Neoadjuvant volumetric modulated arc radiochemotherapy with a simultaneous integrated boost technique for the treatment of locally advanced rectal cancer

Natalia Jankarashvili


Locally advanced rectal cancer includes cancers which are extending through the rectal wall and/or regional lymph nodes are involved. Preoperative chemoradiotherapy with radiation doses up to 45-50 Gy and radical transabdominal surgery are considered as best treatment options in such cases, but dose escalation to the gross tumor using simultaneous integrated boost technique has been introduced recently. We present a case of locally advanced rectal cancer treated with simultaneous integrated boost, capecitabine and surgical intervention.


simultaneous integrated boost technique, locally advanced rectal cancer, neoadjuvant chemoradiation.

Full Text:



Atthaphorn Trakarnsanga, Suthinee Ithimakin, Martin R Weiser. Treatment of locally advanced rectal cancer: Controversies and questions. World J Gastroenterol 18(39): 5521–5532, 2012.

Rob Glynne-Jones, Mark Harrison. Locally Advanced Rectal Cancer: What Is the Evidence for Induction Chemoradiation. The Oncologist vol. 12 no. 11: 1309-1318, 2007.

Krishnan S, Janjan NA, Skibber JM, et al. Phase II study of capecitabine (Xeloda) and concomitant boost radiotherapy in patients with locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 66: 762-771, 2006.

Movsas B, Diratzouian H, Hanlon A, Cooper H, Freedman G, Konski A, Sigurdson E, Hoffman J, Meropol NJ, Weiner LM, et al. Phase II trial of preoperative chemoradiation with a hyper fractionated radiation boost in locally advanced rectal cancer. Am J Clin Oncol. 29(5): 435-41, 2006.

Lupattelli M, Matrone F, Gambacorta MA, Osti M, Macchia G, Palazzari E, Nicosia L, Navarria F, Chiloiro G, Valentini V, Aristei C, De Paoli A. Preoperative intensity-modulated radiotherapy with a simultaneous integrated boost combined with Capecitabine in locally advanced rectal cancer: short-term results of a multicentric study. Radiat Oncol. 12(1): 139, 2017.

Palma D, Vollans E, James K, Nakano S, Moiseenko V, Shaffer R, McKenzie M, Morris J, Otto K. Volumetric modulated arc therapy for delivery of prostate radiotherapy: comparison with intensity-modulated radiotherapy and three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys. 15;72(4):996-1001, 2008.

Zhang T, Liang ZW, Han J, Bi JP, Yang ZY, Ma H. Double-arc volumetric modulated therapy improves dose distribution compared to static gantry IMRT and 3D conformal radiotherapy for adjuvant therapy of gastric cancer. Radiat Oncol. 19 (10):114, 2015.

Münch S, Aichmeier S, Hapfelmeier A, Duma MN, Oechsner M, Feith M, Combs SE, Habermehl D. Comparison of dosimetric parameters and toxicity in esophageal cancer patients undergoing 3D conformal radiotherapy or VMAT. Strahlenther Onkol. 192(10):722-9, 2016.

Wang XJ, Chi P, Lin HM, Lu XR, Huang Y, Xu ZB, Huang SH, Sun YW, Ye DX. Effects of neoadjuvant chemoradiotherapy on the rates of sphincter preserving surgery in lower rectal cancer and analysis of their prognostic factors. Zhonghua Wai Ke Za Zhi. 1;54(6):419-423, 2016.

Davis AM, O'Sullivan B, Turcotte R, Bell R, Catton C, Chabot P, Wunder J, Hammond A, Benk V, Kandel R, Goddard K, Freeman C, Sadura A, Zee B, Day A, Tu D, Pater J, Late radiation morbidity following randomization to preoperative versus postoperative radiotherapy in extremity soft tissue sarcoma; Radiother Oncol. 75(1):48-53, 2005.

Machtay M, Moughan J, Trotti A, Garden AS, Weber RS, Cooper JS, Forastiere A, Ang KK. Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol. 26(21):3582-9, 2008.



  • There are currently no refbacks.


Become a REVIEWER 


ISSN: 2346-8491 (online)