High-dose-rate intraluminal brachytherapy during preoperative chemoradiation for locally advanced rectal cancers

Table 4 Selected trials of intraluminal brachytherapy during preoperative chemoradiation or as preoperative monotherapy in patients with locally advanced rectal cancer

Study, period of study (type of study)	No. of patients	Follow up (mo)	Treatment, protocol	Sphincter preservation rates	ypT0	Local recurrence rate	Distant metastasis	Acute toxicity (ileitis, proctitis), all grades	Disease free survival
Yanagi et al[6], 1986-1995 (retrospective)	Arm A: 96	60	Arm A: MDR-ILBT→surgery	Arm A: 72%		Arm A: 8%	Arm A: 23%	38%	Arm A: 72%
	Arm B: 19		ArmB: HDR-ILBT→surgery	Arm B: 63%	-	Arm B: 5%	Arm B: 16%	74%	Arm B: 68%
	Arm C: 115		Arm C: surgery alone	Arm C: 42%		Arm C: 21%	Arm C: 17%		Arm C: 65%
Kusunoki et al[10], 1986-1995 (case series)								Perforation
	Arm A: 59	5-108	Arm A: MDR-ILBT→surgery	Arm A: 74%				Arm A: 0%
	Arm B: 65		Arm B: HDR-ILBT→surgery	Arm B: 63%	-	-	-	Arm B: 11%	-
Vuong et al[22], 1998-2001 (case series)	49	29 (16-48)	HDR-ILBT→surgery→ chemoradiation	-	64%	2%	4.10%	Grade 2 proctitis 100%	-
								Grade 4 dermatitis 4%
Ishikawa et al[23], 1988-1997 (case series)	41	79.2	EBRT 30 Gy→HDR-ILBT 10 Gy × 4→surgery	-	-	15%	10%	61%	71.80%
Jakobsen et al[24] (case series)	50	Not mentioned	CRT 45 Gy→HDR-ILBT boost→surgery	-	27%	-	-	30%	-
Present study	36	18 (5-22)	Arm A: CRT 45 Gy→ILBT boost 5.5-7 Gy × 2→surgery	Arm A: 66.7%	Arm A: 58.8%		N/A	Arm A: 70.6%	-
			Arm B: CRT 45 Gy→EBRT boost 5.4 Gy→surgery	Arm B: 50%	Arm B: 15.80%	N/A		Arm B: 42.1%

MDR: Moderate dose rate; HDR-ILBT: High dose rate intraluminal brachytherapy; EBRT: External beam radiotherapy; CRT: Chemoradiation; ypT0: Post chemoradiation pathologic T0 stage; N/A: Not available.