REIRRADIATION FOR UNOPERATED RECTAL CANCERAFTER PRIOR PELVIC RADIATION THERAPY: A CASEREPORT

摘要

INTRODUCTION: REGARDING PELVIC RECURRENCE OF UNOPERATED COLORECTAL CANCER,REIRRADIATION MAY BE AN OPTION FOR PATIENTS WHO STILL REFUSE SURGERY. COMORBIDITIESLIKE HIGH BODY-MASS-INDEX AND DIABETES HAS BEEN PROVEN TO BE UNFAVORABLEPROGNOSTIC FACTORS FOR PATIENTS WITH RECTAL CANCER. THE REPORT DESCRIBESCASE DESCRIPTION: A 52 YEAR-OLD MAN KNOWN WITH TYPE 2 DIABETES MELLITUS ANDDIAGNOSED IN 2012 WITH LOCALLY ADVANCED RECTAL ADENOCARCINOMA WHICH UNDERWENTNEOADJUVANT CHEMORADIOTHERAPY THAT REFUSED SURGERY. THE PATIENT ALSO REFUSEDCHEMOTHERAPY REGIMENS, UNDERGOING ONLY CAPECITABINE SINGLE-AGENT THERAPY.FOLLOW-UP CT SCAN AND COLONOSCOPY IDENTIFIED LOCAL PROGRESSION AND, DUE TOPATIENT’S SURGERY REFUSAL, REIRRADIATION AND CONCURRENT CAPECITABINE BASEDCHEMOTHERAPY WAS ADMINISTERED. REIRRADIATION WAS PERFORMED USING THE IMRTTECHNIQUE AND A HYPOFRACTIONATED RADIOTHERAPY REGIMEN. AT FOLLOW-UP CT SCAN AREDUCTION OF THE TUMORAL MASS WAS OBSERVED, WITH NO SIGNS OF METASTATIC DISEASE.CONCLUSION: THIS CASE REPORT SUGGESTS THAT, IN VERY CAREFULLY SELECTED RECTALCANCER PATIENTS, PELVIC RE-REIRRADIATION MIGHT BE AN OPTION FOR THOSE WHO REFUSESURGERY.