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Radiation Oncology
Published in: Radiation Oncology 1/2011

Open Access 01-12-2011 | Research

Robotic image-guided reirradiation of lateral pelvic recurrences: preliminary results

Authors: Sylvain Dewas, Jean Emmanuel Bibault, Xavier Mirabel, Philippe Nickers, Bernard Castelain, Thomas Lacornerie, Hajer Jarraya, Eric Lartigau

Published in: Radiation Oncology | Issue 1/2011

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Abstract

Background

The first-line treatment of a pelvic recurrence in a previously irradiated area is surgery. Unfortunately, few patients are deemed operable, often due to the location of the recurrence, usually too close to the iliac vessels, or the associated surgical morbidity. The objective of this study is to test the viability of robotic image-guided radiotherapy as an alternative treatment in inoperable cases.

Methods

Sixteen patients previously treated with radiotherapy were reirradiated with CyberKnife® for lateral pelvic lesions. Recurrences of primary rectal cancer (4 patients), anal canal (6), uterine cervix cancer (4), endometrial cancer (1), and bladder carcinoma (1) were treated. The median dose of the previous treatment was 45 Gy (EqD2 range: 20 to 96 Gy). A total dose of 36 Gy in six fractions was delivered with the CyberKnife over three weeks. The responses were evaluated according to RECIST criteria.

Results

Median follow-up was 10.6 months (1.9 to 20.5 months). The actuarial local control rate was 51.4% at one year. Median disease-free survival was 8.3 months after CyberKnife treatment. The actuarial one-year survival rate was 46%. Acute tolerance was limited to digestive grade 1 and 2 toxicities.

Conclusions

Robotic stereotactic radiotherapy can offer a short and well-tolerated treatment for lateral pelvic recurrences in previously irradiated areas in patients otherwise not treatable. Efficacy and toxicity need to be evaluated over the long term, but initial results are encouraging.
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Metadata
Title
Robotic image-guided reirradiation of lateral pelvic recurrences: preliminary results
Authors
Sylvain Dewas
Jean Emmanuel Bibault
Xavier Mirabel
Philippe Nickers
Bernard Castelain
Thomas Lacornerie
Hajer Jarraya
Eric Lartigau
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2011
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-6-77

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