BACKGROUND: Local recurrence after @entity5 treatment occurs in    5% to 10% of @entity1 . Neoadjuvant (chemo)radiotherapy for primary @entity5 renders treatment of recurrent disease more difficult. OBJECTIVE: The purpose of this study was to review contemporary multimodality therapies, including their outcome, for locally recurrent @entity189 after (chemo)radiotherapy and complete surgical resection of primary @entity5 . DATA SOURCES: A comprehensive literature search of PubMed and EMBASE was performed. STUDY SELECTION: All English language articles presenting original @entity1 data regarding treatment and the respective outcome of previously irradiated locally recurrent @entity5 were included. INTERVENTIONS: All of the treatment modalities for locally recurrent @entity5 were reviewed. MAIN OUTCOME MEASURES: Primary outcome parameters were local control, metastasis-free survival, and overall survival. Secondary outcome parameters were perioperative morbidity and mortality, and prognostic factors for treatment outcome. RESULTS: Of 854 studies, 9 studies and 474 @entity1 with locally recurrent @entity189 were included. Various treatment regimens were used, most with curative intent. Reirradiation was composed of (neo-)adjuvant external beam radiotherapy (with or without concurrent chemotherapy), additional intraoperative radiotherapy, or intraoperative radiotherapy only. Surgical technique highly varied, depending on the extent of the lesion. @entity137 , perioperative morbidity, and mortality were generally acceptable. Outcome was better after curative intent treatment, any surgical resection, and R0 resections in particular. Moreover, reirradiation is associated with increased complete resection rates, which in turn positively affected local control and overall survival. LIMITATIONS: Most studies were retrospectively designed, with highly variable therapies, @entity1 populations, and duration of follow-up. CONCLUSIONS: A complete resection is the most important prognostic factor and should be the goal of treatment in locally recurrent @entity189 . Reirradiation seems safe and of additional value in reaching a complete resection. Considering the available evidence, at present reirradiation should be given on a case-specific basis, with all of the @entity1 entering an international prospective database.

Treatment of Locally Recurrent XXXX in Previously (Chemo)Irradiated @entity1 : A Review.

@entity5 :: ('MESH:D009369', 'Disease') :: ['rectal cancer'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity137 :: ('MESH:D064420', 'Disease') :: ['Radiation toxicity'] @entity189 :: ('MESH:D002277', 'Disease') :: ['rectal carcinoma']
@entity189 :: (MESH:D002277,Disease) :: ['Rectal Carcinoma']
