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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1459024

Could Elective Nodal Irradiation for Locally Advanced Rectal Cancer Be Omitted in the Context of Total Neoadjuvant Therapy? An Analysis of the Recurrence Sites of Rectal Cancer

Provisionally accepted
Linlin Xiao Linlin Xiao Shiyu Zhuo Shiyu Zhuo Yuanhang Gao Yuanhang Gao Jingyi Sun Jingyi Sun Yuting Xiao Yuting Xiao Lu Wang Lu Wang Xuan Wang Xuan Wang Fuyin Qu Fuyin Qu Ming Liu Ming Liu Yi Wang Yi Wang Chao Gao Chao Gao Jun Wang Jun Wang Fengpeng Wu Fengpeng Wu *
  • Fourth Hospital of Hebei Medical University, Shijiazhuang, China

The final, formatted version of the article will be published soon.

    Purpose：This study aims to optimize neoadjuvant radiotherapy target area for locally advanced rectal cancer (LARC) patients undergoing total neoadjuvant therapy (TNT) by examining local recurrence patterns.We retrospectively analyzed the clinical data of rectal cancer patients who undergone local recurrence after surgery. Recurrence sites were categorized and compared with initial diagnosis imaging, focusing on visible and suspicious lesions.Results: Of the 126 patients who met our criteria, 186 lesions were analyzed. Within these, 75.40% of cases (95/126) and 83.33% of lesions (155/186) were located within the pelvic cavity. Conversely, 3.97% of cases (5/126) and 3.33% of lesions (6/186) occurred outside the pelvic cavity. Additionally, 20.63% of cases (26/126) and 13.44% of lesions (25/186) were found in both regions. Recurrences were predominantly observed in mesenteric regions (MR) (40.86%, 76/186) and presacral regions (PR) (32.26%, 60/186). In addition, 86.51% of patients (109/126) had recurrent lesions in HRA and the suspected lesions areas. Further analysis showed that initial CEA levels and adjuvant therapy types were identified as independent predictors for recurrence in MR/PR and initially suspected lesions. 86.51% of patients had recurrent lesions in HRA and the suspected lesions areasThe MR, PR, and areas of initial suspicious lesions are high-risk zones for post-surgical recurrence of LARC. Exploratory study of involved-field irradiation (IFI) can be carried out in the context of TNT in LARC.

    Keywords: Locally advanced rectal cancer, recurrence location, radiotherapy target area, Involved-field irradiation, Total neoadjuvant therapy

    Received: 10 Jul 2024; Accepted: 06 Nov 2024.

    Copyright: © 2024 Xiao, Zhuo, Gao, Sun, Xiao, Wang, Wang, Qu, Liu, Wang, Gao, Wang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Fengpeng Wu, Fourth Hospital of Hebei Medical University, Shijiazhuang, China

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