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January 1983, Vol 118, No. 1 >
ARTICLE | January 1983

Role of Radiation Therapy in Gastrointestinal Cancer FREE

Joseph B. Weissberg, MD
[+] Author Affiliations

Accepted for publication Aug 10, 1982.

Reprint requests to Department of Therapeutic Radiology, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510 (Dr Weissberg).


Arch Surg. 1983;118(1):96-104. doi:10.1001/archsurg.1983.01390010072017
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• The introduction of megavoltage radiation techniques in the last several decades has resulted in a wider application of radiation therapy to the treatment of gastrointestinal cancer. Controlled and uncontrolled clinical trials have shown benefit for preoperative and/or postoperative irradiation in carcinoma of the rectum and rectosigmoid. Endocavitary radiation techniques have been employed successfully in early, accessible rectal cancers as an alternative to abdominal perineal resection. High-dose external beam irradiation with and without concomitant chemotherapy has produced encouraging results in locally advanced, unresectable pancreatic carcinoma. Benefit for radiotherapy in locally advanced gastric carcinoma has been demonstrated as well. In carcinoma of the esophagus, radiotherapy has resulted in long-term control in selected patients and also has been employed with modest success in combination with surgery. Interstitial radiation techniques, intraoperative electron beam therapy, and fast neutrons, heavy charged particles, and other forms of high linear energy transfer radiation are being investigated and may eventually find greater application.

(Arch Surg 1983;118:96-104)

