Kovalic J J
St. Joseph's Hospital, Milwaukee, Wisconsin.
Int J Radiat Oncol Biol Phys. 1988 Feb;14(2):261-4. doi: 10.1016/0360-3016(88)90430-0.
Endocavitary irradiation has been used for rectal adenocarcinoma and villous adenoma at St. Joseph's Hospital, Milwaukee, Wisconsin since 1978. The 52 patients treated since that time include 32 patients with adenocarcinoma, 19 patients with villous adenoma, and 1 patient with an adenomatous polyp and associated atypia. The average age of these patients (70.5 years) was a full decade older than the average age of all rectal cancer patients. The treatment was administered by a superficial contact machine with most patients receiving 80 Gy over four treatments in a period of 1.5 months. The overall local recurrence rate was 24% in the cancer group and 32% in the villous adenoma group. The 1-, 2-, and 3-year determinate disease-free survival rates were 90.4%, 78.6%, 74.2% and 80.4%; 60.3%, 45.2% for invasive adenocarcinoma and villous adenoma patients, respectively. There was no mortality and very little morbidity associated with the treatment. It is concluded that endocavitary irradiation is an effective alternative to surgery for the treatment of rectal cancer in selected cases. However, villous adenomas do not respond as well. Better results may be obtained for this group of patients by higher doses than were used in this study.
自1978年以来，威斯康星州密尔沃基市圣约瑟夫医院一直采用腔内照射治疗直肠腺癌和绒毛状腺瘤。自那时起接受治疗的52例患者中，包括32例腺癌患者、19例绒毛状腺瘤患者和1例伴有异型增生的腺瘤性息肉患者。这些患者的平均年龄（70.5岁）比所有直肠癌患者的平均年龄整整大十岁。治疗采用浅表接触式机器进行，大多数患者在1.5个月内分四次接受80 Gy的照射。癌症组的总体局部复发率为24%，绒毛状腺瘤组为32%。腺癌和绒毛状腺瘤患者的1年、2年和3年确定无病生存率分别为90.4%、78.6%、74.2%和80.4%；浸润性腺癌和绒毛状腺瘤患者分别为60.3%、45.2%。该治疗未导致死亡，且几乎没有相关的发病率。结论是，腔内照射在某些情况下是治疗直肠癌的一种有效的手术替代方法。然而，绒毛状腺瘤的反应不太理想。对于这组患者，采用比本研究中更高的剂量可能会获得更好的结果。
