Rectal Cancer

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


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.


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.


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© Springer International Publishing Switzerland 2016

Authors and Affiliations

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

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