Background: Radiotherapy (RT) plays an important role in the treatment of patients with previously irradiated locally recurrent rectal cancer (LRRC). Over the years, numerous technologies and different types of RT have emerged. The aim of our systematic literature review was to determine whether the new techniques have led to improvements in both outcomes and toxicities. Methods: A computerized search was performed by MEDLINE and the Cochrane database. The studies reported data from patients treated with carbon ion radiotherapy (CIRT), intensity-modulated photon radiotherapy (IMRT), and stereotactic radiotherapy (SBRT). Results: Seven publications of the 126 titles/abstracts that emerged from our search met the inclusion criteria and presented outcomes of 230 patients. OS was reported with rates of 90.0% and 73.0% at 1 and 2 years, respectively; LC was 89.0% and 71.6% at 1 and 2 years after re-RT, respectively. Toxicity data vary widely, with emphasis on acute and chronic gastrointestinal and urogenital toxicity, even with modern techniques. Conclusion: data on toxicity and outcomes of re-RT for LRRC with new technologies are promising compared with 3D techniques. Comparative studies are needed to define the best technique, also in relation to the site of recurrence.
背景：放射治疗（RT）在既往接受过照射的局部复发性直肠癌（LRRC）患者的治疗中扮演重要角色。多年来，多种技术和不同类型的放射治疗相继出现。本系统性文献综述旨在探讨新技术是否在疗效和毒性方面均带来改善。 方法：通过MEDLINE和Cochrane数据库进行计算机检索。研究报道了接受碳离子放射治疗（CIRT）、调强光子放射治疗（IMRT）和立体定向放射治疗（SBRT）的患者数据。 结果：检索获得的126篇文献标题/摘要中，有7篇符合纳入标准，共涉及230例患者。总生存率（OS）在1年和2年分别为90.0%和73.0%；局部控制率（LC）在再程放疗后1年和2年分别为89.0%和71.6%。毒性数据差异较大，重点关注急性和慢性胃肠道及泌尿生殖系统毒性，即使采用现代技术亦存在此类问题。 结论：与三维技术相比，采用新技术对LRRC进行再程放疗的毒性和疗效数据表现出良好前景。仍需开展比较性研究以确定最佳技术，并需结合复发部位进行综合分析。
Modern Techniques in Re-Irradiation for Locally Recurrent Rectal Cancer: A Systematic Review
肿瘤(癌症)患者之家