Naseem Begum, Shahida Nasreen, Saeed Shah, Jawad Gilani.
The use of high dose rate Intraluminal Brachytherapy in the palliative treatment of Malignant Melanoma of Rectum.
Pak J Radiol Jan ;14(2):13-5.

A 50 years old man suffering from malignant melanoma of lower third of rectum, staged as T4N0 M0. He underwent wide local excision of the tumour. One year later he developed lung and bone metastases along with local recurrence and was referred to the Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar for further management. To achieve quick palliation of distressing symptoms of pain, bleeding per rectum (PIR ) and tenesmus, the patient was treated with high dose rate intraluminal brachytherapy (HDRILD) alone. He received a total dose of 11 Gy in three large fractions (7 Gy/wk) for three weeks. At the end of treatment the tumor regressed to 75% and other symptoms were significantly improved The procedure was well tolerated He died four months later due to brain metastasis but remained free of the local symptoms till death. HDRILB alone can be used as a treatment option in patients with local recurrence and distant metastases, where the life span is limited and aim of the treatment is to palliate the symptoms, as exhibited in our limited experience.

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