Dr Hall on Refining the Use of Radiation Therapy in Rectal Cancer

“How do we further refine the use of radiation therapy for these patients? This is such a fundamental question in the management of rectal cancer. We've spent the last decade dialing in on different types of systemic therapies that can be applied for rectal cancer. How do we sequence those systemic therapies?

William A. Hall, MD, a professor in and the chair of radiation oncology, the medical director of Froedtert Radiation Oncology, and the Bob Uecker Endowed Chair, Department of Surgery, School of Graduate Studies, at the Medical College of Wisconsin, discussed the unmet need in rectal cancer of more refined radiation therapy approaches.

A fundamental unanswered question in the field of rectal cancer is how the use of radiation therapy can be refined and personalized, Hall began. Over the past few decades, major changes have occurred in the space, including the adoption of nearly universal neoadjuvant therapy compared with the previous approach of adjuvant therapy, he noted. Exciting developments have also occurred in terms of precision oncology approaches, he added.

Although these advances are notable, radiation therapy practices have lagged behind and have remained the same for several decades, according to Hall. New approaches such as MRI-guided radiation therapy, adaptive real-time CT based radiation therapy, and endorectal brachytherapy boosting need to be evaluated in prospective, randomized phase 3 trials in order to enhance patient outcomes, he argued. Investing time, energy and resources into the advancement and development of radiation therapy is one of the most pressing areas of future rectal cancer research over the next 10 years, he concluded.

Disclosures: Hall reported having stock and other ownership interests in Sonoptima; he holds consulting or advisory roles with Aktis Oncology and Sonoptima. He received institutional research funding as well as travel, accommodations, and expenses from Elekta. He has a patent pending for a wearable device for radiation treatment planning.