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Japanese Journal of Clinical Oncology Advance Access published online on August 22, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyn083
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© The Author (2008). Published by Oxford University Press. All rights reserved

Stereotactic Body Radiation Therapy in Patients with Pelvic Recurrence from Rectal Carcinoma

Mi-Sook Kim1, ChulWon Choi1, SungYul Yoo1, ChulKoo Cho1, YoungSeok Seo1, YoungHoon Ji2, DongHan Lee2, DaeYong Hwang3, SunMi Moon3, Min Suk Kim4 and HyeJeong Kang5

1 Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
2 CyberKnife Center, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
3 Department of General Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
4 Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
5 Department of Hemato-oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea

For reprints and all correspondence: Mi-Sook Kim, Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 215-4 Gongneung-dong, Nowon-gu, Seoul 139-706, Republic of Korea. E-mail: mskim{at}kcch.re.kr

Received June 10, 2008; accepted July 23, 2008

Objective: To investigate the clinical applications of stereotactic body radiation therapy (SBRT) using the CyberKnife system for pelvic recurrence from rectal cancer with a focus on survival and toxicity.

Methods: Between 2002 and 2006, 23 patients with recurrent rectal cancer were treated with SBRT at our institution. The median follow-up was 31 months. Sites of recurrence were pre-sacral in seven patients and the pelvic wall in 16. SBRT doses ranged from 30 to 51 Gy (median 39 Gy) and were delivered in three fractions. Response to treatment was assessed by computed tomography. Overall and local progression-free survival and toxicities were recorded.

Results: Four-year overall survival and local control rates were 24.9 and 74.3%, respectively. No prognostic factor was found to affect patient survival or local progression. One patient developed a severe radiation-related toxicity, but recovered completely after treatment.

Conclusions: SBRT for pelvic recurrence was found to be comparable with other modalities with respect to overall survival and complication rates. Further studies are needed to confirm these preliminary results.

Key Words: rectal cancer • recurrence • CyberKnife • stereotactic body radiation therapy


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