High-dose-rate intraoperative brachytherapy for recurrent colorectal cancer Journal Article
| Authors: | Alektiar, K. M.; Zelefsky, M. J.; Paty, P. B.; Guillem, J.; Saltz, L. B.; Cohen, A. M.; Minsky, B. D. |
| Article Title: | High-dose-rate intraoperative brachytherapy for recurrent colorectal cancer |
| Abstract: | Purpose: Management of locally recurrent colorectal adenocarcinoma represents a significant challenge. Many of these tumors adhere to or invade into vital pelvic structures rendering surgery or external beam radiotherapy (EBRT) as palliative treatment. Therefore, a treatment approach was developed to evaluate the role of high-dose-rate intraoperative brachytherapy (HDR-IORT) and surgery as a component of therapy in the management of locally recurrent colorectal cancer. This is an update of our preliminary report with longer follow-up and larger patient numbers. Methods and Materials: Between January 1992 and September 1998, 74 patients with locally recurrent rectal cancer were treated with surgery and HDR-IORT. Additional EBRT was given to 29 patients, and 33 patients received 5-fluorouracil based chemotherapy. All patients underwent complete gross resection, and 21 of 74 had positive microscopic margin. The dose of HDR-IORT ranged from 10 to18 Gy. Results: With a median follow-up of 22 months, the 5-year local control, distant metastasis disease-free, disease-free, and overall survival rates were 39%, 39%, 23%, and 23%, respectively. The only predictor of improved local control was a negative margin of resection with a 5-year local control rate of 43%, compared to 26% in those with positive margin (p = 0.02). For overall survival, a negative microscopic margin (p = 0.04) and the use of IORT + EBRT (p = 0.04) were significant predictors of improved survival. The incidence of peripheral neuropathy was 16%.Conclusion: The results with HDR-IORT in this group of patients are encouraging. Further improvements in local and distant control are still needed. Copyright (C) 2000 Elsevier Science Inc. |
| Keywords: | adult; aged; aged, 80 and over; middle aged; survival rate; treatment failure; major clinical study; clinical trial; fluorouracil; antineoplastic agents; radiation dose; combined modality therapy; recurrent cancer; follow-up studies; antineoplastic agent; pelvis; colorectal cancer; adenocarcinoma; neoplasm recurrence, local; peripheral neuropathy; colonic neoplasms; cancer invasion; intraoperative period; radiation injuries; brachytherapy; rectal neoplasms; leucovorin; iort; hdr brachytherapy; humans; prognosis; human; male; female; priority journal; article; recurrent colorectal cancer |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 48 |
| Issue: | 1 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2000-08-01 |
| Start Page: | 219 |
| End Page: | 226 |
| Language: | English |
| DOI: | 10.1016/s0360-3016(00)00634-9 |
| PUBMED: | 10924992 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work