35 y/o M with cT4N2M0 rectal adenocarcinoma w/ extension into the prostate and bilateral common, and internal and external iliac lymphadenopathy
He was treated with total neoadjuvant therapy, beginning with chemoradiation using IMRT with concurrent Xeloda followed by FOLFOX. Following treatment, given complete clinical response, surgery was deferred in favor of surveillance (per Fernandez et al. Lancet Oncol 2021).
He received 45 Gy in 25 fractions to the pelvis with simultaneous integrated boost to involved pelvic nodes to 55 Gy, followed by sequential boost to 5.4 Gy in 3 fractions to the mesorectum (50.4Gy cumulative).
Case contributed by UPMC
Lateral Nodal Disease
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