Colorectal Cancer

Scientists at the American Health Foundation’s Nutritional Carcinogenesis Division, under the direction of Dr. Bandaru S. Reddy, division chief and associate director of the Foundation’s Naylor Dana Institute, Valhalla, New York, and Dr. Karen Seibert of Searle Research & Development, St. Louis, Missouri, described an exceptionally strong inhibitor of colon cancer development in an animal model assay in the February 1, 1998, issue of Cancer Research.

Sphincter-preserving treatment with combined radiation and chemotherapy has replaced abdominoperineal resection as the standard of care for patients with carcinoma of the anal canal. Randomized studies have shown

A genetic mutation in the adenomatous polyposis (APC) gene found in 7% of Ashkenazi Jewish families in the United States does not necessarily lead to colon cancer, according to a study in the December 15, 1997, issue of Cancer Research.

Surgical oncology themes at the 1997 European Cancer Conference (ECCO 9) included the need for meticulous surgery and the need for surgeons to develop and implement guidelines for the management of cancer.

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

Screening for colon colon by any of several different strategies is highly cost effective, but nonetheless expensive. It is unclear whether American society--in the form of the federal government, private insurers, managed care organizations, or individual

In this issue, Harrison et al give the rationale for intraoperative high-dose-rate brachytherapy (IOHDR) and provide an excellent summary of the Memorial Sloan-Kettering Cancer Center (MSKCC) experience with this treatment. Intraoperative high-dose-rate brachytherapy is used in very few centers [1-4], and its worldwide use has been recently summarized [5,6]. Although our experience with IOHDR at Ohio State University parallels that of Harrison et al in some respects, it differs in others. I will highlight these differences to give readers a more balanced view of IOHDR.

Intraoperative radiation therapy (IORT) has the obvious advantage of maximally irradiating the tumor bed while eliminating surrounding normal organs from the field of radiation. This approach has been especially useful when the required radiation dose exceeds the tolerance dose of the surrounding normal tissues. However, the application of IORT has been significantly limited by cost, logistic issues, and technical problems related to delivering treatment to difficult anatomic areas. We have developed a new approach to IORT that obviates the need for patient transport: In a dedicated, shielded operating room, the surgery is performed and IORT is delivered via HDR remote afterloading. We have found this approach to be cost effective, logistically sound, and suitable for a wide range of anatomic sites. The technical aspects of the procedure, as well our preliminary results in colorectal cancer, will be presented. Lastly, the authors present the technical aspects of delivering HDR intraoperative brachytherapy, their dosimetry atlas, and their results using HDR-IORT in the treatment of patients with colorectal cancer[ONCOLOGY 9(7):679-683, 1995]