scholarly journals A Concise Review of Pelvic Radiation Therapy (RT) for Rectal Cancer with Synchronous Liver Metastases

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Omer Sager ◽  
Ferrat Dincoglan ◽  
Selcuk Demiral ◽  
Bora Uysal ◽  
Hakan Gamsiz ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Radiation Therapy ◽  
Liver Metastases ◽  
Stage Iv ◽  
Local Tumor Control ◽  
Health Concern ◽  
Treatment Modalities ◽  
Tumor Control ◽  
Pelvic Radiation ◽  
Synchronous Liver Metastases

Background and Objective. Colorectal cancer is a major health concern as a very common cancer and a leading cause of cancer-related mortality worldwide. The liver is a very common site of metastatic spread for colorectal cancers, and, while nearly half of the patients develop metastases during the course of their disease, synchronous liver metastases are detected in 15% to 25% of cases. There is no standardized treatment in this setting and no consensus exists on optimal sequencing of multimodality management for rectal cancer with synchronous liver metastases. Methods. Herein, we review the use of pelvic radiation therapy (RT) as part of potentially curative or palliative management of rectal cancer with synchronous liver metastases. Results. There is accumulating evidence on the utility of pelvic RT for facilitating subsequent surgery, improving local tumor control, and achieving palliation of symptoms in patients with stage IV rectal cancer. Introduction of superior imaging capabilities and contemporary RT approaches such as Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT) offer improved precision and toxicity profile of radiation delivery in the modern era. Conclusion. Even in the setting of stage IV rectal cancer with synchronous liver metastases, there may be potential for extended survival and cure by aggressive management of primary tumor and metastases in selected patients. Despite lack of consensus on sequencing of treatment modalities, pelvic RT may serve as a critical component of multidisciplinary management. Resectability of primary rectal tumor and liver metastases, patient preferences, comorbidities, symptomatology, and logistical issues should be thoroughly considered in decision making for optimal management of patients.

scholarly journals NEOADJUVANT RADIATION THERAPY FOR RECTAL CANCER WITH SYNCHRONOUS LIVER METASTASES (LITERATURE REVIEW)

2021 ◽  
Vol 20 (5) ◽  
pp. 123-137
Author(s):  
T. P. Pochuev ◽  
A. A. Nevolskikh ◽  
L. O. Petrov ◽  
L. N. Titova ◽  
A. A. Karpov
Keyword(s):  
Rectal Cancer ◽  
Radiation Therapy ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Distant Metastases ◽  
Point Of View ◽  
Surgical Approaches ◽  
Primary Tumors ◽  
Synchronous Liver Metastases ◽  
Number Of Patients

Background. In Russia, synchronous distant metastases are annually detected in approximately 6,200 patients and synchronous liver metastases in 4,000 patients. To plan treatment for rectal cancer with synchronous liver metastases, it is necessary to consider the location of the tumor, extent of the primary tumor involvement, tumor-related complications, and resectability of metastases.The purpose of this review was to analyze the results of studies aimed at finding the best regimens for treating rectal cancer patients with synchronous liver metastases.Material and Methods. The review includes both retrospective and prospective studies devoted to treatment of rectal cancer with synchronous liver metastases. Previous reviews and clinical recommendations were analyzed.Results. Most oncologists are in favor of preoperative radiotherapy, especially when rectal cancer is located in the lower-and middle-ampullary regions. However, there are no randomized trials with a representative number of patients to confirm or refute this point of view. Due to the increased life expectancy of patients and introduction of modern minimally invasive surgical approaches, there is an urgent need for radical treatment of rectal cancer patients. Thus, the approaches to the treatment of primary tumors with synchronous metastatic liver damage should be the same as in stage II–III of the disease, and neoadjuvant radiation therapy is an integral part of this strategy. 

scholarly journals Thermal Ablation of Bone Metastases

2018 ◽  
Vol 35 (04) ◽  
pp. 299-308 ◽  
Author(s):  
A. Kurup ◽  
Matthew Callstrom ◽  
Michael Moynagh
Keyword(s):  
Radiation Therapy ◽  
Bone Metastases ◽  
Thermal Ablation ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Pain Palliation ◽  
Local Tumor ◽  
Image Guided ◽  
Skeletal Related Events ◽  
Percutaneous Thermal Ablation

AbstractImage-guided, minimally invasive, percutaneous thermal ablation of bone metastases has unique advantages compared with surgery or radiation therapy. Thermal ablation of osseous metastases may result in significant pain palliation, prevention of skeletal-related events, and durable local tumor control. This article will describe current thermal ablation techniques utilized to treat bone metastases, summarize contemporary evidence supporting such thermal ablation treatments, and outline an approach to percutaneous ablative treatment.

scholarly journals Optimizing prognostication in patients with synchronous liver metastases from rectal cancer treated according to the liver-first approach.

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S966-S967
Author(s):  
M. Nierop ◽  
M. Verseveld ◽  
B. Galjart ◽  
J. Rothbarth ◽  
J. Nuyttens ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Liver Metastases ◽  
Synchronous Liver Metastases

Prognostic factors and outcome of incompletely resected invasive thymoma following radiation therapy.

1994 ◽  
Vol 12 (7) ◽  
pp. 1484-1490 ◽  
Author(s):  
I F Ciernik ◽  
U Meier ◽  
U M Lütolf
Keyword(s):  
Survival Rate ◽  
Spindle Cell ◽  
Local Treatment ◽  
Stage Iv ◽  
Local Tumor Control ◽  
Stage Iii ◽  
Tumor Control ◽  
Invasive Thymoma ◽  
Local Tumor ◽  
Stage Iv Disease

BACKGROUND Stage III and stage IV thymomas with significant macroscopic infiltration to the neighboring structures are rarely completely resectable. It therefore remains unclear to what extent tumors must be surgically debulked to improve prognosis. PATIENTS AND METHODS We reviewed the cases of 31 patients with incompletely resected invasive thymoma and residual macroscopic disease who were referred to postoperative irradiation. Survival and local tumor control were analyzed. All patients were treated between 1958 and 1990 with megavoltage irradiation at doses ranging from 42 to 66 Gy. The shortest follow-up time for living patients was more than 5 years. RESULTS The overall median 5-year survival rate was 45%. Eighteen stage III patients had a 5-year survival rate of 61% and a 10-year survival rate of 57%. Thirteen patients had stage IV disease and 5- and 10-year survival rates of 23% and 8%, respectively. Univariate and multivariate analyses confirmed a worse prognosis for stage IV disease. Epithelial or spindle-cell thymoma was associated with stage IV disease. Twenty-two percent of patients with stage III disease had epithelial or spindle-cell thymoma, versus 69% of patients with stage IV disease (P = .02 for univariate and P = .05 for multivariate analysis). Initial tumor diameter greater than 10 cm correlated with poor prognosis in the univariate analysis (P = .05). However, more importantly, debulking of tumor did not significantly improve outcome when compared with patients who received biopsy only. The median survival rate of patients with stage IVa disease did not differ from that of those with stage IVb disease. Mediastinal control was achieved in 23 patients (74%). Stage IV disease did not correlate with an increase in local treatment failure after irradiation, although epithelial or spindle-cell thymoma predisposed for local treatment failure (46% v 11%; P = .04 in univariate and P = .055 in multivariate analysis). CONCLUSION Tumor debulking leaving macroscopic residual thymoma, as opposed to biopsy alone, does not improve prognosis when followed by radiation. Radiation therapy for local tumor control is most effective in nonepithelial-predominant thymomas.

Sign in / Sign up

Export Citation Format

Share Document