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Intraoperative Radiotherapy

Kay Mursch, Martin Scholz, Wolfgang Brück, Julianne Behnke-Mursch
Purpose: The aim of this study was to investigate whether intraoperative ultrasonography (IOUS) helped the surgeon navigate towards the tumor as seen in preoperative magnetic resonance imaging and whether IOUS was able to distinguish between tumor margins and the surrounding tissue. Methods: Twenty-five patients suffering from high-grade gliomas who were previously treated by surgery and radiotherapy were included. Intraoperatively, two histopathologic samples were obtained a sample of unequivocal tumor tissue (according to anatomical landmarks and the surgeon's visual and tactile impressions) and a small tissue sample obtained using a navigated needle when the surgeon decided to stop the resection...
August 8, 2016: Ultrasonography
Marco Krengli, Carla Pisani, Letizia Deantonio
The guidelines of the European and American Societies of Radiation Oncology (GEC-ESTRO and ASTRO) defined the selection criteria to offer partial breast irradiation (PBI) after lumpectomy in patients with low risk breast cancer regardless pre-operative staging. A recent publication by Tallet et al. explored the impact of preoperative magnetic resonance imaging (MRI) on patient eligibility for PBI. From their study, an ipsilateral BC was detected in 4% of patients, excluding these patients from intraoperative radiotherapy (IORT)...
September 2016: Journal of Thoracic Disease
Florence K Keane, Jennifer Y Wo, Cristina R Ferrone, Jeffrey W Clark, Lawrence S Blaszkowsky, Jill N Allen, Eunice L Kwak, David P Ryan, Keith D Lillemoe, Carlos Fernandez-Del Castillo, Theodore S Hong
OBJECTIVES: Improved outcomes with FOLFIRINOX or gemcitabine with nab-paclitaxel in the treatment of metastatic pancreatic adenocarcinoma (PDAC) have prompted incorporation of these regimens into neoadjuvant treatment of locally advanced unresectable PDAC. Whereas some patients remain unresectable on surgical exploration, others are able to undergo resection after intensive neoadjuvant treatment. We evaluated outcomes and toxicity associated with use of intensive neoadjuvant treatment followed by intraoperative radiotherapy (IORT) in combination with resection or exploratory laparotomy...
October 12, 2016: American Journal of Clinical Oncology
Peng Gao, Chengche Tsai, Yuchong Yang, Yingying Xu, Changwang Zhang, Cong Zhang, Longyi Wang, Hongpeng Liu, Zhenning Wang
BACKGROUND: The treatment effects of intraoperative radiotherapy (IORT) for gastric and esophageal cancer remain uncertain. We therefore performed meta-analyses to investigate whether IORT was associated with more favorable oncologic outcomes when compared to non-IORT for patients who have gastric or esophageal cancer. METHODS: PubMed, Embase, and the references of relevant studies were systematically searched up to March 2016. Outcomes were analyzed with fixed-effect or random-effect models, and the meta-analysis was completed with odds ratio (OR), hazards ratio (HR), and 95% confidence intervals (CI) as effect values...
October 4, 2016: Minerva Medica
Jayant S Vaidya, Frederik Wenz, Max Bulsara, Jeffrey S Tobias, David J Joseph, Christobel Saunders, Chris Brew-Graves, Ingrid Potyka, Stephen Morris, Hrisheekesh J Vaidya, Norman R Williams, Michael Baum
BACKGROUND: Based on our laboratory work and clinical trials we hypothesised that radiotherapy after lumpectomy for breast cancer could be restricted to the tumour bed. In collaboration with the industry we developed a new radiotherapy device and a new surgical operation for delivering single-dose radiation to the tumour bed - the tissues at highest risk of local recurrence. We named it TARGeted Intraoperative radioTherapy (TARGIT). From 1998 we confirmed its feasibility and safety in pilot studies...
September 2016: Health Technology Assessment: HTA
Zulma Tovar-Spinoza, Hoon Choi
BACKGROUND: Pediatric low-grade gliomas (LGGs) account for approximately half of all pediatric central nervous system tumors. The low-grade gliomas' first line of treatment is gross total resection. However, when gross total resection is not possible, options for adjuvant therapy are limited. MRI-guided laser ablation (magnetic resonance-guided laser interstitial thermal therapy (MRgLITT)) offers a new option for treatment in selected cases. We present a description of the current MRgLITT technology and an exemplary case-series review of our experience in its use in LGGs...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Kris Armoogum, Simon Evans, David Morgan
PURPOSE: We present a framework, in which we compare a conventional standard dose of 50 Gy in 25 fractions with accelerated partial breast irradiation (APBI) using electronic brachytherapy (eBT). We discuss how radiobiological modelling enables us to establish a framework, within which we can compare external beam radiotherapy (EBRT). This leads to a determination of the shell of isoeffect in breast tissue, at which very low kV eBT can be considered to be clinically equivalent to standard EBRT...
August 2016: Journal of Contemporary Brachytherapy
Emanuela Esposito, Michae Douek
No abstract text is available yet for this article.
August 2016: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Tom Treasure, Paul De Leyn
Third Mediterranean Symposium on Thoracic Surgical Oncology, Catania, Italy, 21-22 April 2016 The primary justification for mediastinal lymphadenectomy is that it provides more complete nodal staging to help select best adjuvant treatments. There is a secondary argument that dissection of nodes might remove otherwise unrecognized nodal disease to increase the chance of cure. They have to be thought through again as patients look for less invasive treatments for their cancers such as videothoracoscopy and stereotactic radiotherapy...
September 19, 2016: Future Oncology
Mara Bozza Stephenson, Bryan Glaenzer, Angelo Malamis
Spinal metastases are a common and morbid condition in America. Of the 1.6 million new cases of cancer estimated to be diagnosed in the USA in 2015, approximately 5-10 % will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with osteolytic spinal metastases experience severe and often debilitating pain, which significantly reduces quality of life. Due to the morbidity of open surgery, particularly in oncologic patients, the treatment paradigm has shifted towards minimally invasive therapy...
November 2016: Current Treatment Options in Oncology
Adrian Sh Ooi, David H Song
Implant-based procedures are the most commonly performed method for postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk...
2016: Breast Cancer: Targets and Therapy
M Aumont
Breast-conserving surgery followed by whole breast postoperative irradiation is considered to be the current standard treatment for patients with early stage breast cancer. It allows an excellent local tumour control with 6% of local recurrence. Over the last years, partial breast radiotherapy has been developed to reduce treatment volume and duration. Intraoperative radiotherapy is one of the techniques. It offers an excellent delineation of the tumour bed and high normal tissue sparing. This purpose of this review is to describe the different intraoperative radiotherapy techniques available, to assess their potential clinical efficiency and tolerance, the recommendations for new practice with a selected population of patients and for future research...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Michał Falco, Bartłomiej Masojć, Magdalena Rolla, Agnieszka Czekała, Jolanta Pietruszewska, Agnieszka Rubik-Leszczyńska, Mirosław Lewocki, Magdalena Łukowiak, Andrzej Kram
BACKGROUND: Novel techniques in oncology provide new treatment opportunities but also introduce different patterns of side effects. Intraoperative radiotherapy (IORT) allows a shortened overall treatment time for early breast cancer either combined with whole breast radiotherapy (WBRT), or alone. Although the early side effects of IORT are well known, data on clinically important late side effects, which require medical intervention, are scarce. AIM: In this study, we analyze risk factors for seroma evacuation more than 6 months after IORT...
May 2016: Reports of Practical Oncology and Radiotherapy
Nicole A Larrier, Brian G Czito, David G Kirsch
Soft tissue sarcomas are rare mesenchymal cancers that pose a treatment challenge. Although small superficial soft tissue sarcomas can be managed by surgery alone, adjuvant radiotherapy in addition to limb-sparing surgery substantially increases local control of extremity sarcomas. Compared with postoperative radiotherapy, preoperative radiotherapy doubles the risk of a wound complication, but decreases the risk for late effects, which are generally irreversible. For retroperitoneal sarcomas, intraoperative radiotherapy can be used to safely escalate the radiation dose to the tumor bed...
October 2016: Surgical Oncology Clinics of North America
Sandra D Scherer, Jochen Bauer, Anja Schmaus, Christian Neumaier, Carsten Herskind, Marlon R Veldwijk, Frederik Wenz, Jonathan P Sleeman
In patients with low-risk breast cancer, intraoperative radiotherapy (IORT) during breast-conserving surgery is a novel and convenient treatment option for delivering a single high dose of irradiation directly to the tumour bed. However, edema and fibrosis can develop after surgery and radiotherapy, which can subsequently impair quality of life. TGF- β is a strong inducer of the extracellular matrix component hyaluronan (HA). TGF-β expression and HA metabolism can be modulated by irradiation experimentally, and are involved in edema and fibrosis...
2016: PloS One
C R Wirtz
Intraoperative navigation systems are widely used in ENT, oral and maxillofacial, and neurosurgery. The benefits of such systems have been demonstrated in various applications, including intracranial and skull base surgery. Intraoperative shift, "brain shift" and changes in anatomy caused by the surgical procedure itself impair the accuracy of navigation and represent factors limiting its application, particularly in glioma and metastatic brain surgery. For this reason, intraoperative imaging was incorporated into neurosurgery...
September 2016: HNO
Marina Nikitović, Danica Grujičić, Milica Skender Gazibara, Dragana Stanić, Jelena Bokun, Milan Sarić
Primary spinal cord germinomas are an extremely rare group of tumors, most commonly reported as single cases in young Japanese adults. They usually present as intramedullary lesions located in the thoracic and thoracolumbar spine. The importance of preoperative diagnosis lies in the fact that by using radiotherapy and chemotherapy, even without surgery, a good cure rate can be achieved in patients with spinal cord germinoma. However, these tumors demonstrate unspecific imaging characteristics and only some secrete tumor markers...
August 20, 2016: World Neurosurgery
Adel H Metwally, Mahmoud H Sherief, Mohamed A Elkoushy
OBJECTIVE: To evaluate the safety and efficacy of percutaneous cystolitholapaxy (PCCL) under cystoscopic guidance and without fluoroscopy for the management of large or multiple bladder stones. PATIENTS AND METHODS: Prospectively collected data were reviewed for patients undergoing PCCL with cystoscopic guidance and without fluoroscopy. Patients with a bladder stone burden of ⩾30 mm were included. Stone fragmentation was achieved using a pneumatic lithotripter through a rigid nephroscope and the fragments were removed with peanut forceps...
September 2016: Arab Journal of Urology
Henk Struikmans, Malou Snijders, Mirjam E Mast, Ursula Fisscher, Jan-Huib Franssen, Marcelle J Immink, Andreas Marinelli, Jos Merkus, Anna Petoukhova, Gabrielle Speijer, Peter Koper
BACKGROUND: Scarce data are available about the cosmetic result of single dose intraoperative electron radiotherapy (IOERT) in breast-conserving radiotherapy. METHODS AND MATERIALS: We included 71 breast cancer patients. Breast-conserving surgery and sentinel node procedure had started almost 3 years earlier. Subsequently, 26 patients were treated with IOERT and 45 patients received postoperative whole breast irradiation (WBI). For both groups we determined seven dimensionless asymmetry features...
October 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
S Saito, S Fujita, J Mizusawa, Y Kanemitsu, N Saito, Y Kinugasa, Y Akazai, M Ota, M Ohue, K Komori, M Shiozawa, T Yamaguchi, T Akasu, Y Moriya
BACKGROUND: We conducted a randomized controlled trial (JCOG0212) to determine whether the outcome of mesorectal excision (ME) alone for rectal cancer is not inferior to that of ME with lateral lymph node dissection (LLND). The present study focused on male sexual dysfunction after surgery. METHODOLOGY: Eligibility criteria included clinical stage II/III rectal cancer, the lower margin of the lesion below the peritoneal reflection, the absence of lateral pelvic lymph node enlargement, and no preoperative radiotherapy...
July 30, 2016: European Journal of Surgical Oncology
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