiat Oncol Biol Phys 77:60–65CrossRefPubMedGoogle Scholar
  13. Defoe SG, Bernard ME, Rwigema JC, Heron DE, Ozhasoglu C, Burton S et al (2011) Stereotactic body radiotherapy for the treatment of presacral recurrences from rectal cancers. J Cancer Res Ther 7(4):408–411CrossRefPubMedGoogle Scholar
  14. Dewas S, Bibault JE, Mirabel X, Nickers P, Castelain B, Lacornerie T, Jarraya H, Lartigau E (2011) Robotic image-guided reirradiation of lateral pelvic recurrences: preliminary results. Radiat Oncol 6:77. doi: 10.1186/1748-717X-6-77 CrossRefPubMedPubMedCentralGoogle Scholar
  15. Dicle O, Obuz F, Cakmakci H (1999) Differentiation of recurrent rectal cancer and scarring with dynamic MR imaging. Br J Radiol 72:11559Google Scholar
  16. Dresen RC, Gosens MJ, Martijn H et al (2008) Radical resection after IORT-containing multimodality treatment is the most important determinant for outcome in patients treated for locally recurrent rectal cancer. Ann Surg Oncol 15:1937–1947CrossRefPubMedPubMedCentralGoogle Scholar
  17. Dresen RC, Kusters M, Daniels-Gooszen AW, Cappendijk VC, Nieuwenhuijzen GA, Kessels AG et al (2010) Absence of tumor invasion into pelvic structures in locally recurrent rectal cancer: prediction with preoperative MR imaging. Radiology 256(1):143–150CrossRefPubMedGoogle Scholar
  18. Dubois JB, Bussieres E, Richaud P, Rouanet P, Becouarn Y, Mathoulin-Pélissier S et al (2011) Intraoperative radiotherapy of rectal cancer: results of the French multi-institutional randomized study. Radiother Oncol 98(3):298–303CrossRefPubMedGoogle Scholar
  19. Eble MJ, Lehnert T, Treiber M, Latz D, Herfarth C, Wannenmacher M (1998) Moderate dose intraoperative and external beam radiotherapy for locally recurrent rectal carcinoma. Radiother Oncol 49:169–174CrossRefPubMedGoogle Scholar
  20. Enker WE, Thaler HT, Cranor ML et al (1995) Total mesorectal excision in the operative treatment of carcinoma of the rectum. J Am Coll Surg 181:335–346PubMedGoogle Scholar
  21. Enríquez-Navascués JM, Borda N, Lizerazu A, Placer C, Elosegui JL, Ciria JP et al (2011) Patterns of local recurrence in rectal cancer after a multidisciplinary approach. World J Gastroenterol 17(13):1674–1684. doi: 10.3748/wjg.v17.i13.1674 CrossRefPubMedPubMedCentralGoogle Scholar
  22. Ferenschild FT, Vermaas M, Nuyttens JJ, Graveland WJ, Marinelli AW, van der Sijp JR (2006) Value of intraoperative radiotherapy in locally advanced rectal cancer. Dis Colon Rectum 49:1257–1265CrossRefPubMedGoogle Scholar
  23. Ferenschild FT, Vermaas M, Verhoef C et al (2009) Total pelvic exenteration for primary and recurrent malignancies. World J Surg 33(7):1502e–1508eCrossRefGoogle Scholar
  24. Figueredo A, Rumble RB, Maroun J, Earle CC, Cummings B, McLeod R et al (2003) Follow-up of patients with curatively resected colorectal cancer: a practice guideline. BMC Cancer 3:26CrossRefPubMedPubMedCentralGoogle Scholar
  25. Floriani I, Torri V, Rulli E et al (2010) Performance of imaging modalities in diagnosis of liver metastases from colorectal cancer: a systematic review and meta-analysis. J Magn Reson Imaging 31:1931CrossRefGoogle Scholar
  26. Georgiou PA, Tekkis PP, Constantinides VA, Patel U, Goldin RD, Darzi AW et al (2013) Diagnostic accuracy and value of magnetic resonance imaging (MRI) in planning exenterative pelvic surgery for advanced colorectal cancer. Eur J Cancer 49:72–81CrossRefPubMedGoogle Scholar
  27. Gérard JP, Azria D, Gourgou-Bourgade S, Martel-Lafay I, Hennequin C, Etienne PL et al (2012) Clinical outcome of the ACCORD 12/0405 PRODIGE 2 randomized trial in rectal cancer. J Clin Oncol 30(36):4558–4565. doi: 10.1200/JCO.2012.42.8771 CrossRefPubMedGoogle Scholar
