Mantello Giovanna, Galofaro Elena, Bisello Silvia, Chiloiro Giuditta, Romano Angela, Caravatta Luciana, Gambacorta Maria Antonietta
Radiotherapy Department, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy.
Departments of Radiation Oncology, Fondazione Policlinico Universitario A.Gemelli IRCCS, 00168 Roma, Italy.
Cancers (Basel). 2023 Oct 3;15(19):4838. doi: 10.3390/cancers15194838.
Radiotherapy (RT) plays an important role in the treatment of patients with previously irradiated locally recurrent rectal cancer (LRRC). Over the years, numerous technologies and different types of RT have emerged. The aim of our systematic literature review was to determine whether the new techniques have led to improvements in both outcomes and toxicities.
A computerized search was performed by MEDLINE and the Cochrane database. The studies reported data from patients treated with carbon ion radiotherapy (CIRT), intensity-modulated photon radiotherapy (IMRT), and stereotactic radiotherapy (SBRT).
Seven publications of the 126 titles/abstracts that emerged from our search met the inclusion criteria and presented outcomes of 230 patients. OS was reported with rates of 90.0% and 73.0% at 1 and 2 years, respectively; LC was 89.0% and 71.6% at 1 and 2 years after re-RT, respectively. Toxicity data vary widely, with emphasis on acute and chronic gastrointestinal and urogenital toxicity, even with modern techniques.
data on toxicity and outcomes of re-RT for LRRC with new technologies are promising compared with 3D techniques. Comparative studies are needed to define the best technique, also in relation to the site of recurrence.
放射治疗（RT）在既往接受过放疗的局部复发性直肠癌（LRRC）患者的治疗中发挥着重要作用。多年来，出现了众多技术和不同类型的放射治疗。我们进行系统文献综述的目的是确定这些新技术是否在疗效和毒性方面均有改善。
通过MEDLINE和Cochrane数据库进行计算机检索。纳入的研究报告了接受碳离子放疗（CIRT）、调强光子放疗（IMRT）和立体定向放疗（SBRT）患者的数据。
在我们检索出的126篇标题/摘要中，有7篇出版物符合纳入标准，并呈现了230例患者的治疗结果。报告的1年和2年总生存率（OS）分别为90.0%和73.0%；再程放疗后1年和2年的局部控制率（LC）分别为89.0%和71.6%。毒性数据差异很大，重点是急性和慢性胃肠道及泌尿生殖系统毒性，即使采用现代技术也是如此。
与三维技术相比，新技术用于LRRC再程放疗的毒性和疗效数据很有前景。需要进行比较研究以确定最佳技术，同时也需考虑复发部位。
