Intraoperative radiation therapy for locally advanced recurrent rectal or rectosigmoid cancer

Katja Lindel, Christopher G. Willett, Paul C. Shellito, Mark J. Ott, Jeffrey Clark, Michael Grossbard, David Ryan, Marek Ancukiewicz

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


Background and purpose: To update and summarize the experience at the Massachusetts General Hospital of a treatment program of high-dose preoperative irradiation, surgical re-resection, and intraoperative radiation therapy (IORT) as a salvage treatment for patients with recurrent rectal or rectosigmoid carcinoma. Patients and methods: From June 1978 to February 1997, the records of 69 patients with locally recurrent rectal carcinomas or rectosigmoid carcinomas without metastases referred for consideration of IORT were reviewed. Forty-nine patients received IORT and local control and disease-free survival curves were calculated using the actuarial method of Kaplan-Meier. Results: The 5-year overall survival, local control and disease-free survival rates of 49 patients receiving IORT were 27, 35, and 20%, respectively. Thirty-four patients who underwent a macroscopic complete resection had a significantly better 5-year overall survival than the remaining 15 patients with gross residual disease (33 vs. 13%, P=0.05, log rank). For those patients, local control and disease-free survival rates were 46 and 27%, respectively. Patients with a microscopic complete resection had a superior 5-year overall survival than partially resected patients (40 vs. 14%, P = 0.0001, log rank). Chemotherapy had no significant influence on overall or disease-free survival. Conclusion: The current analysis shows the importance of a microscopic complete resection in a multi-modality approach with IORT for survival and local control. Salvage is rare for patients undergoing subtotal resection.

Original languageEnglish
Pages (from-to)83-87
Number of pages5
JournalRadiotherapy and Oncology
Issue number1
StatePublished - 20 Jan 2001
Externally publishedYes


  • Intraoperative radiation therapy
  • Local failure
  • Recurrent rectal carcinoma
  • Salvage


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