Intraoperative radiation therapy for locally advanced recurrent rectal or rectosigmoid cancer.

Published

Journal Article

BACKGROUND AND PURPOSE: To update and summarize the experience at the Massachusetts General Hospital of a treatment program of high-dose preoperative irradiation, surgical re-resection, and intraoperative radiation therapy (IORT) as a salvage treatment for patients with recurrent rectal or rectosigmoid carcinoma. PATIENTS AND METHODS: From June 1978 to February 1997, the records of 69 patients with locally recurrent rectal carcinomas or rectosigmoid carcinomas without metastases referred for consideration of IORT were reviewed. Forty-nine patients received IORT and local control and disease-free survival curves were calculated using the actuarial method of Kaplan-Meier. RESULTS: The 5-year overall survival, local control and disease-free survival rates of 49 patients receiving IORT were 27, 35, and 20%, respectively. Thirty-four patients who underwent a macroscopic complete resection had a significantly better 5-year overall survival than the remaining 15 patients with gross residual disease (33 vs. 13%, P=0.05, log rank). For those patients, local control and disease-free survival rates were 46 and 27%, respectively. Patients with a microscopic complete resection had a superior 5-year overall survival than partially resected patients (40 vs. 14%, P=0.0001, log rank). Chemotherapy had no significant influence on overall or disease-free survival. CONCLUSION: The current analysis shows the importance of a microscopic complete resection in a multi-modality approach with IORT for survival and local control. Salvage is rare for patients undergoing subtotal resection.

Full Text

Duke Authors

Cited Authors

  • Lindel, K; Willett, CG; Shellito, PC; Ott, MJ; Clark, J; Grossbard, M; Ryan, D; Ancukiewicz, M

Published Date

  • January 2001

Published In

Volume / Issue

  • 58 / 1

Start / End Page

  • 83 - 87

PubMed ID

  • 11165686

Pubmed Central ID

  • 11165686

Electronic International Standard Serial Number (EISSN)

  • 1879-0887

International Standard Serial Number (ISSN)

  • 0167-8140

Digital Object Identifier (DOI)

  • 10.1016/s0167-8140(00)00309-1

Language

  • eng