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Intraoperative Radiotherapy

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https://www.readbyqxmd.com/read/28918848/a-multi-institutional-analysis-of-intraoperative-radiotherapy-for-early-breast-cancer-does-age-matter
#1
A M Abbott, S A Valente, L Loftus, R D Tendulkar, J M Greif, K P Bethke, E D Donnelly, C Lottich, D L Ross, N B Friedman, C G Bedi, J E Joh, P Kelemen, R A Hoefer, S K Kang, J Ruffer, A Police, A Fyles, G M Graves, S C Willey, E A Tousimis, W Small, J Lyons, S Grobmyer, C Laronga
BACKGROUND: Single-session intraoperative radiation therapy (IORT) minimizes treatment demands associated with traditional whole breast radiation therapy (WBRT) but outcomes on local disease control and morbidity among the elderly is limited. METHODS: A multi-institutional retrospective registry was established from 19 centers utilizing IORT from 2007 to 2013. Patient, tumor, and treatment variables were analyzed for ages <70 and ≥70. RESULTS: We evaluated 686 patients (<70 = 424; ≥70 = 262) who were margin and lymph node negative...
October 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28894737/fmeca-application-to-intraoperative-electron-beam-radiotherapy-procedure-as-a-quality-method-to-prevent-and-reduce-patient-s-risk-in-conservative-surgery-for-breast-cancer
#2
Cristiana Vidali, Mara Severgnini, Monica Urbani, Licia Toscano, Alfredo Perulli, Marina Bortul
INTRODUCTION: Failure Mode Effects and Criticalities Analysis (FMECA) represents a prospective method for risk assessment in complex medical practices. Our objective was to describe the application of FMECA approach to intraoperative electron beam radiotherapy (IOERT), delivered using a mobile linear accelerator, for the treatment of early breast cancer as an anticipated boost. MATERIALS AND METHODS: A multidisciplinary Working Group, including several different professional profiles, was created before the beginning of clinical practice in 2012, with the purpose of writing the Flow Chart and applying the FMECA methodology to IOERT procedure...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28894694/evaluation-of-partial-breast-reirradiation-with-intraoperative-radiotherapy-after-prior-thoracic-radiation-a-single-institution-report-of-outcomes-and-toxicity
#3
Christine Chin, Priya Jadeja, Bret Taback, David P Horowitz, Sheldon M Feldman, Richard Ha, Eileen P Connolly
INTRODUCTION: Mastectomy is the current standard of care for ipsilateral breast tumor recurrences after prior whole breast irradiation (WBI). We report our single-institution experience with breast-conserving surgery (BCS) followed by intraoperative radiotherapy (IORT) as an alternative to salvage mastectomy for new or recurrent breast cancers that develop in the setting of prior thoracic radiation. METHODS: We performed an IRB-approved retrospective review of patients treated with breast IORT between September 2013 and November 2016...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28885120/threshold-of-the-extent-of-resection-for-who-grade-iii-gliomas-retrospective-volumetric-analysis-of-122-cases-using-intraoperative-mri
#4
Yu Fujii, Yoshihiro Muragaki, Takashi Maruyama, Masayuki Nitta, Taiichi Saito, Soko Ikuta, Hiroshi Iseki, Kazuhiro Hongo, Takakazu Kawamata
OBJECTIVE WHO Grade III gliomas are relatively rare and treated with multiple modalities such as surgery, chemotherapy, and radiotherapy. The impact of the extent of resection (EOR) on improving survival in patients with this tumor type is unclear. Moreover, because of the heterogeneous radiological appearance of Grade III gliomas, the MRI sequence that best correlates with tumor volume is unknown. In the present retrospective study, the authors evaluated the prognostic significance of EOR. METHODS Clinical and radiological data from 122 patients with newly diagnosed WHO Grade III gliomas who had undergone intraoperative MRI-guided resection at a single institution between March 2000 and December 2011 were analyzed retrospectively...
