Radiation Oncology

Colorectal Cancer

Questions discussed in this category

When treating a high rectal cancer, does your coverage of the caudal mesorectum depend on the surgical plan?

How do you construct the caudal extent of your volume - for example, pelvic floor via RTOG/international consensus vs 4 cm below gross disease via RAP...

2 Answers available

How was treatment response assessed on the PROSPECT trial?

Specifically, on re-staging imaging, would the tumor regression be strictly defined by reduction in cranio-caudal direction only, or would other measu...

1 Answer available

Would you offer chemoRT to a colon cancer case with a resected polyp with positive margins if the patient wishes to avoid surgery?

Would chemoRT be preferred over surgery if there is LVI or PNI?

3 Answers available

What are your top takeaways from ASCO GI 2023?

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...

8 Answers available

When treating rectal cancer with neoadjuvant chemoRT, is it appropriate to employ IMRT planning, rather than 3D conformal, for all cases, or should IMRT be reserved for special circumstances?

3 Answers available

What are your top takeaways in GI Cancers from ASCO 2023?

6 Answers available

Would you recommend adjuvant capecitabine and radiation in addition to adjuvant FOLFOX for a patient with resected pT3N2 rectosigmoid adenocarcinoma with other high-risk pathologic features?

In general: when would you recommend adjuvant radiation and capecitabine for a colon cancer?

2 Answers available

In what setting do you omit adjuvant radiation therapy in a T3N0 rectal cancer?

The NCCN guidelines categorically recommend adjuvant XRT for a cT1-2N0 rectal adenocarcinoma upstaged to a pT3N0, yet there are multipl...

1 Answer available

How would you approach a patient with clinical T3N1 anorectal malignant melanoma referred by a surgeon for neoadjuvant therapy?

Is there a potential role for concurrent radiation therapy? What if the tumor is BRAF mutated?

2 Answers available

Would you offer adjuvant chemotherapy or radiation to a resected MSS T3N0 high-rectal lesion with low anterior resection without pre-op therapy?

Staging/pre-op MRI only showed mild non-specific thickening.

4 Answers available

How do you manage colorectal tumors that have components in the colon and rectum on MRI?

For example, portion is seen above and below the mesorectal fascia. Do you feel comfortable treating as colon cancer with surgery upfront?

3 Answers available

Is 500 cGy x 5 an appropriate palliative regimen for a patient with a low-lying metastatic rectal cancer with ongoing pain and bleeding despite chemotherapy?

3 Answers available

What are your top takeaways in GI Cancers from ASCO 2022?

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice?

5 Answers available

Following transanal excision with positive margins for for T1 or T2 rectal cancer, is it more appropriate to proceed with APR or attempt sphincter preservation with RT/Chemo?

If RT/chemo is preferred, what is an acceptable final boost dose?

1 Answer available

In what situations can short course RT (5 Gy x 5fx) be used instead of chemoRT for rectal cancer?

6 Answers available

For locally advanced rectal cancer, would you consider utilizing the RAPIDO trial approach of short course radiation followed by neoadjuvant chemotherapy prior to surgery?

Colleagues in surgery have raised concerns about post radiation effects in the pelvis with the ordering of short course RT->chemo ->surgery.

5 Answers available

What is your approach following R1 resection in a patient who has received total neoadjuvant therapy for rectal cancer?

1 Answer available

Which patients with rectal cancer who have not received neoadjuvant treatment do you offer adjuvant radiation to?

Is there a subset of patients you would avoid neoadjuvant CRT and operate first?

3 Answers available

In rectal cancer in patients receiving total neoadjuvant therapy of FOLFOX followed by 5FU-radiation, is there a role for additional adjuvant chemotherapy based on significant residual disease at time of surgery?

1 Answer available

Do you treat rectosigmoid/upper rectal cancers with neoadjuvant chemoradiation?

The German trial included patients with tumors up to 16cm from the anal verge, while the Swedish trial update found no local control benefit for tumor...

