title: Is restaging with chest and abdominal CT scan after neoadjuvant chemoradiotherapy for locally advanced rectal cancer necessary?
abstract: BACKGROUND
  There is no evidence regarding restaging of patients with locally advanced rectal cancer after a long course of neoadjuvant radiotherapy with or without chemotherapy. This study evaluated the value of restaging with chest and abdominal computed tomographic (CT) scan after radiotherapy.
  
  
  METHODS
  Between January 2000 and December 2010, all newly diagnosed patients in our tertiary referral hospital, who underwent a long course of radiotherapy for locally advanced rectal cancer, were analyzed. Patients were only included if they had chest and abdominal imaging before and after radiotherapy treatment.
  
  
  RESULTS
  A total of 153 patients who met the inclusion criteria and were treated with curative intent were included. A change in treatment strategy due to new findings on the CT scan after radiotherapy was observed in 18 (12%) of 153 patients. Twelve patients (8%) were spared rectal surgery due to progressive metastatic disease.
  
  
  CONCLUSIONS
  Restaging with a chest and abdominal CT scan after radiotherapy for locally advanced rectal cancer is advisable because additional findings may alter the treatment strategy.
authors.affiliation: Department of Surgical Oncology, Erasmus MC, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. n.ayez@erasmusmc.nl
authors.forename: Ninos
authors.initials: N
authors.lastname: Ayez
authors.forename: Wijnand J
authors.initials: WJ
authors.lastname: Alberda
authors.forename: Jacobus W A
authors.initials: JW
authors.lastname: Burger
authors.forename: Alexander M M
authors.initials: AM
authors.lastname: Eggermont
authors.forename: Joost J M E
authors.initials: JJ
authors.lastname: Nuyttens
authors.forename: Roy S
authors.initials: RS
authors.lastname: Dwarkasing
authors.forename: François E J A
authors.initials: FE
authors.lastname: Willemssen
authors.forename: Cornelis
authors.initials: C
authors.lastname: Verhoef
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000556:secondary / Q000628:therapy; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000069287:Capecitabine; D059186:Chemoradiotherapy, Adjuvant; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019583:Dose Fractionation, Radiation; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil