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Intraoperative Radiotherapy

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https://www.readbyqxmd.com/read/28107823/biology-of-high-single-doses-of-iort-rbe-5-r-s-and-other-biological-aspects
#1
REVIEW
Carsten Herskind, Lin Ma, Qi Liu, Bo Zhang, Frank Schneider, Marlon R Veldwijk, Frederik Wenz
Intraoperative radiotherapy differs from conventional, fractionated radiotherapy in several aspects that may influence its biological effect. The radiation quality influences the relative biologic effectiveness (RBE), and the role of the five R's of radiotherapy (reassortment, repair, reoxygenation, repopulation, radiosensitivity) is different. Furthermore, putative special biological effects and the small volume receiving a high single dose may be important. The present review focuses on RBE, repair, and repopulation, and gives an overview of the other factors that potentially contribute to the efficacy...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28103903/intraoperative-radiotherapy-iort-as-boost-in-breast-cancer
#2
REVIEW
Felix Sedlmayer, Roland Reitsamer, Frederik Wenz, Elena Sperk, Christoph Fussl, Julia Kaiser, Ingrid Ziegler, Franz Zehentmayr, Heinz Deutschmann, Peter Kopp, Gerd Fastner
The term IORT (intraoperative radiotherapy) is currently used for various techniques that show huge differences in dose delivery and coverage of the tissue at risk. The largest evidence for boost IORT preceding whole breast irradiation (WBI) originates from intraoperative electron treatments (IOERT) with single doses around 10 Gy. At median follow-up periods at 6 years, outstandingly low local recurrence rates of less than 1% are observed. Higher local relapse rates were described for G3 tumors and triple negative breast cancers as well as for IORT following primary systemic treatment for locally advanced tumors...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28102948/use-of-parallel-plate-ionization-chambers-in-reference-dosimetry-of-novac-and-liac-%C3%A2-mobile-electron-linear-accelerators-for-intraoperative-radiotherapy-a-multi-center-survey
#3
Paolo Scalchi, Alessia Ciccotelli, Giuseppe Felici, Assunta Petrucci, Raffaella Massafra, Valeria Piazzi, Paola D'Avenia, Francesca Cavagnetto, Federica Cattani, Raffaella Romagnoli, Antonella Soriani
PURPOSE: LIAC(®) and NOVAC are two mobile linear accelerators dedicated to intraoperative radiation therapy (IORT), generating electron beams in the energy range of 3-12 MeV. Due to high dose-per-pulse (up to 70 mGy per pulse), in 2003 the Italian National Institute of Health (ISS) stated that "for the measure of dose to water in reference conditions, ionization chambers cannot be employed and no published dosimetry protocol can be used". As a consequence, ferrous sulphate (or, alternatively alanine) dosimetry was recommended...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28100242/intraoperative-radiotherapy-in-gynaecological-and-genito-urinary-malignancies-focus-on-endometrial-cervical-renal-bladder-and-prostate-cancers
#4
REVIEW
Marco Krengli, Carla Pisani, Letizia Deantonio, Daniela Surico, Alessandro Volpe, Nicola Surico, Carlo Terrone
Intraoperative radiotherapy (IORT) refers to the delivery of a single radiation dose to a limited volume of tissue during a surgical procedure. A literature review was performed to analyze the role of IORT in gynaecological and genito-urinary cancer including endometrial, cervical, renal, bladder and prostate cancers.Literature search was performed by Pubmed and Scopus, using the words "intraoperative radiotherapy/IORT", "gynaecological cancer", "uterine/endometrial cancer", "cervical/cervix cancer", "renal/kidney cancer", "bladder cancer" and "prostate cancer"...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28099603/squamoid-eccrine-ductal-carcinoma
#5
Maria Isabel Ramos Saraiva, Marcella Amaral Horta Barbosa Vieira, Larissa Karine Leite Portocarrero, Rafael Cavanellas Fraga, Priscila Kakizaki, Neusa Yuriko Sakai Valente
Squamoid eccrine ductal carcinoma is an eccrine carcinoma subtype, and only twelve cases have been reported until now. It is a rare tumor and its histopathological diagnosis is difficult. Almost half of patients are misdiagnosed as squamous cell carcinoma by the incisional biopsy. We report the thirteenth case of squamoid eccrine ductal carcinoma. Female patient, 72 years old, in the last 6 months presenting erythematous, keratotic and ulcerated papules on the nose. The incisional biopsy diagnosed squamoid eccrine ductal carcinoma...
