K. Haustermans MD, PhD

Clinical practice guidelines for the treatment of rectal cancer patients: The Leuven Rectal Cancer Consensus

SUMMARY

The multidisciplinary management of rectal cancer is an evolving field, and these guidelines seek to offer direction for treating this condition. A tailored treatment approach should be based on a multi-disciplinary tumour board discussion taking into account tumour staging, patient performance status, and expectations. Patients with node-negative T1 rectal cancer can be managed by a local excision. In patients with early rectal cancer, primary surgery is the standard-of-care. In some of these patients, an organ-sparing approach by long-course chemoradiotherapy can be an alternative. A total neoadjuvant therapy (TNT)-approach consisting of a combination of (chemo)radiotherapy and chemotherapy is preferred for locally advanced disease.

(BELG J MED ONCOL 2024;18(7):271–278)

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Radiotherapy for metastatic colorectal cancer: When is it worth it?

SUMMARY

Colorectal cancer is a prevalent cancer in Belgium. Unfortunately, many of these patients will develop metastases at some point in their disease. However, given the new therapeutic options, the prognosis of these patients is better than before. Local ablation of metastases is among these therapeutic options. This concept of metastasis-directed therapy (MDT) is generally accepted for oligometastatic disease. It can be accomplished by a multitude of techniques, including surgery, radiofrequency and microwave ablation, but also radiotherapy (RT). This review addressed the rationale and application of RT within this context.

(BELG J MED ONCOL 2022;16(7):336–42)

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The potential of proton therapy in oesophageal cancer treatment

Radiotherapy has become the standard of care in the curative treatment of locally advanced oesophageal cancer. Advanced radiotherapy techniques, such as intensity-modulated radiotherapy, can reduce doses to normal tissues resulting in lower toxicities and an improved outcome. The unique physical features of proton beam therapy has tremendous potential to further spare organs at risk. Besides the clear dosimetric advantages of proton beam therapy in oesophageal cancer, there is evidence that supports a clinical benefit. However, results from prospective randomised trials are awaited. To maximise the cost-effectiveness of this new technology, patient selection for proton beam therapy using validated multifactorial normal tissue complication probability models is suggested. However, this requires international collaboration to prospectively collect data of patients treated with proton beam therapy.

(BELG J MED ONCOL 2019;13(1):11–15)

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