Henning Jonathan, Choo Sylvia, Singh Pranit, Redler Gage, Palm Russell F
Radiation Oncology, University of South Florida Morsani College of Medicine, Tampa, USA.
Radiation Oncology, Moffitt Cancer Center, Tampa, USA.
Cureus. 2024 Sep 12;16(9):e69264. doi: 10.7759/cureus.69264. eCollection 2024 Sep.
Rectal cancer is a highly prevalent malignancy with an increasing number of treatment strategies and sequencing. Short-course radiotherapy (SCRT) combined with chemotherapy has shown to be a feasible treatment option for non-metastatic disease within the total neoadjuvant therapy paradigm. In contrast to conventionally fractionated chemoradiation, SCRT carries less logistical burden and reduces time off systemic therapy, which is particularly beneficial for patients with metastatic disease. We present a case of a 42-year-old male with metastatic rectal cancer who received SCRT using CT-based adaptive radiation, delivering 25 Gy to the pelvis with a simultaneous integrated boost of 30 Gy to the rectal tumor over five treatments. CT-based adaptive radiation was effective and well-tolerated and offers a pathway towards isotoxic radiotherapy dose escalation for patients considered to be inoperable. This case demonstrates the integration of adaptive SCRT as a promising strategy for rectal cancer.
直肠癌是一种高度常见的恶性肿瘤，其治疗策略和治疗顺序不断增加。短程放疗（SCRT）联合化疗已被证明是全新辅助治疗模式下非转移性疾病的一种可行治疗选择。与传统分割放化疗相比，SCRT的后勤负担较小，且减少了全身治疗的中断时间，这对转移性疾病患者尤为有益。我们报告一例42岁转移性直肠癌男性患者，其接受了基于CT的自适应放疗的SCRT，在五次治疗中向盆腔给予25 Gy的剂量，同时对直肠肿瘤同步加量至30 Gy。基于CT的自适应放疗有效且耐受性良好，为被认为无法手术的患者提供了一条实现等毒性放疗剂量递增的途径。该病例证明了自适应SCRT作为一种有前景的直肠癌治疗策略的整合应用。