  28. Gezen C, Kement M, Altuntas YE, Okkabaz N, Seker M, Vural S et al (2012) Results after multivisceral resections of locally advanced colorectal cancers: an analysis on clinical and pathological t4 tumors. World J Surg Oncol 15(10):39. doi: 10.1186/1477-7819-10-39 CrossRefGoogle Scholar
  29. Goes RN, Beart RW Jr, Simons AJ, Gunderson LL, Grado G, Streeter O (1997) Use of brachytherapy in management of locally recurrent rectal cancer. Dis Colon Rectum 40:1177–1179CrossRefPubMedGoogle Scholar
  30. Goldberg PA, Nicholls RJ, Porter NH et al (1994) Long-term results of a randomised trial of short-course low-dose adjuvant preoperative radiotherapy for rectal cancer: reduction in local treatment failure. Eur J Cancer 30A:1602–1606CrossRefPubMedGoogle Scholar
  31. Grabbe E, Winkler R (1985) Local recurrence after sphincter-saving resection for rectal and rectosigmoid carcinoma. Value of various diagnostic methods. Radiology 155:305–310CrossRefPubMedGoogle Scholar
  32. Gunderson LL, Nelson H, Martenson JA et al (1996) Intraoperative electron and external beam irradiation with or without 5-fluorouracil and maximum surgical resection for previously unirradiated locally recurrent colorectal cancer. Dis Colon Rectum 39:1379–1395CrossRefPubMedGoogle Scholar
  33. Gunderson LL, Nelson H, Martenson JA, Cha S, Haddock M, Devine R (1997) Locally advanced primary colorectal cancer: Intraoperative electron and external beam irradiation ± 5-FU. Int J Radiat Oncol Biol Phys 37:601–614CrossRefPubMedGoogle Scholar
  34. Guren MG, Undseth C, Rekstad BL, Brændengen M, Dueland S, Spindler KL et al (2014) Reirradiation of locally recurrent rectal cancer: a systematic review. Radiother Oncol 113(2):151–157. doi: 10.1016/j.radonc.2014.11.021 CrossRefPubMedGoogle Scholar
  35. Haddock MG, Gunderson LL, Nelson H, Cha SS, Devine RM, Dozois RR, Wolff BG (2001) Intraoperative irradiation for locally recurrent colorectal cancer in previously irradiated patients. Int J Radiat Oncol Biol Phys 49:1267–1274Google Scholar
  36. Haddock MG, Miller RC, Nelson H et al (2011) Combined modality therapy including intraoperative electron irradiation for locally recurrent colorectal cancer. Int J Radiat Oncol Biol Phys 79:143–150CrossRefPubMedGoogle Scholar
  37. Harji DP, Griffiths B, McArthur DR, Sagar PM (2013) Surgery for recurrent rectal cancer: higher and wider? Colorectal Dis 15:139–145CrossRefPubMedGoogle Scholar
  38. Heald RJ (1995) Total mesorectal excision is optimal surgery for rectal cancer: a Scandinavian consensus. Br J Surg 82:1297–1299CrossRefPubMedGoogle Scholar
  39. Heriot AG, Tekkis PP, Darzi A, Mackay J (2006) Surgery for local recurrence of rectal cancer. Colorectal Dis 8:73347. doi: 10.1111/j.1463-1318.2006.01018.x CrossRefGoogle Scholar
  40. Huebner RH, Park KC, Shepherd JE et al (2000) A meta-analysis of the literature for whole-body FDG PET detection of recurrent colorectal cancer. J Nucl Med 41:117789Google Scholar
  41. Kalff V, Hicks R, Ware R et al (2002) The clinical impact of 18F-FDG PET in patients with suspected or confirmed recurrence of colorectal cancer: a prospective study. J Nucl Med 43:492–499PubMedGoogle Scholar
  42. Konski AA, Suh WW, Herman JM, Blackstock AW Jr, Hong TS, Poggi MM et al (2012) ACR appropriateness criteria® - recurrent rectal cancer. Gastrointest Cancer Res 5(1):3–12PubMedPubMedCentralGoogle Scholar
  43. Koom WS, Choi Y, Shim SJ, Cha J, Seong J, Kim NK et al (2012) Reirradiation to the pelvis for recurrent rectal cancer. J Surg Oncol 105:637–642CrossRefPubMedGoogle Scholar
  44. Kusters M, Marijnen CA, van de Velde CJ, Rutten HJ, Lahaye MJ, Kim JH et al (2010) Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial. Eur J Surg Oncol 36(5):470–476CrossRefPubMedGoogle Scholar
