Intraoperative and stereotactic ablative radiation therapy in recurrent rectal cancer

Despite significant advances in primary management of rectal cancer, local recurrence, although increasingly uncommon, presents a therapeutic challenge. Multimodality therapy, including surgery, radiation therapy, and chemotherapy, is often called for despite, in most cases, having been used in the primary setting. Technical advances in radiation planning and delivery have contributed to development of ways to deliver high-radiation doses to exactly where it is needed, preventing damage to surrounding normal structures. In combination with modern surgical and chemotherapeutic options, these specialized radiation therapy techniques, including intraoperative radiation therapy and stereotactic ablative radiation therapy, have contributed to excellent local control and survival outcomes for these patients.