November 2016: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28088221/role-of-pelvic-and-para-aortic-lymphadenectomy-in-abandoned-radical-hysterectomy-in-cervical-cancer
#6
Salim Abraham Barquet-Muñoz, Gabriel Jaime Rendón-Pereira, Denise Acuña-González, Monica Vanessa Heymann Peñate, Luis Alonso Herrera-Montalvo, Lenny Nadia Gallardo-Alvarado, David Francisco Cantú-de León, René Pareja
BACKGROUND: Cervical cancer (CC) occupies fourth place in cancer incidence and mortality worldwide in women, with 560,505 new cases and 284,923 deaths per year. Approximately, nine of every ten (87%) take place in developing countries. When a macroscopic nodal involvement is discovered during a radical hysterectomy (RH), there is controversy in the literature between resect macroscopic lymph node compromise or abandonment of the surgery and sending the patient for standard chemo-radiotherapy treatment...
January 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28078113/results-of-intraoperative-electron-beam-radiotherapy-containing-multimodality-treatment-for-locally-unresectable-t4-rectal-cancer-a-pooled-analysis-of-the-mayo-clinic-rochester-and-catharina-hospital-eindhoven
#7
Fabian A Holman, Michael G Haddock, Leonard L Gunderson, Miranda Kusters, Grard A P Nieuwenhuijzen, Hetty A van den Berg, Heidi Nelson, Harm J T Rutten
BACKGROUND: The aim of this study is to analyse the pooled results of intraoperative electron beam radiotherapy (IOERT) containing multimodality treatment of locally advanced T4 rectal cancer, initially unresectable for cure, from the Mayo Clinic, Rochester, USA (MCR) and Catharina Hospital, Eindhoven, The Netherlands (CHE), both major referral centers for locally advanced rectal cancer. A rectal tumor is called locally unresectable for cure if after full clinical work-up infiltration into the surrounding structures or organs has been demonstrated, which would result in positive surgical margins if resection was the initial component of treatment...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28074298/effect-of-intraoperative-radiotherapy-in-the-treatment-of-retroperitoneal-sarcoma
#8
Liz B Wang, David McAneny, Gerard Doherty, Teviah Sachs
BACKGROUND: Current National Comprehensive Cancer Network guidelines for the treatment of retroperitoneal sarcomas (RPS) endorse surgical resection, but the role of radiotherapy (RT) is less clear. We investigate the utilization and benefits of intraoperative RT (IORT) in the treatment of RPS. METHODS: We queried the Surveillance, Epidemiology and End Results (SEER) database (1988-2013) for the utilization of IORT and perioperative external beam RT (EBRT) in patients who underwent surgical resection of RPS...
January 10, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28069018/intraoperative-radiation-therapy-iort-in-pancreatic-cancer
#9
REVIEW
Robert Krempien, Falk Roeder
Despite the important improvements made in the fields of surgery, chemotherapy and radiation therapy, pancreatic cancer remains one of the most lethal malignancies. Improved outcomes with novel chemotherapy regimes led again to increased attention on the role of localized radiotherapy, since local tumor progression causes significant morbidity and mortality in patients. Even after resection local failure rates are as high as 50-80%. The immediate proximity to critical structures (bone marrow, spinal cord, kidneys, liver, and intestine) limits the dose of radiation that can be administered to the tumor bed with conventional external beam radiation therapy (EBRT)...
