Intraoperative electron radiotherapy as a component of salvage therapy for patients with colorectal cancer and advanced nodal metastases

Michael Haddock, Heidi Nelson, John H. Donohue, William E. Taylor, Richard M. Devine, David M. Nagorney, Bruce G. Wolff, Michael J. O'Connell, Leonard L. Gunderson

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: To define the survival rates and relapse patterns in patients with isolated advanced nodal metastases secondary to colorectal cancer, treated with curative intent using aggressive combined-modality treatment. Methods and Materials: Forty-eight patients with isolated advanced lymph node metastases secondary to colorectal cancer received intraoperative radiotherapy as part of curative-intent treatment. Forty-seven patients also received external beam radiotherapy (EBRT). Chemotherapy was delivered concomitantly with EBRT in 35 patients. The median intraoperative radiotherapy dose was 1250 cGy. End points included local failure within the EBRT field, central failure within the intraoperative radiotherapy field, distant metastases, survival, and toxicity. Results: The median survival time and 5-year survival rate were 35 months and 34%, respectively. At 3 years, the local control and central control rates were 81% and 93%, respectively. Macroscopically complete resection and colonic primary site were predictors of survival and disease control. The median survival time and 5-year survival rate in patients with colonic primary sites and macroscopically complete resection were 53 months and 49%, respectively. Intraoperative radiotherapy-related neuropathy occurred in 3 patients and ureteral fibrosis in 1. Conclusion: With aggressive combined-modality therapy that includes intraoperative radiotherapy, long-term survival is achievable in colorectal cancer patients presenting with nodal relapse or advanced nodal disease. Survival and disease control rates are highest in those without gross residual disease.

Original languageEnglish (US)
Pages (from-to)966-973
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume56
Issue number4
DOIs
StatePublished - Jul 15 2003

Fingerprint

Salvage Therapy
metastasis
Colorectal Neoplasms
radiation therapy
therapy
Radiotherapy
cancer
Electrons
Neoplasm Metastasis
Survival
electrons
Survival Rate
Recurrence
Combined Modality Therapy
fibrosis
lymphatic system
chemotherapy
toxicity
Fibrosis
Lymph Nodes

Keywords

  • Colorectal cancer
  • Combined-modality therapy
  • Nodal metastases
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Intraoperative electron radiotherapy as a component of salvage therapy for patients with colorectal cancer and advanced nodal metastases. / Haddock, Michael; Nelson, Heidi; Donohue, John H.; Taylor, William E.; Devine, Richard M.; Nagorney, David M.; Wolff, Bruce G.; O'Connell, Michael J.; Gunderson, Leonard L.

In: International Journal of Radiation Oncology Biology Physics, Vol. 56, No. 4, 15.07.2003, p. 966-973.

Research output: Contribution to journalArticle

Haddock, Michael ; Nelson, Heidi ; Donohue, John H. ; Taylor, William E. ; Devine, Richard M. ; Nagorney, David M. ; Wolff, Bruce G. ; O'Connell, Michael J. ; Gunderson, Leonard L. / Intraoperative electron radiotherapy as a component of salvage therapy for patients with colorectal cancer and advanced nodal metastases. In: International Journal of Radiation Oncology Biology Physics. 2003 ; Vol. 56, No. 4. pp. 966-973.
@article{9f8c65eba93b494285aa722317980374,
title = "Intraoperative electron radiotherapy as a component of salvage therapy for patients with colorectal cancer and advanced nodal metastases",
abstract = "Purpose: To define the survival rates and relapse patterns in patients with isolated advanced nodal metastases secondary to colorectal cancer, treated with curative intent using aggressive combined-modality treatment. Methods and Materials: Forty-eight patients with isolated advanced lymph node metastases secondary to colorectal cancer received intraoperative radiotherapy as part of curative-intent treatment. Forty-seven patients also received external beam radiotherapy (EBRT). Chemotherapy was delivered concomitantly with EBRT in 35 patients. The median intraoperative radiotherapy dose was 1250 cGy. End points included local failure within the EBRT field, central failure within the intraoperative radiotherapy field, distant metastases, survival, and toxicity. Results: The median survival time and 5-year survival rate were 35 months and 34{\%}, respectively. At 3 years, the local control and central control rates were 81{\%} and 93{\%}, respectively. Macroscopically complete resection and colonic primary site were predictors of survival and disease control. The median survival time and 5-year survival rate in patients with colonic primary sites and macroscopically complete resection were 53 months and 49{\%}, respectively. Intraoperative radiotherapy-related neuropathy occurred in 3 patients and ureteral fibrosis in 1. Conclusion: With aggressive combined-modality therapy that includes intraoperative radiotherapy, long-term survival is achievable in colorectal cancer patients presenting with nodal relapse or advanced nodal disease. Survival and disease control rates are highest in those without gross residual disease.",
keywords = "Colorectal cancer, Combined-modality therapy, Nodal metastases, Radiotherapy",
author = "Michael Haddock and Heidi Nelson and Donohue, {John H.} and Taylor, {William E.} and Devine, {Richard M.} and Nagorney, {David M.} and Wolff, {Bruce G.} and O'Connell, {Michael J.} and Gunderson, {Leonard L.}",
year = "2003",
month = "7",
day = "15",
doi = "10.1016/S0360-3016(03)00189-5",
language = "English (US)",
volume = "56",
pages = "966--973",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Intraoperative electron radiotherapy as a component of salvage therapy for patients with colorectal cancer and advanced nodal metastases

