Local recurence is the most common problem in locally advanced stomach and colorectal cancer even after curative resection. In spite of remarkable improvement of surgical technique, skill of anesthesiology and surportive therapy, reported local
recurence is still 50~94% in stomach cancer and 50~100% in colorectal cancer.
External irradiation has been advocated for reducing local recurence, but the result is not satisfactory because tumorcidal dose(above 7000cGy) can not be delivered safely to the high risk-target area without normal tissue damage which may cause
unacceptable complication. Intraoperative radiation therapy(IORT) was suggested as a promising modality for reducing local recurence without increasing complication by excluding radiosensitive normal organ (small bowoel, colon) from irradiation
field
and giving a single high dose with proper electron area on the high risk-target area.
Yeunganam University medical Center started IORT in locally advanced stomach cancer on Jung 15, 1988 and in rectal cnacer on May 30, 1991 as lst trial in Korea. By May 30, 1992, total 58 cases of stomach cancer and 7 cases of colorectal cancer
were
entered in IORT protocol, but 54 cases of stomach cancer and 6 cases of colorectal cancer were performed IORT. Five cases were excluded because of advaned stages(3 cases), ealrly stage(1 cases) and unexpected machinnary problem(1 case). Eleven
cases of
59 who had IORT were dead, because of bleeding (4 cases) in reminant stomach and around anastomosis site which were not included in IORT evidence of local recurence were noted, this suggested us that the effect of IORT in reducing local recurence
is
satisfactory.
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