BACKGROUND: The survival of @entity1 with recurrent or metastatic @entity14 usually is less than 12 months. In an attempt to improve this dismal prognosis, we investigated the role of intraoperative high dose rate brachytherapy (IOHDR) in the management of these @entity1 . METHODS: From April 1992 to December 1996, 26 @entity1 with locally recurrent or metastatic @entity14 were treated with maximal surgical resection and IOHDR. Intraoperative radiation dose ranged from 10 to 20 Gy, prescribed at 0.5 cm depth. The @entity41 irradiated was microscopic in 16 @entity1 (62%) and gross residual in 10 @entity1 (38%). Six @entity1 received postoperative external beam radiation therapy. RESULTS: After a median follow-up of 28 months (range 6 to 54 months), seven of 15 evaluable @entity1 (47%) failed in the area treated with IOHDR. The median time to local failure was 21 months (range 4 to 52 months). The median survival was 23 months (microscopic 24 months; gross 17 months), with a 4-year actuarial survival rate of 36%. Major morbidity was observed in 7 @entity1 (47%) and usually was surgery-related. CONCLUSION: The use of IOHDR in association with radical resection increases local control in @entity1 with recurrent or metastatic @entity14 . @entity1 with microscopic @entity66 achieved a better result than do those with gross @entity66 . Future strategies include the addition of limited EBRT dose to IOHDR, even for previously irradiated @entity1 .

Intraoperative high dose rate brachytherapy in recurrent or metastatic XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity41 :: ('MESH:D018365', 'Disease') :: ['residual tumor'] @entity66 :: ('MESH:D004194', 'Disease') :: ['residual disease'] @entity14 :: ('MESH:D015179', 'Disease') :: ['colorectal carcinoma', 'colorectal cancer']
@entity14 :: (MESH:D015179,Disease) :: ['colorectal carcinoma']
