Pelvic Reirradiation for the Treatment of Locally Recurrent Rectal Cancer

Purpose of review: This study aims to summarize the literature on pelvic reirradiation for the treatment of locally recurrent rectal cancer. Symptom palliation, rates of local progression after reirradiation with or without surgery, overall survival, and toxicity outcomes are discussed. Recent findings: The majority of patients received total doses of 30–40 Gy given in 1.2 or 1.5 Gy twice-daily fractions. Treatment evolved over time to include more conformal fields. The overall rates of local control generally range from 25 to 70% and surgical salvage after reirradiation was performed in 20–79% of patients. Some studies suggest that patients treated with reirradiation may have a higher rate of a complete R0 resection, which is an important predictor of overall survival. Survival outcomes have improved over time along with increased use of reirradiation. Summary: Pelvic reirradiation can offer effective symptom palliation and be part of a curative salvage treatment strategy for locally recurrent rectal cancer.