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Intracavitary radiation for rectal carcinoma.
Journal of the Canadian Association of Radiologists
|March 1, 1983
Summary
Intracavitary radiation effectively treats low-lying rectal adenocarcinoma, offering a curative option comparable to surgery without requiring colostomy. This minimally invasive treatment is suitable for various patients, including those with advanced age or medical conditions.
Area of Science:
- Oncology
- Radiation Oncology
Background:
- Low-lying rectal adenocarcinoma presents treatment challenges.
- Intracavitary radiation offers a potential alternative to traditional surgery.
Purpose of the Study:
- To evaluate the efficacy and outcomes of intracavitary radiation (Papillon's technique) for low-lying rectal adenocarcinoma.
Main Methods:
- Thirty-five patients received intracavitary radiation, 23 for cure and 12 for palliation.
- Curative treatment targeted mobile, polypoid tumors (<3 cm, Broder's Grade I-II) within 11 cm of the anal verge.
- Radiation doses ranged from 2,000-4,000 cGy per fraction to a total of 7,000-20,000 cGy.
Main Results:
- Complete tumor resolution was achieved in curative cases.
- 87% of patients in the curative group were alive and well up to 42 months post-treatment (minimum 6-month follow-up).
- Three recurrences occurred within 18 months in the curative group; two patients survived after salvage surgery.
Conclusions:
- Intracavitary radiation provides comparable outcomes to surgery for rectal adenocarcinoma, avoiding permanent colostomy.
- This technique is suitable for elderly or medically frail patients, requiring no anesthesia or hospitalization.
- It is also effective for palliation in recurrent cases or for patients unfit for surgery.