Abstract
Endoscopic laser therapy (ELT) combined with endocavitary IR-192 HDR is performed in rectal cancer with an anatomical non resectability due to advanced tumor stage and in patients which are unsuitable for resection caused by severe concomitant medical illness. <h3>Patients, Methods and Results</h3> 75 patients (48 males, 27 females) have been treated 63 patients had ELT only using a Nd-Yag Laser system (wavelength 1064nm, 100 watts, energy density>1000 j/cm<sup>2</sup>) 24 patients (80.5 yrs) had a severe concomitant medical illness which made them unsuitable for surgery (Group I). 39 patients had an advanced locally inoperable tumor (Group II). 12 patients had a combined therapeutic regime with endocavitary IR-192 afterloading (Gammamed II, 7 Gy at 1cm distance) following prior ELT (Group III). The interval between the following subsequent treatments was 8.4–9.4 weeks in group I and II compared to 11.5 weeks in group III. Complications mainly laser induced bleedings occurred in 7 patients (9%) and could be dealt by subsequently laser coagulation. <h3>Conclusion</h3> The frequency of treatment was governed by the amount of tumor and the length of time the patient lived. The results suggest, that additional endocavitary radiation significantly prolongs the maintainance of normal bowel function as compared to laser alone.
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