COMBINED TREATMENT WITH LASERTHERAPY (ND-YAG) AND ENDOCAVITARY RADIATION IN THE PALLIATION OF RECTAL-CANCER

Background/Aims: The ideal treatment for patients with advanced rectal cancer and who cannot undergo a radical therapy is still undefined. T he association between lasertherapy (LT) and infernal radiotherapy (IR T) could affect both technical results and quality of life. This study was aimed at evaluating the association of LT and IRT in the palliati ve treatment of rectal cancer. Material and Methods: Between January a nd April 1994, 9 patients (2 males, 7 females) with rectal cancer unde rwent a combined treatment modality in order to control their symptoms . All patients were unfit for surgery and EUS showed an invasion of th e whole muscular layer; After laser recanalization, brachytherapy was applied at a one week interval from last laser session. Two reactions of 10 Gy were administered at one week intervals. Results: The mean nu mber of laser sessions to obtain a complete recanalization was 3 (rang e:2-5) and no complications occurred. After IRT, we obtained a good re sult in 7/9 patients (79%) and 2 patients required further LT. The mea n follow-up was 146 days (range: 74-240): during this period no laser treatment was performed. Four patients complained of acute perineal pa in and tenesmus after brachytherapy: in one patient, a colostomy was p erformed. Conclusion: We deem that the administration of two fractions of 10 Gy is not advisable, particularly for the treatment of non-circ umferential lesions, due to the severe side effects we observed.