The application of preoperative radiation therapy for unresectable malignancies

Preoperative radiation therapy is one of the major indications for the use of ionizing radiation in the treatment of malignant disease. The preoperative application of radiation treatment is given with the intention of reducing the size of bulky cancers, thus converting unresectable tumors into resectable ones. Other benefits are reduction in the risk of locoregional recurrence and in the risk of blood-borne dissemination of malignant cells promoted during surgical resection.This paper presents and discusses three cases of unresectable intrapelvic tumors initially treated by radiation therapy with the primary goal of palliation. These three cases included rectal, cecal, and uterine carcinoma. In each case, a preoperative radiation dose of 4500 to 5000 cGy was delivered. Evaluations during and after the completion of the radiation treatments revealed that the tumor responded remarkably well to the treatment, which encouraged the surgical intervention; at surgery, minimal tumor was found. These three patients are alive to date without apparent evidence of disease.