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DOI:10.2214/AJR.07.2649
AJR 2009; 192:137-141
© American Roentgen Ray Society

Clinical Observations

CT-Guided Radiofrequency Ablation in the Treatment of Recurrent Rectal Cancer

Giuseppe Belfiore1, Enrico Tedeschi1, Francesco Michele Ronza2, Maria Paola Belfiore1, Ettore Borsi3, Giovanni Pietro Ianniello4 and Antonio Rotondo2

1 Department of Diagnostic Imaging, "S. Anna-S. Sebastiano" Hospital, Via F. Palasciano, 81100, Caserta, Italy.
2 Institute of Radiology, Second University of Naples, Naples, Italy.
3 Department of General Surgery, "S. Anna-S. Sebastiano" Hospital, Caserta, Italy.
4 Department of Oncology and Palliative Care, "S. Anna-S. Sebastiano" Hospital, Caserta, Italy.

OBJECTIVE. Locally recurrent rectal adenocarcinoma remains a therapeutic challenge that is unsatisfactorily managed by surgery and radiation therapy or chemotherapy. Palliative CT-guided radiofrequency ablation was used in 14 patients with recurrent rectal adenocarcinoma who had been previously treated with abdominoperineal resection and radiation therapy. Follow-up CT or MRI was performed at 3, 6, 12, and 24 months. Pain palliation was monitored by the brief pain inventory (BPI).

CONCLUSION. One month after radiofrequency ablation, 11 patients reported satisfactory BPI mean scores reduction compared to baseline (from 7.6 to 3.4 and from 5.1 to 1.6 for worst and average pain, respectively). In two unresponsive patients, retreatment was successfully performed at 3 months. After 24 months, worst and average pain scores further decreased (to 2.6 and 0.8, respectively) in 10 patients, who, at imaging, showed an ablation zone covering the entire original lesion in two patients and incomplete ablation in eight. In our experience, radiofrequency ablation is a safe and effective palliative treatment for patients with recurrent rectal adenocarcinoma.

Keywords: extravascular interventional radiology • palliative treatment • radiofrequency ablation • rectal cancer recurrence • thermoablation


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