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Intraoperative high-dose-rate brachytherapy (HDR-BT) may reduce the risk of local recurrence. However, the optimal therapeutic regimen remains unclear. The aim of this retrospective monocentric study was to evaluate the toxicity of HDR-BT after resection of RRC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Between 2018 and 2022, 17\u00a0patients with RRC received resection and HDR-BT. HDR-BT was delivered alone or as an anticipated boost with a\u00a0median dose of 13\u202fGy (range 10\u201313\u202fGy) using an <jats:sup>192<\/jats:sup>iridium microSelectron HDR remote afterloader (Elekta AB, Stockholm, Sweden). All participants were followed for assessment of acute and late adverse events using the Common Terminology Criteria for Adverse Events version\u00a05.0 and the modified Late Effects in Normal Tissues criteria (subjective, objective, management, and analytic; LENT-SOMA) at 3\u2011 to 6\u2011month intervals.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A\u00a0total of 17\u00a0patients were treated by HDR-BT with median dose of 13\u202fGy (range 10\u201313\u202fGy). Most patients (47%) had an RRC tumor stage of cT3\u20114 N0. At the time of RRC diagnosis, 7\u00a0patients (41.2%) had visceral metastases (hepatic, pulmonary, or peritoneal) in the sense of oligometastatic disease. The median interval between primary tumor resection and diagnosis of RRC was 17\u00a0months (range 1\u201365\u00a0months). In addition to HDR-BT, 2\u00a0patients received long-course chemoradiotherapy (CRT; up to 50.4\u202fGy in 1.8-Gy fractions) and 2\u00a0patients received short-course CRT up to 36\u202fGy in 2\u2011Gy fractions. For concomitant CRT, all patients received 5\u2011fluorouracil (5-FU) or capecitabine. Median follow-up was 13\u00a0months (range 1\u201354). The most common acute grade\u00a01\u20132 toxicities were pain in 7\u00a0patients (41.2%), wound healing disorder in 3\u00a0patients (17.6%), and lymphedema in 2\u00a0patients (11.8%). Chronic toxicities were similar: grade\u00a01\u20132 pain in 7\u00a0patients (41.2%), wound healing disorder in 3\u00a0patients (17.6%), and incontinence in 2\u00a0patients (11.8%). No patient experienced a\u00a0grade \u22653 event.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Reirradiation using HDR-BT is well tolerated with low toxicity. An individualized multimodality approach using HDR-BT in the oligometastatic setting should be evaluated in prospective multi-institutional studies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00066-024-02271-1","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T13:03:40Z","timestamp":1723122220000},"page":"27-35","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcome of intraoperative brachytherapy as a\u00a0salvage treatment for locally recurrent rectal cancer"],"prefix":"10.1007","volume":"201","author":[{"given":"Raluca","family":"Stoian","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannes P.","family":"Neeff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Gainey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Kollefrath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Kirste","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantinos","family":"Zamboglou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan Philipp Harald","family":"Exner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimos","family":"Baltas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Fichtner Feigl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anca-Ligia","family":"Grosu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4052-6632","authenticated-orcid":false,"given":"Tanja","family":"Sprave","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,8]]},"reference":[{"issue":"10","key":"2271_CR1","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.6004\/jnccn.2022.0051","volume":"20","author":"AB Benson","year":"2022","unstructured":"Benson\u00a0AB, Venook\u00a0AP, Al-Hawary\u00a0MM, Azad\u00a0N, Chen\u00a0YJ, Ciombor\u00a0KK et\u00a0al (2022) Rectal cancer, version\u00a02.2022, NCCN clinical practice guidelines in oncology. 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