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Strahlentherapie und Onkologie

, Volume 174, Issue 8, pp 403–407 | Cite as

Conservative treatment of anorectal tumors

  • Josef Kovarik
  • Vladimir H. J. Svoboda
  • Bernard Higgins
Originalarbeit

Abstract

Purpose

To evaluate the results of interstitial radiotherapy of anorectal tumors.

Patients and 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.

Key Words

Anal Carcinoma Rectal carcinoma External radiotherapy Intestinal brachytherapy 

Die konservative Behandlung von anorektalen Tumoren

Zusammenfassung

Ziel

Die Auswertung der Ergebnisse der interstitiellen Radiotherapie anorektaler Geschwülste.

Patienten und Methode

Das Krankengut bestand aus 45 Patienten mit anorektalen Tumoren, die im Zeitraum von 1972 bis 1993 durch interstitielle Implantate behandelt wurden. Von 33 Patienten mit primären Tumoren wurden 19 wegen spinozellulärer, zwei wegen basozellulärer Karzinome des Anus, weitere zwölf wegen Adenokarzinomen des Rektums behandelt. Außerdem wurden zwölf Patienten wegen Lokalrezidiven, davon zehn wegen Adeno- und zwei wegen Spinozellularkarzinomen bestrahlt. Von den 33 Patienten mit primären Tumoren wurden 27 vor dem Implantat mit Teletherapie perkutan bestrahlt. Die mediane Nachbeobachtungszeit betrug 35 Monate.

Ergebnisse

Der Behandlungserfolg war von der Tumorgröße abhängig. In der Gruppe von 21 Patienten mit Analtumoren, bei der eine komplette Tumorremission erreicht wurde, traten in fünf Fällen Lokalrezidive, in vier Fällen Fernmetastasen auf, drei Patienten sind bisher verstorben. Bei zwölf rektalen Adenokarzinomen wurde neunmal eine komplette Tumorremission erreicht, bei vier Patienten mit Fernmetastastasen. Sechs Patienten verstarben. In der Gruppe von zwölf Patienten, die wegen Lokalrezidiven behandelt wurden, kam es bei sieben zu einer kompletten Remission, bei einem davon entwickelte sich später ein zweites Lokalrezidiv. Es traten neun Fernmetastasen auf, acht Patienten verstarben.

Schlußfolgerung

Die Kombination der perkutanen Bestrahlung mit interstitiellem Implantat erweist sich als relativ einfache, aber sehr effektive Methode der Behandlung von frühen analen und tiefer liegenden Rektumkarzinomen.

Schlüsselwörter

Analkarzinom Rektumkarzinom Externe Radiotherapie Interstitielle Brachytherapie 

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Copyright information

© Urban & Vogel 1998

Authors and Affiliations

  • Josef Kovarik
    • 1
  • Vladimir H. J. Svoboda
    • 2
  • Bernard Higgins
    • 3
  1. 1.Department of Radiotherapy and OncologyUniversity Hospital “Kralovske Vinohrady”Prague 10Czech Republic
  2. 2.Department of Radiotherapy and OncologySaint Mary’s HospitalUK
  3. 3.School of Mathematical StudiesUniversity of PortsmouthPortsmouthUK

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