AU - Haddock, Michael

AU - Nelson, Heidi

AU - Donohue, John H.

AU - Taylor, William E.

AU - Devine, Richard M.

AU - Nagorney, David M.

AU - Wolff, Bruce G.

AU - O'Connell, Michael J.

AU - Gunderson, Leonard L.

PY - 2003/7/15

Y1 - 2003/7/15

N2 - Purpose: To define the survival rates and relapse patterns in patients with isolated advanced nodal metastases secondary to colorectal cancer, treated with curative intent using aggressive combined-modality treatment. Methods and Materials: Forty-eight patients with isolated advanced lymph node metastases secondary to colorectal cancer received intraoperative radiotherapy as part of curative-intent treatment. Forty-seven patients also received external beam radiotherapy (EBRT). Chemotherapy was delivered concomitantly with EBRT in 35 patients. The median intraoperative radiotherapy dose was 1250 cGy. End points included local failure within the EBRT field, central failure within the intraoperative radiotherapy field, distant metastases, survival, and toxicity. Results: The median survival time and 5-year survival rate were 35 months and 34%, respectively. At 3 years, the local control and central control rates were 81% and 93%, respectively. Macroscopically complete resection and colonic primary site were predictors of survival and disease control. The median survival time and 5-year survival rate in patients with colonic primary sites and macroscopically complete resection were 53 months and 49%, respectively. Intraoperative radiotherapy-related neuropathy occurred in 3 patients and ureteral fibrosis in 1. Conclusion: With aggressive combined-modality therapy that includes intraoperative radiotherapy, long-term survival is achievable in colorectal cancer patients presenting with nodal relapse or advanced nodal disease. Survival and disease control rates are highest in those without gross residual disease.

AB - Purpose: To define the survival rates and relapse patterns in patients with isolated advanced nodal metastases secondary to colorectal cancer, treated with curative intent using aggressive combined-modality treatment. Methods and Materials: Forty-eight patients with isolated advanced lymph node metastases secondary to colorectal cancer received intraoperative radiotherapy as part of curative-intent treatment. Forty-seven patients also received external beam radiotherapy (EBRT). Chemotherapy was delivered concomitantly with EBRT in 35 patients. The median intraoperative radiotherapy dose was 1250 cGy. End points included local failure within the EBRT field, central failure within the intraoperative radiotherapy field, distant metastases, survival, and toxicity. Results: The median survival time and 5-year survival rate were 35 months and 34%, respectively. At 3 years, the local control and central control rates were 81% and 93%, respectively. Macroscopically complete resection and colonic primary site were predictors of survival and disease control. The median survival time and 5-year survival rate in patients with colonic primary sites and macroscopically complete resection were 53 months and 49%, respectively. Intraoperative radiotherapy-related neuropathy occurred in 3 patients and ureteral fibrosis in 1. Conclusion: With aggressive combined-modality therapy that includes intraoperative radiotherapy, long-term survival is achievable in colorectal cancer patients presenting with nodal relapse or advanced nodal disease. Survival and disease control rates are highest in those without gross residual disease.

KW - Colorectal cancer

KW - Combined-modality therapy

KW - Nodal metastases

KW - Radiotherapy

UR - http://www.scopus.com/inward/record.url?scp=0038048223&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038048223&partnerID=8YFLogxK

U2 - 10.1016/S0360-3016(03)00189-5

DO - 10.1016/S0360-3016(03)00189-5

M3 - Article

VL - 56

SP - 966

EP - 973

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 4

ER -