From analysis of 490 case records of patients with stage IV A rectal carcinoma, 3 groups of patients were distinguished according to the size of the tumor and the degree of its fixation to the surrounding tissues and growth into the adjacent organs. Such locally spread tumors of the rectum must be subjected to combined treatment: preoperative large-fractional radiotherapy in concurrent local SHF-hyperthermia followed by operation 24-48 hours later. If resectability of the tumor is doubtful, a relieving colostoma is formed in the first stage and distance gammatherapy is applied in a dose of 4 Gy twice a week to a total dose of 32 Gy auring medication with metronidazole and local SHF-therapy. Concurrent intraarterial chemotherapy with 5-fluorouracil (15 mg/kg body weight) has been lately introduced into practice in the treatment of such patients. The results of this complex treatment are evaluated 3-4 weeks after the course is completed.
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