September 8, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28882523/role-of-intraoperative-radiotherapy-in-the-treatment-of-sacral-chordoma
#5
A C Jullien-Petrelli, J M Asencio, M I Orue-Echebarria, P Lozano, A Álvarez, J Serrano, F M Calvo, J A Calvo-Haro, J M Lasso, J L García-Sabrido
BACKGROUND CONTEXT: Sacral chordoma is a rare entity with high local recurrence rates when complete resection is not achieved. Till date, there are not any series available in literature combining surgery and intraoperative radiotherapy (IORT). PURPOSE: To report the experience of our Centre in the management of sacral chordoma combining radical resection with both external radiotherapy and intraoperative radiotherapy (IORT). STUDY DESIGN: Retrospective case series...
September 4, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28877298/association-of-intraoperative-radiotherapy-in-the-treatment-of-early-stage-breast-cancer-with-minor-surgical-site-complications-in-oncoplastic-breast-conserving-surgery
#6
Angelena Crown, Janie W Grumley
No abstract text is available yet for this article.
September 6, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28874627/iort-in-breast-cancer-our-experience-of-the-first-patients-treated
#7
Andrea Morlino, Giuseppe La Torre, Loredana Lapadula, Aldo Cammarota
AIM: The aim of this study was to assess the therapeutic effect of intraoperative radiotherapy, describe the method and examine the results of our experience. BACKGROUND: Breast conserving therapy has recently become a standard treatment modality in patients with early invasive cancer. Radiotherapy, along with surgery, is an integral part of such treatment. The important thing of radiotherapy is to deliver a high dose to the tumour bed. One of the methods is the intraoperative radiotherapy...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28833146/trismus-surgical-release-and-free-flap-reconstruction-after-radiation-therapy-in-oral-and-oropharyngeal-squamous-cell-carcinoma
#8
Alba de Pablo, Yu-Ting Chen, Jyh-Kwei Chen, Chung-Kan Tsao
BACKGROUND AND OBJECTIVES: This study aims to review our experience in trismus release followed by free flap reconstruction after radiotherapy in oral and oropharyngeal cancer, describe the results obtained in long-term follow-up and identify possible predictors of outcome. METHODS: Patients' demographics, tumor characteristics and treatment where retrieved. Surgical release and reconstructive procedures were detailed. Interincisor distances (IIDs) where measured preoperatively (PO-IID), intraoperatively after release (IO-IID) and in the last follow-up (FU-IID)...
August 22, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28819694/thoracic-corpectomy-for-neoplastic-vertebral-bodies-using-a-navigated-lateral-extracavitary-approach-a-single-center-consecutive-case-series-technique-and-analysis
#9
Sebastian Hartmann, Christoph Wipplinger, Anja Tschugg, Pujan Kavakebi, Alexander Örley, Pierre Pascal Girod, Claudius Thomé
Thoracic myelopathy is often caused by vertebral body fractures resulting from neoplastic conditions, traumatic events, or infectious diseases. One of the preferred procedures for treating it is the lateral extracavitary approach (LECA) with single-level or multilevel decompressive corpectomy and reconstruction. The aim of this retrospective study was to analyze the thoracic lateral extracavitary approach with corpectomy using vertebral body replacement systems (VBR-S) and dorsal reconstruction. Twenty-four patients with metastatic or primary lesions of thoracic vertebrae T2-T12 underwent spinal decompression and ventral column reconstruction with correction of spinal deformity via a LECA...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28819067/health-economics-of-targeted-intraoperative-radiotherapy-targit-iort-for-early-breast-cancer-a-cost-effectiveness-analysis-in-the-united-kingdom
#10
Anil Vaidya, Param Vaidya, Brigitte Both, Chris Brew-Graves, Max Bulsara, Jayant S Vaidya
OBJECTIVE: The clinical effectiveness of targeted intraoperative radiotherapy (TARGIT-IORT) has been confirmed in the randomised TARGIT-A (targeted intraoperative radiotherapy-alone) trial to be similar to a several weeks' course of whole-breast external-beam radiation therapy (EBRT) in patients with early breast cancer. This study aims to determine the cost-effectiveness of TARGIT-IORT to inform policy decisions about its wider implementation. SETTING: TARGIT-A randomised clinical trial (ISRCTN34086741) which compared TARGIT with traditional EBRT and found similar breast cancer control, particularly when TARGIT was given simultaneously with lumpectomy...