5 Answers available

Is there evidence to support routine use of adjuvant chemotherapy for resected rectal cancer treated with pre-operative chemoradiation?

The NCCN seems to make its recommendation based on extrapolation from colon cancer, but those patients are not treated with pre-op chemoRT.

2 Answers available

When do you consider total neoadjuvant therapy (chemotherapy and chemoradiation) for rectal cancer?

1 Answer available

For rectal cancer with solitary liver metastasis, do you recommend neoadjuvant chemoradiation?

Are these patients better candidates for preop chemotherapy alone?

2 Answers available

Do you treat inguinal lymph nodes for rectal cancers involving the anal canal?

The RTOG contouring atlas doesn't give a consensus on this issue.

4 Answers available

Is there a benefit to adjuvant chemotherapy for patients with a solitary liver metastasis from previously treated colorectal cancer?

If so, what is your preferred regimen?

2 Answers available

Would you treat the inguinal nodes in a patient who had an adenocarcinoma excised from the anal canal?

In a lesion <2.5 cm from anal verge arising in a tubulovillous adenoma, does the data from Taylor, et. al. Red Journal 2001 apply?

2 Answers available

For elderly patients with locally advanced rectal cancer who are not candidates for surgery or chemotherapy, what would be an appropriate palliative regimen?

1 Answer available

What dose and upper field border would you use following transanal excision for rectal cancer found to be T2 by final pathology but without LVSI or perineural invasion?

Should standard post operative radiation fields be used, treating up to the L5-S1 interspace? Or is it acceptable to treat a lower field, for ins...

1 Answer available

What is the appropriate treatment for a low lying rectal cancer in the setting of prior definitive prostate IMRT?

Fore example for a T3N0 rectal cancer on EUS?

1 Answer available

Is it possible to palliate presacral recurrences of rectal cancer in patients who previously received neoadjuvant chemoradiation to the rectum?

In the past, I haven't seen great results in palliating the presacral area. The pain is excruciating for many patients. Is there an effective option f...

1 Answer available

For a patient who has undergone preoperative chemoradiation to 50Gy for locally advanced rectal cancer followed by LAR or APR, would you treat a positive margin with radiation therapy?

If so, what dose?

2 Answers available

Has pelvic MRI replaced EUS as the standard of care for rectal cancer staging?

Are there any indications to choose one over the other?

1 Answer available

Papers discussed in this category

International journal of radiation oncology, biology, physics, 2001-11-01

Elective groin irradiation is not indicated for patients with adenocarcinoma of the rectum extending to the anal canal.

Radiat Oncol, 2014-12-23

Is elective inguinal radiotherapy necessary for locally advanced rectal adenocarcinoma invading anal canal?

Lancet (London, England), 2009-03-07

Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial.

J. Clin. Oncol., 2012-06-01

Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years.

Br J Surg, 2006-10-01

Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-11-01

Randomized trial of short-course radiotherapy versus long-course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer: Trans-Tasman Radiation Oncology Group trial 01.04.

International journal of radiation oncology, biology, physics, 2014-03-15

Five fractions of radiation therapy followed by 4 cycles of FOLFOX chemotherapy as preoperative treatment for rectal cancer.

Ann. Surg. Oncol., 2017 May 30

Short-Course Radiotherapy Followed by Neoadjuvant Bevacizumab, Capecitabine, and Oxaliplatin and Subsequent Radical Treatment in Primary Stage IV Rectal Cancer: Long-Term Results of a Phase II Study.

Ann. Oncol., 2019 Jun 13

Long-course preoperative chemoradiation vs. 5 x 5 Gy and consolidation chemotherapy for clinical T4 and fixed clinical T3 rectal cancer: Long-term results of the randomized Polish II study.

Ann. Surg., 2007-11-01

The TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma.

Journal of cancer research and therapeutics, 2011

Stereotactic body radiotherapy for the treatment of presacral recurrences from rectal cancers.

