Price A, Kerr G R, Arnott S J
Department of Clinical Oncology, Western General Hospital, Edinburgh.
Clin Radiol. 1988 Mar;39(2):186-9. doi: 10.1016/s0009-9260(88)80021-7.
Radioactive needle implants were used to treat 44 patients with inoperable anorectal cancer. An implant dose of 60 Gy or higher was administered to 27 patients at a mean dose rate of 0.493 Gy/h (SE +/- 0.167 Gy/h). In five patients this was preceded by external beam irradiation. A further 17 patients received an implant dose of less than 60 Gy; this followed external irradiation in 10 patients. A complete response was achieved in 52% (16 out of 31) of patients assessed. Three of these patients later relapsed locally. The median duration of response was 23 months. A partial response of median duration 3 months was achieved by a further 13 patients. Five year actuarial survival was 23.9%. Serious morbidity occurred in six patients; three developed strictures and three necrosis. Features of the tumour and the treatment technique contributing to successful management are discussed. It is suggested that radioactive needle implants have an important part to play in the management of low-lying inoperable anorectal cancers.
放射性针植入用于治疗44例无法手术的肛管直肠癌患者。27例患者接受了60 Gy或更高的植入剂量，平均剂量率为0.493 Gy/h（标准误±0.167 Gy/h）。其中5例患者在此之前接受了外照射。另外17例患者接受的植入剂量小于60 Gy；其中10例患者在此之前接受了外照射。在评估的患者中，52%（31例中的16例）达到完全缓解。其中3例患者随后出现局部复发。缓解的中位持续时间为23个月。另有13例患者实现了中位持续时间为3个月的部分缓解。5年精算生存率为23.9%。6例患者出现严重并发症；3例发生狭窄，3例发生坏死。讨论了有助于成功治疗的肿瘤特征和治疗技术。建议放射性针植入在低位无法手术的肛管直肠癌治疗中发挥重要作用。
