Experience with 5-fluoro-uracil and levamisole in the management of advanced rectal carcinoma

Eleven cases of bulky rectal carcinoma occupying the whole of the pelvis are presented. We refer to this advanced rectal carcinoma as "frozen" pelvis. Management of these cases includes performing a divided stoma colostomy, intravenous administration of 5-fluoro-uracil, intraperitoneal instillation of 5-fluoro-uracil when ascites is present, intra-rectal perfusion with 5-fluoro-uracil, administration of levamisole, and radiotherapy. We think this regimen improves, to some extent, the quality of life and probably prolongs survival period, although disturbing tenesmus does not disappear completely. This will buttress the argument that abdomino-perineal resection is justified when possible, even if only as a palliative measure to prevent disturbing tenesmus.