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Posted by on Dec 15, 2013 in Colorectal cancer | 0 comments

In a nutshell

The study aimed to evaluate the safety and efficacy of intraoperative radiotherapy (IORT) in patients with rectal cancer in comparison to patients who undergo rectal surgery alone.

Some background

Rectal cancer develops on the inner surface of the rectum, the last part of the large intestine. The first treatment option for these patients is usually surgery to remove the tumor. IORT is an intensive radiation treatment that is administered directly into the cancer area during surgery. IORT allows direct radiation to the target area while sparing normal surrounding tissues. IORT is used to treat cancers that are difficult to remove during surgery and there is a concern cancer cells may have been missed and the cancer will return. However, IORT is known to cause complications and side effects such as infections in the area irradiated or bowel and urinary problems. This study compared the complication rates and surgical outcomes immediately after IORT and surgery alone in patients with rectal cancer.

Methods & findings

The study involved 162 patients with rectal cancer that have been treated between 2004 and 2012. Patients were treated with either surgery and IORT (52 patients), or with rectal surgery alone (110 patients). Results showed that the operation time was significantly longer for patients undergoing IORT (284 versus 170 minutes) and blood transfusions were needed more often in patients in the IORT group compared to the surgery group (23% versus 2%). However, patients in the IORT group needed radiotherapy after surgery significantly less compared to the surgical group (4% versus 24%). 

There were no significant differences found concerning complications rates. The rate of leakage from the cut tissues for patients who received IORT was 11 % compared to 14% in patients who received rectal surgery alone. Also, the need for a new surgery was lower for patients who received IORT (4%) than for patients who received rectal surgery alone (8%). Bladder problems and wound infections were seen in 8% and 10% for patients who received IORT and surgery alone, respectively, and wound infection rate was 15% for patients who received IORT and 9% for patients who received rectal surgery alone.

The bottom line

In summary, IORT appears to be a safe treatment option in patients with rectal cancer, with similar complication rates to surgery alone.

The fine print

The study involved a small number of patients and the data included was based on patients that have been treated (retrospective study), which is known to provide weaker statistical information.

What’s next?

Consult your physician on the most appropriate therapy in your situation.

Published By :

World Journal of Surgery

Date :

Nov 01, 2013

Original Title :

Influence of Intraoperative Radiotherapy (IORT) on Perioperative Outcome after Surgical Resection of Rectal Cancer.

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