Hypofractionation in locally advanced pelvic tumours

A hypofractionation split course regimen [two courses with a 2-week gap, each comprising 3 fractions 6.5 Gy each given over a week] was used as palliative treatment in 126 patients of locally advanced pelvic malignancies. A subjective response rate of 90% was obtained with >50% tumor regression in 53% of patients and a long-term disease free survival in 5 patients. The regimen has logistic advantages and the results obtained are at least, equivalent to that of conventional fractionation [CF]

Omentoplasty after abdomino-peroneal resection: an approach to minimize complications of surgery and postoperative irradiation

Forty patients with carcinoma of the rectum and/or anal canal were treated between November 1986 and December 1990 by abdomino-perineal resection and postoperative irradiation. Omentoplasty was performed to fill the pelvic cavity and keep the small intestine out of the field of irradiation. Perineal wound healing by primary intention occurred in 92% by 15 days. Patients were followed up by barium meal follow through 1, 3 and 6 months after surgery. 85% of patients had the intestine outside the pelvic cavity and 92% showed free mobility. All patients tolerated well radiotherapy; 7.5% had grade I and II transient subacute enteritis and one patient 2.5% had chronic ileitis. Omentoplasty proved valuable in minimizing postoperative surgical complications and post-irradiation radiation injury to the small intestine