title: Radiotherapy for locally recurrent rectal cancer treated with surgery alone as the initial treatment.
abstract: OBJECTIVE
  Although the technical developments of radiotherapy have been remarkable, there are currently few reports on the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as initial treatment in this three-dimensional conformal radiotherapy era. Thus, we retrospectively evaluated the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as the initial treatment.
  
  
  METHODS
  Thirty-two patients who underwent radiotherapy were enrolled in this study. The dose per fraction was 2.0-3.5 Gy. Because the treatment schedule was variable, the biological effective dose (BED) was calculated.
  
  
  RESULTS
  Local control (LC) and overall survival (OS) rates from the completion of radiotherapy were calculated. The 1-, 2-, 3-, 4-, and 5-year LC rates were 51.5%, 24.5%, 19.6%, 19.6%, and 13.1%, respectively. LC rates were significantly higher for the high BED group (≥75 Gy10) than for the lower BED group (<75 Gy10). All patients who reported pain achieved pain relief. The duration of pain relief was significantly higher for the high BED group than for the lower BED group. The 1-, 2-, 3-, 4-, and 5-year OS rates were 82.6%, 56.5%, 45.2%, 38.7%, and 23.2%, respectively. There was a trend toward higher OS rates in with higher BED group compared to lower BED group.
  
  
  CONCLUSIONS
  For patients with unresectable locally recurrent rectal cancer treated with surgery alone, radiotherapy is effective treatment. The prescribed BED should be more than 75 Gy10, if the dose to the organ at risk is within acceptable levels.
authors.affiliation: Department of Radiology, Gifu University, Gifu, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Radiology, Gifu University, Gifu, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Radiology, Gifu University, Gifu, Japan.
authors.forename: Kae
authors.initials: K
authors.lastname: Hachiya
authors.affiliation: Department of Radiology, Gifu University, Gifu, Japan.
authors.forename: Sunaho
authors.initials: S
authors.lastname: Okada
authors.affiliation: Division of Radiation Oncology, Gifu University Hospital, Gifu, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kitahara
authors.affiliation: Division of Radiation Oncology, Gifu University Hospital, Gifu, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Matsuyama
authors.affiliation: Department of Radiology, Gifu University, Gifu, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Matsuo
keywords: Locally recurrent of rectal cancer; Radiotherapy; Rectal cancer