Is restaging with chest and abdominal CT scan after neoadjuvant chemoradiotherapy for locally advanced rectal cancer necessary?

Ann Surg Oncol. 2013 Jan;20(1):155-60. doi: 10.1245/s10434-012-2537-6. Epub 2012 Aug 9.

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.

MeSH terms

  • Adenocarcinoma / diagnostic imaging*
  • Adenocarcinoma / secondary
  • Adenocarcinoma / therapy
  • Aged
  • Antimetabolites, Antineoplastic / therapeutic use
  • Capecitabine
  • Chemoradiotherapy, Adjuvant
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / therapeutic use
  • Dose Fractionation, Radiation
  • Female
  • Fluorouracil / analogs & derivatives
  • Fluorouracil / therapeutic use
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / secondary
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / secondary
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Radiography, Abdominal*
  • Radiography, Thoracic*
  • Rectal Neoplasms / diagnostic imaging*
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / therapy
  • Rectum / surgery
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Antimetabolites, Antineoplastic
  • Deoxycytidine
  • Capecitabine
  • Fluorouracil