Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2019 , Vol 10, Issue 3
Intraoperative Radiation Therapy For Recurrent Rectal Cancer
İsmail Ahmet Bilgin1,Erman Aytaç1,İlknur Erenler Bayraktar1,Bilgehan Şahin2,Banu Atalar2,Nuran Beşe2,Enis Özyar2,Bilgi Baca1,İsmail Hamzaoğlu1,Tayfun Karahasanoğlu1
1Acıbadem Üniversitesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye
2Acıbadem Üniversitesi, Radyasyon Onkolojisi Anabilim Dalı, İstanbul, Türkiye
DOI : 10.31067/0.2018.88 Introduction: As one of the multimodal treatment options available in locally advanced or recurrent rectal cancer, intraoperative radiotherapy (IORT) may be a preferred option to achieve local control. In this study, we aim to report on our experience with those recurrent rectal cancer cases which were treated with radical surgery and intraoperative radiotherapy.

Methods: Cases treated with radical surgery and IORT for recurrent rectal cancer between November 2012 and December 2016 at Acibadem Mehmet Ali Aydinlar University Medical Faculty Hospital, Maslak, Istanbul, were included in this study.

Results: 8 patients (4 male, 4 female ) with recurrent rectal cancer were included in this study. All the patients had recurrent adenocarcinoma. The median age was 54.5 (range 33-67) and median BMI was 34.3 (range 19.6-32.5) kg/m2. In all cases, the previous surgery undertaken was sphincter-preserving resection. For recurrent tumors, low anterior resection was performed on 4 patients, abdominoperineal resection was performed on 2 patients and pelvic exenteration was performed on 2 patients. R0 resection was observed in 5, R1 in 2, and R2 in 1 patient. At short-term follow-up, infection had developed at the operative site in 2 patients. The median hospital stay was 8 (4-10) days. During the median follow-up period of 36 (7-52) months, 4 patients were observed to be disease-free, 2 patients had pelvic recurrence and 2 patients died.

Conclusion: IORT increases the effectiveness of surgery for local control in recurrent rectal cancer and additionally decreases the risk of toxicity, thus enabling the application of high dose radiotherapy. Keywords : Recurrent rectal cancer, intraoperative radiation therapy, multimodal treatment