AB053. SOH24AB_227. Safety and efficacy of neo-adjuvant high-dose endorectal brachytherapy in locally advanced rectal cancer: a systematic review
Systematic Review Session

AB053. SOH24AB_227. Safety and efficacy of neo-adjuvant high-dose endorectal brachytherapy in locally advanced rectal cancer: a systematic review

Farah Kazi, Conor Toale, Zarah Shane, Yasir Bashir, Abubakr Rayis, Muhammad Umair, Sean Johnston

Department of Surgery, Midland Regional Hospital Tullamore, Puttaghan, Tullamore, Co. Offaly, Ireland

Background: High-dose brachytherapy has an emerging role in the definitive treatment of early rectal cancer, and for patients with more advanced disease who are not fit for operative intervention. High-dose endorectal brachytherapy (HDREBT) has also been employed as a ‘boost’ strategy for patients with locally advanced disease undergoing external-beam radiotherapy and chemotherapy. The aim of this review was to collate the current literature with regards to the safety and efficacy of HDREBT in locally advanced rectal adenocarcinoma.

Methods: PubMed, EMBASE, Cochrane Library and Web of Science databases were searched using a combination of Medical Subject Headings (MeSH) and free-text terms, according to the Preferred Items for Reporting Systematic Reviews and Meta-Analyses (PRISMA) guidelines 2020. Articles were sought reporting safety, clinical and oncological outcomes for patients undergoing neoadjuvant HDREBT.

Results: Of 1,728 records on initial search, 27 were ultimately included in a narrative synthesis. HDREBT is associated with high rates of tumour regression and complete pathological response, with acceptable safety outcomes when combined with established chemo-radiotherapy regimens. Rates of reported pathological complete response range from 18-90% using a combined chemoradiotherapy + HDREBT boost approach.

Conclusions: High-dose rate endorectal brachytherapy may represent a safe and effective method of improving oncological outcomes in patients with locally advanced rectal cancer undergoing neo-adjuvant treatment. Future studies will be required to standardise dosing and timing regimens.

Keywords: Brachytherapy; efficacy; rectal cancer; safety; surgery; colorectal

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab053
Cite this abstract as: Kazi F, Toale C, Shane Z, Bashir Y, Rayis A, Umair M, Johnston S. AB053. SOH24AB_227. Safety and efficacy of neo-adjuvant high-dose endorectal brachytherapy in locally advanced rectal cancer: a systematic review. Mesentery Peritoneum 2024;8:AB053.

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