In what situations do you recommend adjuvant radiotherapy for colon cancer?

How do you deliver it safely? Even when there is adherence to other organs (T4) or positive margins, I'm hesitant to offer RT because the volumes are often large and I've seen significant late toxicities.

Answer from: Radiation Oncologist at Academic Institution

It is appropriate to be cautious when considering the use of CXRT in patients with resected colon cancer. The main reason is that in the post-operative setting there is almost always fixed small bowel adherent to the tumor bed. For this reason, one may not be able to deliver a high enough dose to pr...

Comments

Radiation Oncologist at Providence St Mary Cancer Center
Thank you for your answer. Would you include the b...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
Surgeons have no reason to skimp on the mucosal ma...

Answer from: Radiation Oncologist at Academic Institution

I agree with Chris. I favor adjunctive RT (preferably pre-operative) for T4 or compromised margin T3 colon cancers. The Martenson study did not track local control, so there may actually have been an undetected LC benefit. In treating colon cancer I do not attempt to cover an elective nodal volum...

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In what situations do you recommend adjuvant radiotherapy for colon cancer?

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