Effectiveness of Image-Guided Radiotherapy for Locally Advanced Rectal Cancer

Background Image-guided radiotherapy (IGRT) combines precise target visualization with optimal delivery of radiation dose to spare normal tissue from radiation and may potentially reduce side-effects and long-term treatment complications. We have assessed the effectiveness of IGRT for locally advanced rectal cancer. Methods A retrospective review of 22 patients with locally advanced rectal cancer who underwent preoperative chemoradiation was conducted. Results Nineteen patients (median age, 69 years) underwent surgical resection after chemoradiation. All 19 patients achieved complete resection with negative margins. Seven patients (32%) had no residual tumor in the surgical specimen. One patient had grade 4 gastrointestinal toxicity and hematological toxicity probably related to inadvertent overdosing of capecitabine. The median survival for the whole group—patients who had pCR and those who did not have pCR—was 14, 17, and 15 months, respectively. Conclusions Image-guided radiotherapy provided effective treatment for locally advanced rectal cancer with minimal toxicity and should be investigated in future prospective trials.