August 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28815357/carbon-fiber-reinforced-peek-fixation-system-in-the-treatment-of-spine-tumors-a-preliminary-report
#11
Stefano Boriani, Giuseppe Tedesco, Lu Ming, Riccardo Ghermandi, Maurizio Amichetti, Piero Fossati, Marco Krengli, Loredana Mavilla, Alessandro Gasbarrini
BACKGROUND: Protocols including combination of surgery and radiotherapy are more and more frequent in the treatment of bone tumors of the spine. In metastatic disease, combination of surgery and radiotherapy is since long time accepted, as based on clinical evidence. In primary tumors, combination of surgery and radiotherapy can be considered in all the cases in which a satisfactory oncological margin cannot be achieved: high-grade malignancies, recurrent tumors, huge tumors expanding in an extracompartimental area, and when tumor-free margin requires unacceptable functional sacrifices...
August 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28791250/immunotherapy-combined-with-large-fractions-of-radiotherapy-stereotactic-radiosurgery-for-brain-metastases-implications-for-intraoperative-radiotherapy-after-resection
#12
REVIEW
Carsten Herskind, Frederik Wenz, Frank A Giordano
Brain metastases (BM) affect approximately a third of all cancer patients with systemic disease. Treatment options include surgery, whole-brain radiotherapy, or stereotactic radiosurgery (SRS) while chemotherapy has only limited activity. In cases where patients undergo resection before irradiation, intraoperative radiotherapy (IORT) to the tumor bed may be an alternative modality, which would eliminate the repopulation of residual tumor cells between surgery and postoperative radiotherapy. Accumulating evidence has shown that high single doses of ionizing radiation can be highly efficient in eliciting a broad spectrum of local, regional, and systemic tumor-directed immune reactions...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28766200/keynote-address-at-the-american-society-of-breast-surgeons-18th-annual-meeting-current-and-future-application-of-intraoperative-radiotherapy-iort-in-the-curative-and-palliative-treatment-of-breast-cancer
#13
Frederik Wenz
Intraoperative radiotherapy (IORT) is increasingly used worldwide. Breast cancer is the most rapidly growing indication for IORT, approaching 70-80% of cases in most centers. This report reviews the theoretical background and clinical use of IORT for primary and metastasized breast cancer. There are established applications such as tumor bed boost during breast-conserving surgery followed by whole breast radiotherapy or IORT as a form of accelerated partial-breast irradiation (APBI) for selected patients. Novel applications such as IORT for vertebral or brain metastases are presented as well as technological developments, widening the spectrum of potential clinical applications for IORT...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28761533/outcome-following-surgical-resection-of-craniopharyngiomas-a-case-series
#14
K C Bidur, Devkota Upendra Prasad
INTRODUCTION: Debate continues as to the optimum treatment for craniopharyngioma; radical surgical resection or partial resection followed by radiotherapy. Radical surgical resection may be complicated by intraoperative injury to surrounding structures and stormy postoperative hormonal problem. This study aims to examine the result of safe maximal surgical resection. MATERIALS AND METHODS: Retrospective study of all histopathologically proven craniopharyngiomas who had undergone surgical resection over an almost 8 year period was included...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28761513/outcomes-following-surgical-management-of-cervical-chordoma-a-review-of-published-case-reports-and-case-series
#15
My Pham, Mohammed Awad
AIM: This review aimed to summarize the clinical outcomes in relation to tumor resection margins of cervical chordomas. METHODS: Studies that described any surgical intervention for cervical chordoma were identified. Cervical chordomas with cranial or spinal extension, purely retropharyngeal chordomas or where resection type was not reported, were excluded from the study. RESULTS: Seventy-six articles were obtained and these reported a total of 195 patients...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28755426/radical-hysterectomy-after-radiotherapy-for-recurrent-or-persistent-cervical-cancer
#16
Seiji Mabuchi, Katsumi Kozasa, Tadashi Kimura
OBJECTIVE: To evaluate the safety and efficacy of radical hysterectomy after radiotherapy (RH-AR) for recurrent or persistent cervical cancer. METHODS: The present retrospective study included patients who underwent RH-AR for recurrent or persistent cervical cancer at Osaka University Hospital, Japan, between May 1, 2010 and September 30, 2016. Patient characteristics, intraoperative and postoperative adverse events, and surgical outcomes were investigated to identify patients at increased risk of recurrence or severe surgical adverse events...
