Although local recurrence is most troublesome problem even in early gastric and colorectal cancer, distant metastasis is the other cause of death survivors. Department of Therapeutic Radiology & General Surgery in Yeungnam Medical Center tried
prospective protocol which includes IORT and external irradiation for local control and various chemotherapy for systemic treatment since June 15, 1988.
Total sixty eight patients(59 gastric, 9 colorectal) entered in our protocol. Physical examination, CBC, Chest X-Ray, and other biochemical examinations were performed on monthly basis, if it is necessary, CT, MRI and endoscopy were ordered.
Sixty-one patients(53 gastric, 8 colorectal) were performed IORT(89.7%). Treatment related complications were found in 14 patients(23%) including 4 patients of gastro-intestinal bleedings (6.6%), 2 patients of bone marrow depressions(3.3%), 1
patient of
perioperative abscess and sepsis(1.6%), 4 patients of intestinal obstructions(6.6%) and 4 patients of hand & leg edema(6.6%). Six of 14 patients with complications were dead(9.8%) probably due to complication. Our results are very encouraging,
because
only one patients with rectal cancer had local failure(1.6%)and complication rate is comparable with other published reports, in spite of our aggressive treatment, But reduced dose of chemotherapeutic agents, compromising of treatment sequence
between
chemotherapy and external irradiation and judicious perioperative care should be considered for further better results.
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