Would you offer pelvic re-irradiation in the setting of locally recurrent anal cancer in the presacral region?
Patient had previous 54 Gy in 25 fx to anal cancer with treatment of pelvic lymphatics, now with presacral local recurrence. He had a resection of recurrence with R2 margins, clips were placed.
Answer from: Radiation Oncologist at Academic Institution
Re-irradiation is always tricky. I don't want to miss a chance to help someone, and I really don't want to hurt someone. With re-irradiation, the devil is in the details. If it is small, in a spot where symptomatic toxicity is less likely, and a long period of time has passed since the original chem...
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Radiation Oncologist at Allegheny Health Network If in the presacral space and not adjacent previou...
Answer from: Radiation Oncologist at Academic Institution
This is a complicated topic with a number of different options. Aggressiveness of treatment relates both to disease status and timing of prior lines of therapy. Also, as Dr. Schroeder and Dr. Horne have pointed out, the size and location of the mass are important. Our preference is to retreat prior ...
If in the presacral space and not adjacent previou...