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Allee PE, Gunderson LL, Munzenrider JE:  Postoperative radiation therapy for residual colorectal carcinoma . Int J Rad Oncol Biol Phys 1981;;7:1208.
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Batterman JJ, Breur K:  Fast neutron irradiation for advanced tumors in the pelvis . Int J Rad Oncol Biol Phys 1981;;7:1039-1043.
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Gunderson LL, Shipley WU, Cohen AC, et al:  Residual, unresectable or recurrent colorectal cancer: External beam irradiation and intraoperative electron beam boost±resection . Int J Rad Oncol Biol Phys 1981;; 7:1205.
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1 +
Williams IG, Horwitz H:  Primary treatment of adenocarcinoma of rectum by high voltage roentgen rays (1,000 kv) . AJR 1956;;76:919-928.
2 +
Wang CC, Schulz MD:  The role of radiation therapy in the management of carcinoma of the sigmoid, rectosigmoid and rectum . Radiology 1962;;79:1-5.
3 +
Whiteley HW Jr, Stearns MW Jr, Learning RH, et al:  Palliative radiation therapy in patients with cancer of the colon and rectum . Cancer 1970;;25:343-346.
4 +
Urdaneta-Lafee N, Kligerman MM, Knowlton AH:  Evaluation of palliative irradiation in rectal carcinoma . Radiology 1972;;104:673-677.
5 +
Rao AR, Kagan AR, Chan PYM, et al:  Effectiveness of local radiotherapy in colorectal carcinoma . Cancer 1978;;42:1082-1086.
6 +
Rider WD:  Is the Miles operation really necessary for the treatment of rectal cancer? J Can Assoc Radiol 1975;;26:167-175.
7 +
Gunderson LL, Cohen AM, Welch CE:  Residual, inoperable or recurrent colorectal cancer: Interaction of surgery and radiotherapy . Am J Surg 1980;;139:518-524.
8 +
Allee PE, Gunderson LL, Munzenrider JE:  Postoperative radiation therapy for residual colorectal carcinoma . Int J Rad Oncol Biol Phys 1981;;7:1208.
9 +
Dische S, Senanayake F:  Radiotherapy using hyperbaric oxygen in the palliation of carcinoma of colon and rectum . Clin Radiol 1972;;23:512-518.
10 +
Batterman JJ, Breur K:  Fast neutron irradiation for advanced tumors in the pelvis . Int J Rad Oncol Biol Phys 1981;;7:1039-1043.
11 +
Gunderson LL, Shipley WU, Cohen AC, et al:  Residual, unresectable or recurrent colorectal cancer: External beam irradiation and intraoperative electron beam boost±resection . Int J Rad Oncol Biol Phys 1981;; 7:1205.
12 +
Papillon J:  Intracavitary irradiation of early rectal cancer for cure: A series of 186 cases . Cancer 1975;;36:696-701.
13 +
Sischy B, Remington JH, Sobel SH:  Treatment of rectal carcinomas by means of endocavitary irradiation . Cancer 1978;;42:1073-1076.
14 +
Sischy B, Remington JH, Sobel SH:  Treatment of rectal carcinomas by means of endocavitary irradiation: A progress report . Cancer 1980;; 46:1957-1961.
15 +
Jelden G, Dahliwal R, Lavery I, et al:  Definitive treatment of rectal carcinoma with intracavitary radiation therapy . Int J Rad Oncol Biol Phys 1981;;7:1207.
16 +
Syed AMN, Puthawala A, Neblett D, et al:  Primary treatment of carcinoma of the lower rectum and anal canal by a combination of external irradiation and interstitial implant . Radiology 1978;;128:199-203.
17 +
Gunderson LL, Sosin H:  Areas of failure found at reoperation (second or symptomatic look) following 'curative surgery' for adenocarcinoma of the rectum: Clinicopathologic correlation and implications for adjuvant therapy . Cancer 1974;;34:1278-1292.
18 +
Cass AW, Million RR, Pfaff WW:  Patterns of recurrence following surgery alone for adenocarcinoma of the colon and rectum . Cancer 1976;; 37:2861-2865.
19 +
Walz BJ, Lindstrom ER, Butcher HR, et al:  Natural history of patients after abdominal-perineal resection: Implications for radiation therapy . Cancer 1977;;39:2437-2442.
20 +
Walz BJ, Green MR, Lindstrom ER, et al:  Anatomical prognostic factors after abdominal perineal resection . Int J Rad Oncol Biol Phys 1981;;7:477-484.
21 +
Rao AR, Kagan AR, Chan PM, et al:  Patterns of recurrence following curative resection alone for adenocarcinoma of the rectum and sigmoid colon . Cancer 1981;;48:1492-1495.
22 +
Stearns MW Jr, Deddish MR, Quan SHQ:  Preoperative roentgen therapy for cancer of the rectum . Surg Gynecol Obstet 1959;;109:225-229.
23 +
Stearns MW Jr, Deddish MR, Quan SHQ, et al:  Preoperative roentgen therapy for cancer of the rectum and rectosigmoid . Surg Gynecol Obstet 1974;;138:584-586.
24 +
Roswit B, Higgins GA, Keehn RJ:  Preoperative irradiation for carcinoma of the rectum and rectosigmoid colon: Report of a national Veterans Administration randomized study . Cancer 1975;;35:1597-1602.
25 +
Higgins GA, Conn JH, Jordan PH, et al:  Preoperative radiotherapy for colorectal cancer . Ann Surg 1975;;181:624-630.
26 +
Rider WD, Palmer JA, Mahoney LJ, et al:  Preoperative irradiation in operable cancer of the rectum: Report of the Toronto trial . Can J Surg 1977;;20:335-338.
27 +
Kligerman MM, Urdaneta N, Knowlton A, et al:  Preoperative irradiation of rectosigmoid carcinoma including its regional lymph nodes . AJR 1972;;114:498-503.
28 +
Kligerman MM:  Preoperative radiation therapy in rectal cancer . Cancer 1975;;36:691-695.
29 +
Stevens KR Jr, Allen CV, Fletcher WS:  Preoperative radiotherapy for adenocarcinoma of the rectosigmoid . Cancer 1976;;37:2866-2874.
30 +
Kligerman MM, Urdaneta-Lafee N:  Observations on 15 inoperable/ non-resectable cases of rectal cancer given preoperative irradiation . AJR 1974;;120:624-626.
31 +
Pilepich MV, Munzenrider JF, Tak WK, et al:  Preoperative irradiation of primarily unresectable colorectal carcinoma . Cancer 1978;;42:10771081.
32 +
Mendiondo OA, Wang CC, Welch JP, et al:  Postoperative radiotherapy in carcinomas of the rectum and distal sigmoid colon . Radiology 1976;;119:673-676.
33 +
Withers HR, Romsdahl MM:  Postoperative radiotherapy for adenocarcinoma of the rectum and rectosigmoid . Int J Rad Oncol Biol Phys 1977;;2:1069-1074.
34 +
Turner SS, Vieira EF, Ager PJ, et al:  Elective postoperative radiotherapy for locally advanced colorectal cancer: A preliminary report . Cancer 1977;;40:105-108.
35 +
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