Intraoperative radiation therapy for locally advanced recurrent rectal or rectosigmoid cancer

✍ Scribed by H. Wallace James Iii; Dr. Christopher G. Willett; Paul C. Shellito; John J. Coen; Herbert C. Hoover Jr

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 476 KB
• Volume: 60
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/jso.2930600211

✦ Synopsis

Recurrent rectal or rectosigmoid cancer is a difficult therapeutic problem. A treatment program of external beam irradiation, surgery, and intraoperative irradiation has been used for 41 patients. The 5-year actuarial local control and disease-free survival of all 41 patients was 30% and 16%, respectively. Subset analysis demonstrated differences in outcome by extent of surgical resection. The 5-year actuarial local control and diseasefree survival of 27 patients undergoing complete resection was 47% and 21 %, respectively. By contrast, the outcome of 14 patients undergoing partial resection was poor, with a 5-year actuarial local control and survival of 21% and 7%, respectively. Late complications included soft tissue or peripheral nerve injury, with many of these resolving within 4-18 months. Local control and disease-free survival rates are favorable in comparison with the results achieved by aggressive surgery. Patients who achieve a gross total resection at intraoperative irradiation have a markedly better prognosis than that of patients with residual gross disease.