The role of omental flap transposition in patients with locoregional recurrent rectal cancer treated with reirradiation.
OBJECTIVE
We performed reirradiation after omental flap transposition (OFT) in patients with locoregional recurrent rectal cancer (LRRC) and evaluated the effect of OFT on the irradiated small bowel by comparing the displacement of the small bowel from the radiation field before and after OFT.


METHODS
Between October 2005 and October 2008, this study included 12 patients with LRRC who had previously received radiotherapy. To evaluate the effect of OFT on the irradiated volume of the small bowel and bladder, we measured the closest distances between the small bowel and the tumor or tumor bed (distance(SB)) and between the bladder and tumor or tumor bed (distance(BL)) before and after OFT, respectively.


RESULTS
The median distance(SB) before and after OFT was 5 and 30  mm, respectively (P < 0.001). The median distance(BL) before and after OFT was 10 and 23  mm, respectively (P = 0.002). The respective overall survival and local control rates at 3 years were 50.9% and 54.6%, respectively. No severe complication occurred of grade 3 or higher involving the small bowel or bladder.


CONCLUSIONS
In our study, OFT effectively excluded small bowel from the radiation field. In addition, selective reirradiation after OFT was feasible for patients with LRRC.
Kim
Tae Hyun
TH
Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Kim
Dae Yong
DY
Jung
Kyung Hae
KH
Hong
Yong Sang
YS
Kim
Sun Young
SY
Park
Ji Won
JW
Lim
Seok-Byung
SB
Choi
Hyo Seong
HS
Jeong
Seung-Yong
SY
Oh
Jae Hwan
JH
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007421:Intestine, Small / Q000473:pathology / Q000528:radiation effects* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D009367:Neoplasm Staging; D009852:Omentum / Q000601:surgery*; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D013524:Surgical Flaps; D015996:Survival Rate; D016896:Treatment Outcome