[Combination treatment of rectal cancer using preoperative combination radiotherapy]. / Kombinirovannoe lechenie raka priamoi kishki s predoperatsionnoi sochetannoi luchevoi terapiei.

The paper is concerned with analysis of the results of therapy of 122 rectal cancer patients divided into 2 groups by sex, age, tumor site, type of anatomical tumor growth, and stage of disease: I (72 patients)--combined therapy including preoperative radiotherapy and operation; II (50 patients)--surgery alone. Indications for combined therapy with preoperative irradiation were worked out. The results of histological investigation showed that this method brought about deep radiation injuries of tumors with minimum damage of the adjacent normal tissues. A conclusion was made that combined therapy including preoperative irradiation decreased the number of recurrences and metastases and increased (in combination with surgical intervention) the 5-year survival rate up to 79.6%.

[Thermoradiotherapy of rectal cancer]. / Termoradioterapiia raka priamoi kishki.

Methods of combined and multimodality therapy are widely used for the treatment of malignant rectal tumors. However radical operation cannot be performed in 50% of patients, in some cases patients refuse surgery. In such cases patients are given a split course of radiation therapy using local heating of a tumor and a method of daily dose fractionation. Altogether 58 patients with stage T2-4N0-1M0-1 were treated by this method: 38 received thermoradiotherapy, 20 were controls. At the 1st stage the summary focal dose (SFD) was 40 Gy, temperature in a tumor was 42-44 degrees C, interval 3-4 weeks. At the 2nd stage radiotherapy was given with daily dose fractionation (1 + 1.5 Gy at 4-5- h interval), the SFD was 35-40 Gy. The SFD over the entire therapeutic course was 75-80 Gy. Radiation rectitis in thermoradiotherapy was more frequent and severe. Complete tumor regression was observed in 7 (18.4%) patients, marked regression--in 24 (63.2%) patients, insignificant regression--in 5 (13.1%); 2 patients (5.3%) were treated without any effect. 29 (76.3%) patients lived over 2 yrs., 6 (25.8%) patients died of tumor progression.

Rectal cancer pathomorphology after preoperative radiation treatment.

Using histological and histochemical investigations and morphometric analysis the tumors and surrounding tissues of 70 rectal cancer patients were studied before and after preoperative radiotherapy with the total dose of 19.5 Gy and 40 Gy. Morphological changes proving the radiation damage of the tumors were determined. The extent of radiation damage depended on histological structure, degree of differentiation and radiation dose. The maximum damage was observed in poorly differentiated adenocarcinomas and the minimum--in colloidal cancer.