International journal of radiation oncology, biology, physics, 2012-04-01

Reduced acute bowel toxicity in patients treated with intensity-modulated radiotherapy for rectal cancer.

J Can Assoc Radiol, 1975-09-01

The 1975 Gordon Richards Memorial Lecture. Is the Miles operation really necessary for the treatment of rectal cancer?

Int. J. Radiat. Oncol. Biol. Phys., 1995-01-15

Adenocarcinoma of the rectum treated by radical external radiation therapy.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2004-05-15

Impact of T and N stage and treatment on survival and relapse in adjuvant rectal cancer: a pooled analysis.

Diseases of the colon and rectum, 2008-08

Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984.

JAMA oncology, 2018-06-14

Adoption of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer.

J. Clin. Oncol., 2019 Oct 08

Oxaliplatin-Based Adjuvant Chemotherapy for Rectal Cancer After Preoperative Chemoradiotherapy (ADORE): Long-Term Results of a Randomized Controlled Trial.

The New England journal of medicine, 1985-06-06

Prolongation of the disease-free interval in surgically treated rectal carcinoma.

Int. J. Cancer, 2017 Jun 08

What has preoperative radio(chemo)therapy brought to localized rectal cancer patients in terms of perioperative and long-term outcomes over the past decades? A systematic review and meta-analysis based on 41,121 patients.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-01-20

cT3N0 rectal cancer: potential overtreatment with preoperative chemoradiotherapy is warranted.

Lancet (London, England), 2007-12-15

Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study.

Annals of surgery, 1999-07

Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation.

Journal of the National Cancer Institute, 2000-03-01

Randomized trial of postoperative adjuvant chemotherapy with or without radiotherapy for carcinoma of the rectum: National Surgical Adjuvant Breast and Bowel Project Protocol R-02.

Diseases of the colon and rectum, 2009-04

Long-term survival after transanal excision of T1 rectal cancer.

Radiother Oncol, 2012 Nov 28

Outcomes of unselected patients with pathologic T3N0 rectal cancer.

J Gastrointest Oncol,

Patterns of care and outcomes for adjuvant treatment of pT3N0 rectal cancer using the National Cancer Database.

Radiat Oncol J, 2019 Jun 30

Risk factors for locoregional recurrence in patients with pathologic T3N0 rectal cancer with negative resection margin treated by surgery alone.

Radiat Oncol, 2019 Jan 16

Tumor location as an indication for adjuvant radiotherapy in pT3N0 rectal cancer after surgery.

Radiat Oncol, 2014 Jul 22

In the era of total mesorectal excision: adjuvant radiotherapy may be unnecessary for pT3N0 rectal cancer.

Radiat Oncol, 2016 Sep 05

Adjuvant chemoradiotherapy instead of revision radical resection after local excision for high-risk early rectal cancer.

Lancet Oncol, 2020 Dec 07

Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial.

Ann Oncol,

Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.

Lancet Oncol, 2021 Apr 13

Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial.

International journal of radiation oncology, biology, physics, 2011-01-01

Combined modality therapy including intraoperative electron irradiation for locally recurrent colorectal cancer.

International journal of radiation oncology, biology, physics, 1989-02

Long-term survival and patterns of failure after postoperative radiation therapy for subtotally resected rectal adenocarcinoma.

Int J Radiat Oncol Biol Phys,

Radiotherapy does not compensate for positive resection margins in rectal cancer patients: report of a multicenter randomized trial.

N Engl J Med, 2022 Jun 05

PD-1 Blockade in Mismatch Repair-Deficient, Locally Advanced Rectal Cancer.

Lancet Oncol, 2014 Jul 31

FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer (FIRE-3): a randomised, open-label, phase 3 trial.

N Engl J Med, 2022 Jun 04

Circulating Tumor DNA Analysis Guiding Adjuvant Therapy in Stage II Colon Cancer.

