Objective: To review treatment outcomes for patients with locoregional recu
rrent colon cancer who underwent resection, intraoperative radiotherapy (IO
RT), and external beam radiotherapy (EBRT).
Design: Retrospective study of patients treated between January 1990 and Ju
Setting: Tertiary care cancer center.
Patients: Eleven patients with bulky recurrent colon cancer extending to ad
jacent organs or structures signed informed consent forms to receive IORT.
Intervention: Of 10 patients who underwent exploratory laparotomy, 5 had no
metastatic disease and underwent resection, IORT, and EBRT. Complete resec
tion was accomplished in 4 patients. Doses of IORT ranged from 13 to 20 Gy
depending on residual tumor burden; EBRT was typically delivered postoperat
ively to a dose of 45 Gy.
Main Outcome Measures: Survival and locoregional tumor control.
Results: All 4 patients who underwent complete resection, IORT, and EBRT ar
e alive without locoregional recurrence 53 to 77 months after treatment. Of
these, only I patient developed distant metastases. The fifth patient, who
had gross residual tumor, developed local recurrence 5 months after IORT.
One patient developed an IORT complication-ureteral fibrosis leading to ips
Conclusion: Long-term disease-free survival can be achieved in selected pat
ients with bulky regional recurrence of colon cancer with complete tumor re
section, IORT, and EBRT.