Technique of postoperative pelvic radiation in the management of rectal and rectosigmoid carcinoma.

Improper postoperative pelvic radiation of 5,000 rad in five weeks results in poor patient tolerance, unacceptable complications, and increased local recurrence. Preoperative or postoperative low-dose pelvic radiation results in better tolerance; however, in patients with resectable adenocarcinoma of the rectum and rectosigmoid, low-dose radiation improves neither the local failure rate nor the survival rate compared with treatment by surgery alone. The authors' technique was to deliver 5,000 rad in six weeks only to the pelvic tissues at risk for recurrence following surgery.