  45. Lambregts DM, Cappendijk VC, Maas M, Beets GL, Beets-Tan RG (2011) Value of MRI and diffusion-weighted MRI for the diagnosis of locally recurrent rectal cancer. Eur Radiol 21(6):1250–1258CrossRefPubMedPubMedCentralGoogle Scholar
  46. Langendijk JA, Kasperts N, Leemans CR, Doornaert P, Slotman BJ (2006) A phase II study of primary reirradiation in squamous cell carcinoma of head and neck. Radiother Oncol 78(3):306–312CrossRefPubMedGoogle Scholar
  47. Lingareddy V, Ahmad NR, Mohiuddin M (1997) Palliative reirradiation for recurrent rectal cancer. Int J Radiat Oncol Biol Phys 38:785–790CrossRefPubMedGoogle Scholar
  48. MacFarlane JK, Ryall RD, Heald RJ (1993) Mesorectal excision for rectal cancer. Lancet 341:457–460CrossRefPubMedGoogle Scholar
  49. Mannaerts GH, Rutten HJ, Martijn H et al (2001) Comparison of intraoperative radiation therapy-containing multimodality treatment with historical treatment modalities for locally recurrent rectal cancer. Dis Colon Rectum 44:1749–1758CrossRefPubMedGoogle Scholar
  50. Martinez-Monge R, Nag S, Martin EW (1998) 125Iodine brachytherapy for colorectal adenocarcinoma recurrent in the pelvis and paraortics. Int J Radiat Oncol Biol Phys 42:545–550CrossRefPubMedGoogle Scholar
  51. Masaki T, Takayama M, Matsuoka H, Abe N, Ueki H, Sugiyama M et al (2008) Intraoperative radiotherapy for oncological and function-preserving surgery in patients with advanced lower rectal cancer. Langenbecks Arch Surg 393(2):173–180CrossRefPubMedGoogle Scholar
  52. Messiou C, Chalmers AG, Boyle K, Wilson D, Sagar P (2008) Preoperative MR assessment of recurrent rectal cancer. Br J Radiol 81(966):468–473CrossRefPubMedGoogle Scholar
  53. Milani V, Pazos M, Issels RD, Buecklein V, Rahman S, Tschoep K et al (2008) Radiochemotherapy in combination with regional hyperthermia in preirradiated patients with recurrent rectal cancer. Strahlenther Onkol 184(3):163–168CrossRefPubMedGoogle Scholar
  54. Mohiuddin M, Marks G (1993) Patterns of recurrence following high-dose preoperative radiation and sphincter-preserving surgery for cancer of the rectum. Dis Colon Rectum 36(2):117–126CrossRefPubMedGoogle Scholar
  55. Mohiuddin M, Lingareddy V, Rakinic J, Marks G (1993) Reirradiation for rectal cancer and surgical resection after ultra high doses. Int J Radiat Oncol Biol Phys 27:1159–1163CrossRefPubMedGoogle Scholar
  56. Mohiuddin M, Marks GM, Lingareddy V, Marks J (1997) Curative surgical resection following reirradiation for recurrent rectal cancer. Int J Radiat Oncol Biol Phys 39:643–649CrossRefPubMedGoogle Scholar
  57. Mohiuddin M, Marks G, Marks J (2002) Long-term results of reirradiation for patients with recurrent rectal carcinoma. Cancer 95:1144–1150CrossRefPubMedGoogle Scholar
  58. Moore HG, Shoup M, Riedel E et al (2004) Colorectal cancer pelvic recurrences: determinants of resectability. Dis Colon Rectum 47(10):1599e–1606eCrossRefGoogle Scholar
  59. Ng MK, Leong T, Heriot AG, Ngan SY (2013) Once-daily reirradiation for rectal cancer in patients who have received previous pelvic radiotherapy. J Med Imaging Radiat Oncol 57:512–518CrossRefPubMedGoogle Scholar
  60. Nielsen MB, Laurberg S, Holm T (2011) Current management of locally recurrent rectal cancer. Colorectal Dis 13:732–742CrossRefPubMedGoogle Scholar
  61. Nielsen M, Rasmussen P, Lindegaard J, Laurberg S (2012) A 10-year experience of total pelvic exenteration for primary advanced and locally recurrent rectal cancer based on a prospective database. Colorectal Dis 14(9):1076e–1083eCrossRefGoogle Scholar
  62. Ogunbiyi O, Flanagan F, Dehdashti F et al (1997) Detection of recurrent and metastatic colorectal cancer: comparison of positron emission tomography and computed tomography. Ann Surg Oncol 4:613–620CrossRefPubMedGoogle Scholar
