Intracavitary radiotherapy of rectal tumours

A total of 19 patients with rectal carcinoma or villous adenoma received intracavitary radiotherapy at the Norwegian Radium Hospital during 1991-93. These patients did not have a standard Miles' operation because of poor general condition or refused colostomy. All tumours were staged with rectal sonography. Only patients with tumour diameter < 3.5 cm were included in the study, 9 villous adenomas and 13 adenocarcinomas. Irradiation was delivered by a Philips RT 50 machine (50 kilovolt energy) through a special proctoscope according to Papillon. The patients received 30 Gy once every third week up to 150 Gy. No side effects were observed except one transitory irradiation necrosis. Median observation time was 32 (12-45) months. At evaluation 1 month after treatment 1 patient had stable disease, 3 partial response and 15 complete response. Of the latter, 1 patient developed a recurrent tumour 3 years later. It is concluded that endoluminal radiotherapy should be offered patients who cannot have or refuse a Miles operation for small, distal rectal carcinomas or villous adenomas