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High dose rate afterloading intraluminal brachytherapy for advanced inoperable rectal carcinoma
Peter J Hoskin1, Sandra M de Canha, Peter Bownes
1Mount Vernon Cancer Centre, Mount Vernon Hospital, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK.
Summary
High dose rate intraluminal brachytherapy effectively treats rectal and anal canal tumors in frail patients. This radiation therapy offers local tumor control and symptom relief for those unfit for surgery.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Physics
Background:
- Rectal and anal canal tumors pose treatment challenges, especially in elderly or frail patients.
- Inoperable advanced or metastatic disease necessitates alternative therapeutic strategies.
Purpose of the Study:
- To evaluate the efficacy of high dose rate (HDR) intraluminal brachytherapy for inoperable rectal and anal canal tumors.
- To assess HDR brachytherapy as both a radical treatment component and a palliative procedure.
Main Methods:
- Retrospective review of 50 consecutive patients undergoing HDR intraluminal brachytherapy.
- Patients were categorized into radical (n=26) or palliative (n=22) treatment groups.
- Treatment regimens included radical doses (up to 36 Gy) or palliative single doses (10 Gy).
Main Results:
- Median patient age was 82 years, predominantly frail elderly individuals.
- Local tumor response observed in 21/25 assessable patients (14 complete responses).
- Significant response rates for bleeding (64%) and mucous discharge (64%) were achieved.
Conclusions:
- Intraluminal HDR brachytherapy is an effective local treatment for patients unfit for radical surgery.
- It serves as a valuable component of radical treatment or a standalone palliative procedure.
- HDR brachytherapy provides local tumor control and symptom management in challenging patient populations.