J Clin Oncol, 2022 Jun 06

Upfront Modified Fluorouracil, Leucovorin, Oxaliplatin, and Irinotecan Plus Panitumumab Versus Fluorouracil, Leucovorin, and Oxaliplatin Plus Panitumumab for Patients With Wild-Type Metastatic Colorectal Cancer: The Phase III TRIPLETE Study by GONO.

Journal of gastrointestinal oncology, 2017-12

Short course radiation as a component of definitive multidisciplinary treatment for select patients with metastatic rectal adenocarcinoma.

Pract Radiat Oncol, 2022 May 05

Oligometastatic Rectal Adenocarcinoma Treated With Short-Course Radiation Therapy and Chemotherapy With Nonoperative Intent of the Primary for Locoregional Complete Responders.

Pract Radiat Oncol, 2020 Oct 21

Radiation Therapy for Rectal Cancer: Executive Summary of an ASTRO Clinical Practice Guideline.

The New England journal of medicine, 2013-10-31

Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine.

N. Engl. J. Med.,

FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer.

Lancet, 2021 Jun 05

First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial.

Eur J Cancer, 2018 Aug 24

A randomised phase 2 trial of nab-paclitaxel plus gemcitabine with or without capecitabine and cisplatin in locally advanced or borderline resectable pancreatic adenocarcinoma.

NEJM Evidence, 2022 Jun 1

Durvalumab plus Gemcitabine and Cisplatin in Advanced Biliary Tract Cancer

Annals of surgery, 2006-12

The role of abdominoperineal resection as surgical therapy for anorectal melanoma.

Annals of surgical oncology, 2013-07

Locoregional lymphadenectomy in the surgical management of anorectal melanoma.

Annals of surgical oncology, 2010-01

Practice patterns and outcomes for anorectal melanoma in the USA, reviewing three decades of treatment: is more extensive surgical resection beneficial in all patients?

Diseases of the colon and rectum, 1999-09

Changing epidemiology of anorectal melanoma.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2006-09-10

Somatic activation of KIT in distinct subtypes of melanoma.

Dermatol Pract Concept, 2019 Jan 31

Mutation Status in Primary, Recurrent, and Metastatic Malignant Melanoma and Its Relation to Histopathological Parameters.

Clin Cancer Res, 2013 Jul 05

Phase II randomized trial comparing high-dose IFN-α2b with temozolomide plus cisplatin as systemic adjuvant therapy for resected mucosal melanoma.

N Engl J Med, 2023 Jun 04

Preoperative Treatment of Locally Advanced Rectal Cancer.

Lancet Oncol, 2021 May 04

Trastuzumab deruxtecan (DS-8201) in patients with HER2-expressing metastatic colorectal cancer (DESTINY-CRC01): a multicentre, open-label, phase 2 trial.

Lancet Oncol, 2023 Jun 02

Zanidatamab for HER2-amplified, unresectable, locally advanced or metastatic biliary tract cancer (HERIZON-BTC-01): a multicentre, single-arm, phase 2b study.

Lancet Oncol., 2011 May 17

Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial.

Lancet (London, England), 2009-03-07

Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial.

Ann Surg, 2011 Apr

Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study.

JAMA Oncol, 2019 Jul 01

Safety and Feasibility of Using Magnetic Resonance Imaging Criteria to Identify Patients With "Good Prognosis" Rectal Cancer Eligible for Primary Surgery: The Phase 2 Nonrandomized QuickSilver Clinical Trial.

J Clin Oncol, 2023 Jun 19

Risk-Adapted Neoadjuvant Chemoradiotherapy in Rectal Cancer: Final Report of the OCUM Study.

International journal of radiation oncology, biology, physics, 2010 Jun 18

Three-dimensional analysis of recurrence patterns in rectal cancer: the cranial border in hypofractionated preoperative radiotherapy can be lowered.

Radiation Oncology

Colorectal Cancer

Questions discussed in this category

Papers discussed in this category

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