Although surgery plays the major role in therapy for recurrent local disease, other modalities of therapy should be considered. Maintenance of chemotherapy as a component of an aggressive treatment approach is recommended, because a local relapse is a prelude of distant metastases in about 50% of cases .
Radiotherapy in all of its modalities deserves an important place. Reduction of pain and bleeding was achieved in the majority of patients, whereas a response to other pelvic symptoms was not apparent. Unfortunately, the duration of effective palliation is achieved for only about one third of the remaining life span of the patient . Also, complications of this mode of therapy are not to be disregarded .
In conclusion, EBRT and IORT, when combined only with R0 resection, improve results of therapy .
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