  63. Pacelli F, Tortorelli AP, Rosa F, Bossola M, Sanchez AM, Papa V, Valentini V, Doglietto GB (2010) Locally recurrent rectal cancer: prognostic factors and long-term outcomes of multimodal therapy. Ann Surg Oncol 17(1):152–162. doi: 10.1245/s10434-009-0737-5 CrossRefPubMedGoogle Scholar
  64. Palmer G, Martling A, Cedermark B, Holm T (2007) A population-based study on the management and outcome in patients with locally recurrent rectal cancer. Ann Surg Oncol 14(2):447–454CrossRefPubMedGoogle Scholar
  65. Quirke P, Durdey P, Dixon MF, Williams NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet 2(8514):996–999CrossRefPubMedGoogle Scholar
  66. Renehan AG (2016) Techniques and outcome of surgery for locally advanced and local recurrent rectal cancer. Clin Oncol (R Coll Radiol) 28(2):103–115CrossRefGoogle Scholar
  67. Rödel C, Grabenbauer GG, Matzel KE, Schick C, Fietkau R, Papadopoulos T et al (2000) Extensive surgery after high-dose preoperative chemoradiotherapy for locally advanced recurrent rectal cancer. Dis Colon Rectum 43(3):312–319CrossRefPubMedGoogle Scholar
  68. Rödel C, Martus P, Papadoupolos T, Füzesi L, Klimpfinger M, Fietkau R et al (2005) Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer. J Clin Oncol 23(34):8688–8696CrossRefPubMedGoogle Scholar
  69. Rödel C, Graeven U, Fietkau R, Hohenberger W, Hothorn T, Arnold D, et al., German Rectal Cancer Study Group (2015) Oxaliplatin added to fluorouracil-based preoperative chemoradiotherapy and postoperative chemotherapy of locally advanced rectal cancer (the German CAO/ARO/AIO-04 study): final results of the multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 16(8):979–89. doi: 10.1016/S1470-2045(15)00159-X
  70. Roeder F, Goetz JM, Habl G, Bischof M, Krempien R, Buechler MW, Hensley FW et al (2012) Intraoperative Electron Radiation Therapy (IOERT) in the management of locally recurrent rectal cancer. BMC Cancer 12:592CrossRefPubMedPubMedCentralGoogle Scholar
  71. Rombouts AJ, Koh CE, Young JM, Masya L, Roberts R, De-Loyde K et al (2015) Does radiotherapy of the primary rectal cancer affect prognosis after pelvic exenteration for recurrent rectal cancer? Dis Colon Rectum 58(1):65–73CrossRefPubMedGoogle Scholar
  72. Sagar PM, Pemberton JH (1996) Surgical management of locally recurrent rectal cancer. Br J Surg 83(3):293–304CrossRefPubMedGoogle Scholar
  73. Saito N, Koda K, Takiguchi N, Oda K, Ono M, Sugito M et al (2003) Curative surgery for local pelvic recurrence of rectal cancer. Dig Surg 20:192–199CrossRefPubMedGoogle Scholar
  74. Song CW, Lee YJ, Griffin RJ, Park I, Koonce NA, Hui S et al (2015) Indirect tumor cell death after high-dose hypofractionated irradiation: implications for stereotactic body radiation therapy and stereotactic radiation surgery. Int J Radiat Oncol Biol Phys 93(1):166–172CrossRefPubMedPubMedCentralGoogle Scholar
  75. Sun DS, Zhang JD, Li L, Dai Y, Yu JM, Shao ZY (2012) Accelerated hyperfractionation field-involved re-irradiation combined with concurrent capecitabine chemotherapy for locally recurrent and irresectable rectal cancer. Br J Radiol 1011:259–264CrossRefGoogle Scholar
  76. Suzuki K, Dozois RR, Devine RM, Nelson H, Weaver AL, Gunderson LL et al (1996) Curative reoperations for locally recurrent rectal cancer. Dis Colon Rectum 39:730–746CrossRefPubMedGoogle Scholar
  77. Swedish Rectal Cancer Trial (1996) Local recurrence rate in a randomised multicentre trial of preoperative radiotherapy compared with operation alone in resectable rectal carcinoma. Eur J Surg 162:397–402Google Scholar
  78. Tan PL, Chan CL, Moore NR (2005) Radiological appearances in the pelvis following rectal cancer surgery. Clin Radiol 60(8):846–855CrossRefPubMedGoogle Scholar
