Would you recommend the addition of radiation to neoadjuvant chemotherapy in unresectable cT4b sigmoid adenocarcinoma (at or above the peritoneal reflection) adherent to the bladder?

Assume for this discussion: ECOG 0-1, life expectancy > 10

How would nodal status influence your recommendation?

Reference: Hawkins et al., PMID 30017250

Answer from: Radiation Oncologist at Academic Institution

Yes. It’s unresectable in the pelvis. This is not an uncommon scenario. I haven’t found it any more problematic than treating a rectal cancer invading the bladder.

Comments

Radiation Oncologist at University of North Carolina
I was hoping you may be able to comment more on th...

Radiation Oncologist at Washington University School of Medicine
I agree that limited adherence to the bladder does...

Radiation Oncologist at Brigham and Women's Hospital
My approach is identical to that described by Dr. ...

Radiation Oncologist at University of North Carolina
I am in agreement with what has been stated in reg...

Answer from: Radiation Oncologist at Community Practice

Please see an old series from Tufts University on sigmoid cancer and radiotherapy from Cancer (May 1983) which I wrote.A much greater MGH and Mayo experience over decades of patients was from Dr. @Leonard L. Gunderson, in many articles and book chapters.

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Would you recommend the addition of radiation to neoadjuvant chemotherapy in unresectable cT4b sigmoid adenocarcinoma (at or above the peritoneal reflection) adherent to the bladder?

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