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Topics:
Radiation Oncology • Gastrointestinal Cancers • Medical Oncology • Inflammatory Bowel Disease
In patients with active IBD and rectal cancer, do you take any precautions before starting TNT?
Would you wait until bowel symptoms are controlled or ever pursue diversion before starting treatment?
Answer from: Radiation Oncologist at Academic Institution
First, I would be sure that the patient really needs TNT. If a patient has active inflammatory bowel disease, they will not tolerate TNT very well. If a patient has inactive IBD, there is not likely to be much added morbidity. I would be very hesitant to use TNT if someone has really active IBD. The...
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Answer from: Radiation Oncologist at Academic Institution
I agree with @Joel's comments and would add that the value of the current widespread trend of the use of TNT is in the realm of non-operative management. If that is not the plan, giving all the treatment upfront is often over-treatment. I would make sure there is an indication for radiation after co...