J Korean Soc Ther Radiol Oncol.  2010 Sep;28(3):133-140. 10.3857/jkstro.2010.28.3.133.

Palliative Irradiation Using Helical Tomotherapy in Recurrent Pelvic Tumors with Prior Radiotherapy

• Kay CS
• Yoo EJ
• Kim JH
• Ro DY
• Kim KJ

• KMID: 1460145
• DOI: http://doi.org/10.3857/jkstro.2010.28.3.133

Abstract

PURPOSE
We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation.
MATERIALS AND METHODS
Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0).
RESULTS
The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed.
CONCLUSION
Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

Keyword

Recurrent pelvic tumor; Irradiation; Helical tomotherapy; Duration of local disease control

MeSH Terms

Follow-Up Studies
Humans
Radiotherapy, Intensity-Modulated
Rectal Neoplasms
Retrospective Studies
Tumor Burden
Uterine Cervical Neoplasms