January 10, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28063782/acceptable-clinical-outcomes-and-recommended-reconstructive-strategies-for-secondary-maxillary-reconstruction-with-vascularized-fibula-osteomyocutaneous-flap-a-retrospective-analysis
#10
Yi Shen, Jun Li, Andrew Ow, Liang Wang, Ming-Ming Lv, Jian Sun
BACKGROUND: We conducted a retrospective analysis of the clinical outcomes and evaluated the reconstructive strategies in patients who underwent secondary maxillary reconstruction with a vascularized fibula osteomyocutaneous flap (VFOF). METHODS: From May of 2001 to June of 2014, 34 patients who underwent secondary maxillary reconstruction with VFOF, with or without titanium mesh, were reviewed. The patients were divided into two groups of maxillary reconstruction, according to different planning and treatment strategies...
December 14, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28063695/ipsilateral-axillary-recurrence-after-breast-conservative-surgery-the-protective-effect-of-whole-breast-radiotherapy
#11
Oreste Gentilini, Edoardo Botteri, Maria Cristina Leonardi, Nicole Rotmensz, Jose Vila, Nickolas Peradze, Maria Virginia Thomazini, Barbara Alicja Jereczek, Viviana Galimberti, Alberto Luini, Paolo Veronesi, Roberto Orecchia
BACKGROUND AND PURPOSE: Whole breast radiotherapy (WBRT) is one of the possible reasons for the low rate of axillary recurrence after breast-conserving surgery (BCS). PATIENTS AND METHODS: We retrospectively collected data from 4,129 consecutive patients with breast cancer ⩽2cm and negative sentinel lymph node who underwent BCS between 1997 and 2007. We compared the risk of axillary lymph node recurrence between patients treated by WBRT (n=2939) and patients who received partial breast irradiation (PBI; n=1,190) performed by a single dose of electron intraoperative radiotherapy...
January 4, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28048665/su-f-t-243-major-risks-in-radiotherapy-a-review-based-on-risk-analysis-literature
#12
J López-Tarjuelo, A Bouché-Babiloni, V Morillo-Macías, M Guasp-Tortajada, N Iglesias-Montenegro, P Monasor-Denia, C Ferrer-Albiach
PURPOSE: We present a literature review of risk analyses in radiotherapy to highlight the most reported risks and facilitate the spread of this valuable information so that professionals can be aware of these major threats before performing their own studies. METHODS: We considered studies with at least an estimation of the probability of occurrence of an adverse event (O) and its associated severity (S). They cover external beam radiotherapy, brachytherapy, intraoperative radiotherapy, and stereotactic techniques...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048153/su-f-p-33-combining-research-and-professional-practice-in-the-clinical-setting-a-medical-physicist-personal-experience
#13
J L Oacutepez-Tarjuelo
PURPOSE: To initiate a discussion on the current and evolving role of Medical Physicists based on author's professional and research experience in patient safety and quality control. METHODS: Several professionals of the departments of Medical Physics and Radiation Oncology, chiefly devoted to clinical tasks, began a research program on patient safety and quality control in a framework provided by the implementation of intraoperative radiotherapy (IORT). We performed studies on virtual simulation for IORT, in vivo dosimetry, failure mode and effect analysis (FMEA), statistical process control (SPC), and receiver operating characteristics of dosimetric equipment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048080/su-f-t-80-a-mobile-application-for-intra-operative-electron-radiotherapy-treatment-planning
#14
C Williams, E Crowley, J Wolfgang
PURPOSE: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047586/su-g-201-10-experimental-determination-of-modified-tg-43-dosimetry-parameters-for-the-xoft-axxent%C3%A2-electronic-brachytherapy-source
#15
S Simiele, B Palmer, L DeWerd
