Intraoperative Radiotherapy in Multimodality Treatment of Locally Advanced Rectal Carcinoma

Authors: R. Soumarová;  M. Škrovina *;  S. Machala;  L. Adamčík *;  J. Bartoš *
Authors‘ workplace: Oddělení radioterapie a onkologie, Komplexní onkologické centrum Nový Jičín primářka: doc. MUDr. R. Soumarová, Ph. D. ;  Chirurgické oddělení nemocnice Nový Jičín, Komplexní onkologické centrum Nový Jičín primář: MUDr. M. Škrovina *
Published in: Rozhl. Chir., 2010, roč. 89, č. 11, s. 685-688.
Category: Monothematic special - Original


Multimodality treatment of locally advanced rectal cancer combines radical surgery, radiotherapy and chemotherapy. This method leads to improvement of local control and overall survival. However, some of the patients incur local failure of disease, which are localized predominantly in presacral region. The integration of intraoperative radiotherapy as part of a multimodal treatment approach helps to a further dose escalation without increasing toxicity, and reduces the likelihood of otherwise difficult curable local failure.

Key words:
locally advanced rectal cancer – intraoperative radiation therapy – multimodality treatment


1. Camma, C., Grunta, M., Fiorica, F., et al. Preoperative radiotherapy for resectable rectal cancer: A meta-analysis. JAMA, 2000; 284: 1008–1015.

2. Glimelius, B., Isacsson, U., Jung, B., et al. Radiotherapy in addition to radical surgery in rectal cancer: Evidence for a dose-response effect favoring preoperative treatment. Int. J. Radiat. Oncol. Biol. Phys., 1997; 37: 281–287.

3. Tepper, J. E., O’Connell, M., Niedzwiecki, D., et al. Adjuvant therapy in rectal cancer: Analysis of stage, sex, and local control – Final report of intergroup 0114. J. Clin. Oncol., 2002; 20: 1744–1750.

4. Kapiteijn, E., Marijnen, C. A., Nagtegaal, I. D., et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N. Engl. J. Med., 2001; 345: 638–646.

5. Lindel, K., Willett, C. G., Shellito, P. C., et al. Intraoperative radiation therapy for locally advanced recurrent rectal or rectosigmoid cancer. Radiother. Oncol., 2001; 58(1): 83–87.

6. Yu, T. K., Bhosale, P. R., Crane, C. H., et al. Patterns of locoregional recurrence after surgery and radiotherapy or chemoradiation for rectal cancer. Int. J. Radiat. Oncol. Biol. Phys., 2008, 15; 71(4): 1175–1180.

7. Hoffman, J. P., Rilly, L., Carp, N. Z., Litwin, S. Isolated locally recurrent rectal cancer: a review of incidence, presentation, and management. Semin. Oncol., 1993; 20: 506–519.

8. Nuyttens, J. J., Kolkman-Deurloo, I. K., Vermaas, M., et al. Highdose-rate intraoperative radiotherapy for close or positive margine in patients with locally advanced or recurrent rectal cancer. Int. J. Radiat. Oncol. Biol. Phys., 2004; 58: 106–112.

9. Willett, C. G., Czito, B. G., Tyler, D. S. Intraoperative radiation therapy. J. Clin. Oncol., 2007; 25: 971–977.

10. Roeder, F., Treiber, M., Oertel, S., et al. Patterns of failure and local control after intraoperative electron boost radiotherapy to the presacral space in combination with total mesorectal exciton in patients with locally advanced rectal cancer. Int. J. Radiat. Oncol. Biol. Phys., 2007; 67: 1381–1388.

11. Calvo, F. A., Gomez-Espi, M., Diaz-Gonzalez, J. A., et al. Intraoperative presacral electron boost following preoperative chemoradiation in T3-4Nx rectal cancer: initial local effects and clinical outcome analysis. Radiother. Oncol., 2002; 62: 201–206.

12. Mannaerts, G. H., Martijn, H., Crommelin, M. A., et al. Feasibility and first results of multimodality treatment, combining EBRT, extensive surgery, and IOERT in locally advanced primary rectal cancer. Int. J. Radiat. Oncol. Biol. Phys., 2000; 47: 425–433.

Surgery Orthopaedics Trauma surgery

Article was published in

Perspectives in Surgery

Issue 11

2010 Issue 11

Most read in this issue

This topic is also in:

Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account