Interstitial implantation of pelvic malignancies with Syed-Neblett template: Update of results, technique, and complications

Eighty-two patients with pelvic malignancies, including ten with recurrent lesions, received interstitial radiation therapy by Syed-Neblett template with or without external irradiation. Follow-up ranged from 11 to 51 months. Twenty-eight of these patients previously described, had a 22% incidence of rectal complications requiring colostomy. Modification of implant treatment - including differential loading, selection of smaller treatment volumes, and use of concomitant staging laparotomy with exclusion of patients with gross pelvic and paraaortic adenopathy - have resulted in improved local control and a 3% incidence of severe rectal injury, in the last 36 patients treated. Further studies and longer follow-up will be required to determine the efficacy of this controversial treatment modality