| 위암과 대장 - 직장암환자에서 항암제와 외부방사선 조사를 병합한 수술중 방사선 치료의 합병증 |
| 김명세, 김성규, 송선교, 김재황, 김홍진, 심민철, 권굉보, 김흥대 |
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| Complication of Intraoperative Radiation Therapy ( IORT ) Combined with External Irradiation and Chemotherapy in Gastric and Colorectal Cancer |
| Myung Se Kim, Seong Kyu Kim, Sun Kyo Song, Jae Hwang Kim, Hong Jin Kim, Min Chul Chim, Koing Bo Kwun, Heung Dae Kim |
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| ABSTRACT |
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Although local recurrence is most troublesome problem even in early gastric and colorectal cancer, distant metastasis is the other cause of death among 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. Fhysical 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. |
| Key words:
IORT, External irradiation, Chemotherapy, Complication |
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