The role of omental flap transposition in patients with locoregional recurrent rectal cancer treated with reirradiation.

Background And Objectives: We performed reirradiation after omental flap transposition (OFT) in patients with locoregional recurrent rectal cancer (LRRC) and evaluated the effect of OFT on the irradiated small bowel by comparing the displacement of the small bowel from the radiation field before and after OFT.

Methods: Between October 2005 and October 2008, this study included 12 patients with LRRC who had previously received radiotherapy. To evaluate the effect of OFT on the irradiated volume of the small bowel and bladder, we measured the closest distances between the small bowel and the tumor or tumor bed (distance(SB)) and between the bladder and tumor or tumor bed (distance(BL)) before and after OFT, respectively.

Results: The median distance(SB) before and after OFT was 5 and 30  mm, respectively (P < 0.001). The median distance(BL) before and after OFT was 10 and 23  mm, respectively (P = 0.002). The respective overall survival and local control rates at 3 years were 50.9% and 54.6%, respectively. No severe complication occurred of grade 3 or higher involving the small bowel or bladder.

Conclusions: In our study, OFT effectively excluded small bowel from the radiation field. In addition, selective reirradiation after OFT was feasible for patients with LRRC.