INTRAOPERATIVE RADIATION-THERAPY FOR LOCALLY ADVANCED RECURRENT RECTAL OR RECTOSIGMOID CANCER

Recurrent rectal or rectosigmoid cancer is a difficult therapeutic pro blem. A treatment program of external beam irradiation, surgery, and i ntraoperative irradiation has been used for 41 patients. The 5-year ac tuarial local control and disease-free survival of all 41 patients was 30% and 16%, respectively. Subset analysis demonstrated differences i n outcome by extent of surgical resection. The 5-year actuarial local control and disease-free survival of 27 patients undergoing complete r esection was 47% and 21%, respectively. By contrast, the outcome of 14 patients undergoing partial resection was poor, with a 5-year actuari al local control and survival of 21% and 7%, respectively. Late compli cations included soft tissue or peripheral nerve injury, with many of these resolving within 4-18 months. Local control and disease-free sur vival rates are favorable in comparison with the results achieved by a ggressive surgery. Patients who achieve a gross total resection at int raoperative irradiation have a markedly better prognosis than that of patients with residual gross disease. (C) 1995 Wiley-Liss, Inc.