PURPOSE: The establishment of an air kerma rate standard at NIST for the Xoft Axxent(®) electronic brachytherapy source (Axxent(®) source) motivated the establishment of a modified TG-43 dosimetry formalism. This work measures the modified dosimetry parameters for the Axxent(®) source in the absence of a treatment applicator for implementation in Xoft's treatment planning system. METHODS: The dose-rate conversion coefficient (DRCC), radial dose function (RDF) values, and polar anisotropy (PA) were measured using TLD-100 microcubes with NIST-calibrated sources...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047521/su-f-t-52-study-of-energy-dependent-effect-of-dosimetry-systems-used-in-therapeutic-soft-x-ray-energy-range
#16
S Souri, X Qian, G Gill, A Jamshidi, Y Cao, Y Chen
PURPOSE: To investigate energy dependent effects of different dosimetry systems which can be used as in vivo dosimetry monitoring for intraoperative radiotherapy in therapeutic soft x-ray energy range. METHODS: Three dosimetry systems were evaluated in therapeutic soft x-ray energy range: optically stimulated luminescent dosimeter (OSLD) nanoDots, radiochromic EBT2 and EBT3 films. The x-ray photons were produced by a Zeiss Intrabeam 50 kV x-ray radiotherapy system...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046864/su-f-t-53-treatment-planning-with-inhomogeneity-correction-for-intraoperative-radiotherapy-using-kv-x-ray-beams
#17
Y Chen, M Ghaly, S Souri, L Wang, F Diaz, Y Cao, E Klein, A Jamshidi
PURPOSE: The current standard in dose calculation for intraoperative radiotherapy (IORT) using the ZEISS Intrabeam 50 kV x-ray system is based on depth dose measurements in water and no heterogeneous tissue effect has been taken into account. We propose an algorithm for pre-treatment planning including inhomogeneity correction based on data of depth dose measurements in various tissue phantoms for kV x-rays. METHODS: Direct depth dose measurements were made in air, water, inner bone and cortical bone phantoms for the Intrabeam 50 kV x-rays with a needle applicator...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046301/su-f-t-670-from-the-or-to-the-radiobiology-lab-the-journey-of-a-small-x-ray-source
#18
J Lehmann, M Barry, R Jones, M Fay
PURPOSE: Irradiation of small animal tumor models within laboratories is vital to radiobiological experiments. Often the animals are not able to be brought back into the lab after being taken out for irradiation. Cell biology laboratories benefit from irradiation capability available around the clock without regard to patient load in an associated radiotherapy clinic. Commercial systems are available, but bulky and expensive. METHODS: An intraoperative kV irradiation system (IntraBeam™) designed to deliver spherical dose distributions to surgical cavities has been repurposed for the irradiation of cell plates and small laboratory animals...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28031042/transitional-cell-carcinoma-with-extension-of-the-renal-vein-and-ivc-tumor-thrombus-report-of-three-cases-and-literature-review
#19
Mingyang Li, An Shi, Wen Kong, Jin Zhang, Yonghui Chen, Jiwei Huang, Yiran Huang
BACKGROUND: Transitional cell carcinoma (TCC) originating from the renal pelvis with a venous tumor thrombus is a rare entity. However, clinicians should be aware of it because of its high malignancy and poor prognosis. CASE PRESENTATION: Here, we report three cases of pathologically confirmed TCC originating from the renal pelvis with extension into the renal vein or inferior vena cava (IVC). Of these patients, two are males and one is female (58~73 years old)...
December 28, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28019107/gross-total-resection-rates-of-grade-ii-iii-intramedullary-ependymomas-using-the-surgical-strategy-of-en-bloc-resection-without-intra-operative-neurophysiological-monitoring
#20
Kieron J Sweeney, Matt Reynolds, Michael Farrell, Ciaran Bolger
INTRODUCTION: Grade II and III intramedullary ependymomas [IME] are circumscribed with a plane of cleavage that should facilitate high gross total resection rates (GTR). Gross total resection of grade II/III IME is superior to subtotal resection (STR) and radiotherapy (RTx) for progression-free and overall survival. We sought to compare our GTR with other series that have utilised standard intraoperative monitoring techniques and we explored factors that may influence rates of resection...
December 25, 2016: British Journal of Neurosurgery
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