Abstract
BackgroundThe first-line treatment of a pelvic recurrence in a previously irradiated area is surgery. Unfortunately, few patients are deemed operable, often due to the location of the recurrence, usually too close to the iliac vessels, or the associated surgical morbidity. The objective of this study is to test the viability of robotic image-guided radiotherapy as an alternative treatment in inoperable cases.MethodsSixteen patients previously treated with radiotherapy were reirradiated with CyberKnife® for lateral pelvic lesions. Recurrences of primary rectal cancer (4 patients), anal canal (6), uterine cervix cancer (4), endometrial cancer (1), and bladder carcinoma (1) were treated. The median dose of the previous treatment was 45 Gy (EqD2 range: 20 to 96 Gy). A total dose of 36 Gy in six fractions was delivered with the CyberKnife over three weeks. The responses were evaluated according to RECIST criteria.ResultsMedian follow-up was 10.6 months (1.9 to 20.5 months). The actuarial local control rate was 51.4% at one year. Median disease-free survival was 8.3 months after CyberKnife treatment. The actuarial one-year survival rate was 46%. Acute tolerance was limited to digestive grade 1 and 2 toxicities.ConclusionsRobotic stereotactic radiotherapy can offer a short and well-tolerated treatment for lateral pelvic recurrences in previously irradiated areas in patients otherwise not treatable. Efficacy and toxicity need to be evaluated over the long term, but initial results are encouraging.
Highlights
The first-line treatment of a pelvic recurrence in a previously irradiated area is surgery
Locoregional recurrence occurs in 3% to 15% of patients treated for rectal adenocarcinoma [1] and 1.5% to 40% of patients treated for carcinoma of the uterine cervix [2]
Patients Sixteen patients have been reirradiated with the CyberKnife for lateral pelvic lesions at our center since June 2007
Summary
The first-line treatment of a pelvic recurrence in a previously irradiated area is surgery. Few patients are deemed operable, often due to the location of the recurrence, usually too close to the iliac vessels, or the associated surgical morbidity. Recurrences of primary rectal cancer (4 patients), anal canal (6), uterine cervix cancer (4), endometrial cancer (1), and bladder carcinoma (1) were treated. The responses were evaluated according to RECIST criteria Cancers such as prostate adenocarcinoma, epidermoid carcinoma of the uterine cervix, and adenocarcinoma of the rectum receive pelvic radiotherapy as part of their initial treatment. In cases of lateral pelvic recurrence, therapeutic options are often limited In these situations, surgery is often proposed, but few patients are found eligible because of the lateral location, the proximity of the iliac vessels and the associated surgical morbidity.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