July 28, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28741896/therapeutic-analysis-of-intrabeam-based-intraoperative-radiation-therapy-in-the-treatment-of-unicentric-breast-cancer-lesions-utilizing-a-spherical-target-volume-model
#17
Madeline Schwid, Eric D Donnelly, Hualin Zhang
It is postulated that the outcomes in treating breast cancer with intraoperative radiotherapy (IORT) would be affected by the residual cancer cell distribution within the tumor bed. The three-dimensional (3D) radiation doses of Intrabeam(TM) (IB) IORT with a 4-cm spherical applicator at the energy of 50 and 40 kV were calculated. The modified linear quadratic model (MLQ) was used to estimate the radiobiological responses of the cancer cells and interspersed normal tissues with various radiosensitivities. By comparing the average survival fraction of normal tissues in IB-IORT and uniform dose treatment for the same level of cancer cell killing, the therapeutic ratios (TRs) were derived...
July 25, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28741839/feasibility-of-spacers-to-facilitate-postoperative-radiotherapy-for-retroperitoneal-sarcomas
#18
Jessica Reid, Richard Smith, Martin Borg, Christopher Dobbins, Raghu Gowda, Steve Chryssidis, Matthew Borg, Susan Neuhaus
INTRODUCTION: The role and timing of postoperative radiotherapy (PORT) in the management of retroperitoneal sarcoma (RPS) remains controversial. METHOD: This is a retrospective cohort review of patients undergoing curative resection for RPS at a single institution between January 2011 and July 2016. Patient selection was through the South Australian Soft Tissue Tumour Multidisciplinary Group (MDT) based at Royal Adelaide Hospital. An individualised approach, including assessment of resectability, histopathological grade and subtype, and radiotherapy considerations, was taken for each patient...
July 25, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28741123/neoadjuvant-radiotherapy-is-associated-with-r0-resection-and-improved-survival-for-patients-with-extremity-soft-tissue-sarcoma-undergoing-surgery-a-national-cancer-database-analysis
#19
Alicia A Gingrich, Sarah B Bateni, Arta M Monjazeb, Morgan A Darrow, Steven W Thorpe, Amanda R Kirane, Richard J Bold, Robert J Canter
BACKGROUND: Neoadjuvant radiotherapy (RT) is increasingly advocated for the management of soft tissue sarcoma (STS). Therefore, this study sought to characterize the impact of neoadjuvant RT on rates of R0 resection and overall survival (OS) in extremity STS patients undergoing surgery. METHODS: From January 2003 to December 2012, the study identified patients with a diagnosis of extremity STS from the National Cancer Database. After exclusion of patients younger than 18 years, not treated by surgery, who had metastases at diagnosis, intraoperative RT, and missing or unknown data, 27,969 patients were identified...
July 24, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28735765/incidental-durotomy-during-total-en-bloc-spondylectomy
#20
Noriaki Yokogawa, Hideki Murakami, Satoru Demura, Satoshi Kato, Katsuhito Yoshioka, Hiroyuki Tsuchiya
BACKGROUND CONTEXT: The incidence of incidental durotomy (ID) during total en bloc spondylectomy (TES) tends to be higher than that during other spinal surgeries because of the peculiarities of TES, including its highly invasive nature, epidural tumor extension, and use in patients who often have complicated medical backgrounds. However, there have been no detailed reports on ID associated with TES. PURPOSE: The study aimed to investigate ID during TES in detail...
July 20, 2017: Spine Journal: Official Journal of the North American Spine Society
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