ENDOCAVITARY RADIOTHERAPY OF RECTAL-CANCER

Purpose: This analysis was performed to evaluate the results of endoca vitary radiotherapy (RT) administered for early rectal cancer at our i nstitution. Methods and Materials: Patient charts were retrospectively reviewed to determine the results of endocavitary RT regarding surviv al, local control, and complications, Between 1987 and 1994, 25 patien ts were treated with endocavitary RT for early rectal cancer, Twenty h ad early, low grade tumors and met the criteria for treatment,vith cur ative intent. Five had more advanced, high grade, or multiple recurren t tumors and were treated with palliative intent, The tumors were trea ted to between 20 and 155 Gy in one to four fractions with 50 KV x-ray s given through a specialized proctoscope, Patients were followed for 5 to 84 months (median = 55 months) after therapy, Local control and s urvival were determined using the Kaplan-Meier method. Results: Local control was achieved in 18 of the 20 patients treated with curative in tent and 4 of 5 treated with palliative intent, For those patients tre ated with curative intent, the 5-year local control rate was 89% and t he 5-year survival rate was 76%. The most significant toxicity was ulc eration that occurred in 5 of the 25 patients, The ulcers were asympto matic in three cases and associated with bleeding in one case, The fif th patient had pain, One ulcer was biopsied, resulting in perforation that was treated with an abdominal perineal resection (APR), There was no tumor found upon pathologic evaluation, Conclusions: Endocavitary RT can be used to treat patients with early, low-grade rectal cancers and will yield a high level of disease control and a low risk of serio us complications, Major advantages of this treatment technique are tha t it requires neither general anesthesia nor hospitalization.