  79. Tan E, Gouvas N, Nicholls RJ, Ziprin P, Xynos E, Tekkis PP (2009) Diagnostic precision of carcinoembryonic antigen in the detection of recurrence of colorectal cancer. Surg Oncol 18:15–24CrossRefPubMedGoogle Scholar
  80. Tanis PJ, Doeksen A, van Lanschot JJ (2013) Intentionally curative treatment of locally recurrent rectal cancer: a systematic review. Can J Surg 56(2):135–144CrossRefPubMedPubMedCentralGoogle Scholar
  81. Valentini V, Morganti AG, De Franco A et al (1999) Chemoradiation with or without intraoperative radiation therapy in patients with locally recurrent rectal carcinoma: prognostic factors and long-term outcome. Cancer 86:2612–2624CrossRefPubMedGoogle Scholar
  82. Valentini V, Morganti AG, Gambacorta MA et al (2006) Preoperative hyperfractionated chemoradiation for locally recurrent rectal cancer in patients previously irradiated to the pelvis: a multicentric phase II study. Int J Radiat Oncol Biol Phys 64:1129–1139CrossRefPubMedGoogle Scholar
  83. Valentini V, van Stiphout RG, Lammering G, Gambacorta MA, Barba MC, Bebenek M et al (2011) Nomograms for predicting local recurrence, distant metastases, and overall survival for patients with locally advanced rectal cancer on the basis of European randomized clinical trials. J Clin Oncol 29:3163–3172CrossRefPubMedGoogle Scholar
  84. van den Brink M, Stiggelbout AM, van den Hout WB et al (2004) Clinical nature and prognosis of locally recurrent rectal cancer after total mesorectal excision with or without preoperative radiotherapy. J Clin Oncol 22:3958–3964CrossRefPubMedGoogle Scholar
  85. van Gijn W, van Stiphout RG, van de Velde CJ, Valentini V, Lammering G, Gambacorta MA et al (2015) Nomograms to predict survival and the risk for developing local or distant recurrence in patients with rectal cancer treated with optional short-term radiotherapy. Ann Oncol 26:928–935CrossRefPubMedGoogle Scholar
  86. Vermaas M, Ferenschild FT, Nuyttens JJ, Marinelli AW, Wiggers T, van der Sijp JR et al (2005) Preoperative radiotherapy improves outcome in recurrent rectal cancer. Dis Colon Rectum 48(5):918–928CrossRefPubMedGoogle Scholar
  87. Wanebo HJ, Antoniuk P, Koness RJ et al (1999) Pelvic resection of recurrent rectal cancer: technical considerations and outcomes. Dis Colon Rectum 42:1438–1448CrossRefPubMedGoogle Scholar
  88. Wang JJ, Yuan HS, Li JN, Jiang YL, Tian SQ, Yang RJ (2010) CT-guided radioactive seed implantation for recurrent rectal carcinoma after multiple therapy. Med Oncol 27:421–429CrossRefPubMedGoogle Scholar
  89. Wang Z, Lu J, Liu L et al (2011) Clinical application of CT-guided (125) I seed interstitial implantation for local recurrent rectal carcinoma. Radiat Oncol 6:138CrossRefPubMedPubMedCentralGoogle Scholar
  90. Würschmidt F, Dahle J, Petersen C, Wenzel C, Kretschmer M, Bastian C (2008) Reirradiation of recurrent breast cancer with and without concurrent chemotherapy. Radiat Oncol 3:28. doi: 10.1186/1748-717X-3-28 CrossRefPubMedPubMedCentralGoogle Scholar
  91. Yamada K, Ishizawa T, Niwa K, Chuman Y, Akiba S, Aikou T (2001) Patterns of pelvic invasion are prognostic in the treatment of locally recurrent rectal cancer. Br J Surg 88:988–993CrossRefPubMedGoogle Scholar
  92. Yu SK, Bhangu A, Tait DM, Tekkis P, Wotherspoon A, Brown G (2014) Chemoradiotherapy response in recurrent rectal cancer. Cancer Med 3(1):111–117CrossRefPubMedGoogle Scholar
  93. Zitt M, Mühlmann G, Weiss H, Kafka-Ritsch R, Oberwalder M, Kirchmayr W et al (2006) Assessment of risk-independent follow-up to detect asymptomatic recurrence after curative resection of colorectal cancer. Langenbecks Arch Surg 391:369–375CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Radiation Oncology Department – Gemelli ARTUniversità Cattolica del Sacro CuoreRomeItaly

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