High dose rate intraluminal brachytherapy in combination with external beam radiotherapy for palliative treatment of cancer rectum

Objective: To evaluate the feasibility, efficacy and toxicity of high dose rate intraluminal brachytherapy (HDRILB) in combination with external beam radiotherapy (EBR) used in the palliative treatment of selected patients of Aden carcinoma rectum. Patients and Methods: The patients with Aden carcinoma rectum, who refused surgery, had contraindications for surgery or had advanced and/or metastasis disease were treated with HDRILB in combination with external beam radiotherapy (EBR). The apparatus used for HDRILB was Ralstron 20B remote after loading unit with /sup 60/Co stepping source. Indigenously designed rectal applicators were used. The EBR was delivered through Phoenix /sup 60/Co teletherapy machine (Theratron AECL). The data for symptom burden and symptomatic relief was analyzed by applying Likert's method of summated scales. Results: Data was analyzed after one week and at the end of the treatment. After one week of treatment, the relief in pain and bleeding per rectum (P/R) was 97%. Excellent palliation was achieved at the end of the treatment when perineal pain and bleeding P/R were relieved in 100%, discharge P/R in 87% and tenesmus in 93% of the cases. Conclusion: The use of HDRILB in combination with EBR can provide quick relief of symptoms in selected patients of Aden carcinoma rectum. This combination has an excellent palliative value because of its effectiveness, acceptable toxicity and overall short treatment duration. (author)