Primary Treatment of Carcinoma of the Lower Rectum and Anal Canal by a Combination of External Irradiation and Interstitial Implant

Abstract

Ten patients with carcinoma of the anorectum were treated with a combination of external irradiation and after-loading interstitial 192Ir implant, which seems to be effective in controlling relatively small cancers of the anorectum and providing effective palliation of extensive lesions. Five of the 10 patients remain free of tumor after a minimum follow-up of 15 months. Four of the 10 were treated with one interstitial implant and 4,000--5,000 rads of external irradiation and 6 were treated with the same amount of irradiation and two implants. When two implants were used, complications were minimal.

Radiation therapy of carcinoma in the rectum and sigmoid colon.

“…The results of recent studies (Papillon 1975 ;Syed et al 1978 ;Wassif 1983) and our present study in radiotherapy of rectal carcinoma may present encouraging data to the management of this malignancy. If all malignant lesions of primary tumor and regional lymph node metastases are perfectly included in the irradiation fields and relatively radioresistant adenocarcinoma of the rectum is eradicated by radiation, curative possibility of rectal carcinoma will be expected by radiotherapy.…”

“…A combination of external irradiation and interstitial implantation of Ir-192 for relatively extensive carcinoma of the lower rectum showed good response of primary tumor (Syed et al 1978). In these 2 modalities, the treatment volume is restricted to primary tumor and the delivered tumor dose is 100 Gy or more.…”

“…Radiotherapy has been considered to have no value for the control of this malignancy. However, some recent studies (Papillon 1975;Syed et al 1978;Wassif 1983) suggest that such issue is questionable.…”