LONG SOURCE-SKIN DISTANCE RECTAL IRRADIATION TECHNIQUE - A REVIEW OF RESULTS

Purpose. This study reports the clinical outcome of fifteen patients w ith low rectal adenocarcinoma treated with the long source-skin distan ce (SSD) of endorectal irradiation technique. This method was designed at McGill University in 1986 as an alternative to the standard short SSD rectal irradiation that was developed by Papillon (Proc. R. Soc. M ed. 65: 1179-1181, 1973). Methods and materials. Between April 1986 an d May 1993, six females and nine males were treated with this techniqu e. Fourteen patients were treated with curative intent and one woman f or palliation, The median total dose was 85 Gy (range 60-135 Gy) in a median of 3 fractions (range 3-5) over a median treatment time of 5 we eks (range 2-9.5 weeks), Results. With a mean follow-up of 39 months a nd a median of 24 months (range 3 months-8.7 years), actuarial overall survival and disease-free survival rates are 50.8% and 71.4%, respect ively, at 8.7 years. No patients have died of recurrent disease, but o ne patient has distant metastatic disease, One patient treated with cu rative intent required an abdominoperineal resection for progressive d isease. Treatments were tolerated well by all patients. Four patients required steroid enemas for localized proctitis for a short period of time. They all responded well and had complete resolution of symptoms. Conclusions. Our results are comparable with those in other reports i n the literature. The complications are similar in type and frequency to other published series. The long SSD technique may be an acceptable alternative to the standard short SSD technique.