PURPOSE: To evaluate survival, relapse patterns, and prognostic factors in patients with colorectal cancer relapse treated with curative-intent therapy, including intraoperative electron radiation therapy (IOERT). METHODS AND MATERIALS: From April 1981 through January 2008, 607 patients with recurrent colorectal cancer received IOERT as a component of treatment. IOERT was preceded or followed by external radiation (median dose, 45.5 Gy) in 583 patients (96%). Resection was classified as R0 in 227 (37%), R1 in 224 (37%), and R2 in 156 (26%). The median IOERT dose was 15 Gy (range, 7.5-30 Gy). RESULTS: Median overall survival was 36 months. Five- and 10-year survival rates were 30% and 16%, respectively. Survival estimates at 5 years were 46%, 27%, and 16% for R0, R1, and R2 resection, respectively. Multivariate analysis revealed that R0 resection, no prior chemotherapy, and more recent treatment (in the second half of the series) were associated with improved survival. The 3-year cumulative incidence of central, local, and distant relapse was 12%, 23%, and 49%, respectively. Central and local relapse were more common in previously irradiated patients and in those with subtotal resection. Toxicity Grade 3 or higher partially attributable to IOERT was observed in 66 patients (11%). Neuropathy was observed in 94 patients (15%) and was more common with IOERT doses exceeding 12.5 Gy. CONCLUSIONS: Long-term survival and disease control was achievable in patients with locally recurrent colorectal cancer. Continued evaluation of curative-intent, combined-modality therapy that includes IOERT is warranted in this high-risk population.
PURPOSE: To evaluate survival, relapse patterns, and prognostic factors in patients with colorectal cancer relapse treated with curative-intent therapy, including intraoperative electron radiation therapy (IOERT). METHODS AND MATERIALS: From April 1981 through January 2008, 607 patients with recurrent colorectal cancer received IOERT as a component of treatment. IOERT was preceded or followed by external radiation (median dose, 45.5 Gy) in 583 patients (96%). Resection was classified as R0 in 227 (37%), R1 in 224 (37%), and R2 in 156 (26%). The median IOERT dose was 15 Gy (range, 7.5-30 Gy). RESULTS: Median overall survival was 36 months. Five- and 10-year survival rates were 30% and 16%, respectively. Survival estimates at 5 years were 46%, 27%, and 16% for R0, R1, and R2 resection, respectively. Multivariate analysis revealed that R0 resection, no prior chemotherapy, and more recent treatment (in the second half of the series) were associated with improved survival. The 3-year cumulative incidence of central, local, and distant relapse was 12%, 23%, and 49%, respectively. Central and local relapse were more common in previously irradiated patients and in those with subtotal resection. Toxicity Grade 3 or higher partially attributable to IOERT was observed in 66 patients (11%). Neuropathy was observed in 94 patients (15%) and was more common with IOERT doses exceeding 12.5 Gy. CONCLUSIONS: Long-term survival and disease control was achievable in patients with locally recurrent colorectal cancer. Continued evaluation of curative-intent, combined-modality therapy that includes IOERT is warranted in this high-risk population.
Authors: Amar U Kishan; Justin C Voog; Jonathan Wiseman; Ryan R Cook; Marek Ancukiewicz; Percy Lee; David P Ryan; Jeffrey W Clark; David L Berger; James C Cusack; Jennifer Y Wo; Theodore S Hong Journal: Br J Radiol Date: 2017-06-14 Impact factor: 3.039
Authors: Felipe A Calvo; Morena Sallabanda; Claudio V Sole; Carmen Gonzalez; Laura Alonso Murillo; Javier Martinez-Villanueva; Juan A Santos; Javier Serrano; Ana Alavrez; Jose Blanco; Ana Calin; Marina Gomez-Espi; Miguel Lozano; Rafael Herranz Journal: Rep Pract Oncol Radiother Date: 2013-08-13
Authors: Felipe A Calvo; Claudio V Sole; Hugo Marsiglia; Eduardo Alvarado; Carlos Ferrer; Brian Czito Journal: Curr Oncol Rep Date: 2015-01 Impact factor: 5.075
Authors: Stephanie Terezakis; Lisa Morikawa; Abraham Wu; Zhigang Zhang; Weiji Shi; Martin R Weiser; Philip B Paty; Jose Guillem; Larissa Temple; Garrett M Nash; Michael J Zelefsky; Karyn A Goodman Journal: Ann Surg Oncol Date: 2015-01-29 Impact factor: 5.344
Authors: Reza Mirnezami; George J Chang; Prajnan Das; Kandiah Chandrakumaran; Paris Tekkis; Ara Darzi; Alexander H Mirnezami Journal: Surg Oncol Date: 2012-12-25 Impact factor: 3.279
Authors: I Shaikh; W Aston; G Hellawell; D Ross; S Littler; D Burling; M Marshall; J M A Northover; A Antoniou; J T Jenkins Journal: Tech Coloproctol Date: 2014-11-08 Impact factor: 3.781
Authors: Claudio V Sole; Felipe A Calvo; Pedro Alvarez de Sierra; Rafael Herranz; Luis Gonzalez-Bayon; Jose Luis García-Sabrido Journal: J Cancer Res Clin Oncol Date: 2014-04-10 Impact factor: 4.553