title: Interstitial Brachytherapy for the Treatment of Locally Recurrent Anorectal Cancer.
abstract: BACKGROUND
  Local tumor control (LC), overall survival (OS), symptom palliation, and late toxicity for patients with locally recurrent anorectal cancer treated with a computed tomography (CT)-guided interstitial brachytherapy implant were examined.
  
  
  METHODS
  The medical records of 20 consecutive patients who had received interstitial brachytherapy for locally recurrent anorectal cancer from 2000 through 2012 were reviewed. Seventeen patients (85 %) had rectal cancer and three had anal cancer [median follow-up time for living patients, 23 months (range 13-132)]. Brachytherapy was used most commonly at the second pelvic recurrence (n = 13, 65 %). The implant dose was prescribed to 80 Gy to a 1-cm margin or 120 Gy to 100 % of the gross tumor volume. Endpoints were OS, LC, toxicity, and symptom palliation rate, all calculated from the time of implant.
  
  
  RESULTS
  The actuarial 1-year rates of LC and OS were 80 and 95 %, respectively. At presentation, 17 patients (85 %) had symptoms related to the treated tumor which were palliated in 13 patients (76 %) at a median time of 3 months (range 1-6); palliation was permanent for seven patients (54 %), and the other six patients lost palliation after a median 8 months (range 5-17). One patient experienced a grade 3 late complication requiring a stent for hydronephrosis; five had grade 2 toxicity, and four had grade 1 toxicity.
  
  
  CONCLUSIONS
  CT-guided interstitial brachytherapy for locally recurrent anorectal tumors produced durable tumor control and long-term survival, with effective palliation and minimal long-term morbidity.
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Bishop
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Mandy G
authors.initials: MG
authors.lastname: Cunningham
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Randa
authors.initials: R
authors.lastname: Tao
authors.affiliation: Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Paula A
authors.initials: PA
authors.lastname: Berner
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Samantha G
authors.initials: SG
authors.lastname: Korpela
authors.affiliation: Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Geoffrey S
authors.initials: GS
authors.lastname: Ibbott
authors.affiliation: Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Ann A
authors.initials: AA
authors.lastname: Lawyer
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. ccrane@mdanderson.org.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Crane
mesh_terms: D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D001918:Brachytherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010166:Palliative Care; D010386:Pelvic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed