Conservative treatment of anorectal tumors.
OBJECTIVE
To evaluate the results of interstitial radiotherapy of anorectal tumors.


METHODS
From 1972 to 1993, one of the authors treated 45 patients by an interstitial implant for anorectal tumors. Of these, 33 patients suffered from primary tumors, 19 from squamous carcinoma, 2 from basaloid carcinoma of the anus and the other 12 from primary adenocarcinoma of the rectum. Of 12 patients treated for local recurrence, 10 had adenocarcinoma and 2 squamous cell carcinoma. Of the 33 patients with primary tumors, 27 received a course of external-beam radiotherapy before the implant. The median follow-up was 35 months.


RESULTS
Local response depended on the tumor volume treated. All 21 anal tumors showed complete response, 5 patients developed local recurrence and 4 distant metastases: 3 died from their disease. Of 12 rectal adenocarcinomas, 9 responded completely, 4 patients developed local recurrence and 4 distant metastases; 6 died from active disease. In the last group of 12 patients who were treated for recurrent tumors, 7 responded completely. One patient developed local recurrence and 9 distant metastases, only 4 are alive.


CONCLUSIONS
A combination of external-beam and interstitial radiotherapy is a relatively simple, non-mutilating, but well-tolerated and very effective method of treatment for early carcinoma of the lower rectum and anus.
Kovarik
J
J
Department of Radiotherapy and Oncology, University Hospital Kralovske Vinohrady, Prague, Czech Republic. kovarik@fnkv.cz
Svoboda
V H
VH
Higgins
B
B
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology; D000368:Aged; D001005:Anus Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D001918:Brachytherapy / Q000009:adverse effects; D002280:Basal Cell Carcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011859:Radiography; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D015996:Survival Rate; D013997:Time Factors
D007496:Iridium Radioisotopes