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https://www.readbyqxmd.com/read/28077144/intraoperative-radiation-therapy-for-colon-and-rectal-cancers-a-clinical-review
#1
REVIEW
Michael G Haddock
Although there have been significant advances in the adjuvant therapy of colorectal cancer, results for patients have historically been poor when complete resection is unlikely or not possible. Similarly, locally recurrent colorectal cancer patients often experience significant tumor related morbidity and disease control and long term survival have historically been poor with standard therapies. Intraoperative radiation therapy (IORT) has been proposed as a possible tool for dose escalation in patients with locally advanced colorectal cancer...
January 11, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28074298/effect-of-intraoperative-radiotherapy-in-the-treatment-of-retroperitoneal-sarcoma
#2
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
#3
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/28048758/su-f-t-90-patterns-of-electron-iort-treatments-in-the-u-s-europe-and-asia
#4
S Adamczyk, D Goer, R Ash
PURPOSE: We analyzed data collected from worldwide centers active in electron IORT with a focus on the technical variables of the treatment. Particular attention was given to the dominant tumor sites. METHODS: 54 Mobetron users from 14 countries in clinical operation prior to December 31, 2014, were invited to participate in this study. 29 centers contributed to this survey in sufficient detail to be included in this report. 6,035 patients were treated since 1997...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048434/su-f-t-654-pacemaker-dose-estimate-using-optically-stimulated-luminescent-dosimeter-for-left-breast-intraoperative-radiation-therapy
#5
Y Chen, A Goenka, A Sharma, L Wang, Y Cao, A Jamshidi
PURPOSE: To assess and report the in vivo dose for a patient with a pacemaker being treated in left breast intraoperative radiation therapy (IORT). The ZEISS Intrabeam 50 kVp X-ray beam with a spherical applicator was used. METHODS: The optically stimulated luminescent dosimeters (OSLDs) (Landauer nanoDots) were employed and calibrated under the conditions of the Intrabeam 50 kVp X-rays. The nanoDots were placed on the patient at approximately 15 cm away from the lumpectomy cavity both under and above a shield of lead equivalence 0...
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
#6
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
#7
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/28047865/we-de-bra-10-development-of-a-novel-scanning-beam-low-energy-intraoperative-radiation-therapy-sbiort-system-for-pancreatic-cancer
#8
B Wears, I Mohiuddin, R Flynn, T Waldron, Y Kim, B Allen, J Xia
PURPOSE: Developing a compact collimator system and validating a 3D surface imaging module for a scanning beam low-energy x-ray radiation therapy (SBIORT) system that enables delivery of non-uniform radiation dose to targets with irregular shapes intraoperatively. METHODS: SBIORT consists of a low energy x-ray source, a custom compact collimator module, a robotic arm, and a 3D surface imaging module. The 3D surface imaging system (structure sensor) is utilized for treatment planning and motion monitoring of the surgical cavity...
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
#9
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/28046691/su-f-t-45-dosimetric-effects-of-saline-filled-balloons-during-iort-using-xoft-electronic-brachytherapy
#10
G Redler, A Templeton, J Turian, J Chu, D Bernard, H Zhen, Y Liao
PURPOSE: The portability of Xoft Axxent Electronic Brachytherapy (EBx) System has made it a viable option for intraoperative radiation therapy (IORT) treatment of early-stage breast cancer. The low energy (50kVp) of the X-ray source makes the shielding easy, but also means its dose distribution is sensitive to the medium's composition. Current treatment planning systems (TPS) typically assume homogenous water for brachytherapy dose calculations, including the pre-calculated atlas plans for the Xoft IORT cases...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27977569/intraoperative-radiation-therapy-iort-in-head-and-neck-cancer-a-systematic-review
#11
George Kyrgias, Jiannis Hajiioannou, Maria Tolia, Vassilios Kouloulias, Vasileios Lachanas, Charalambos Skoulakis, Ioannis Skarlatos, Alexandros Rapidis, Ioannis Bizakis
BACKGROUND: Multimodality therapy constitutes the standard treatment of advanced and recurrent head and neck cancer. Since locoregional recurrence comprises a major obstacle in attaining cure, the role of intraoperative radiation therapy (IORT) as an add-on in improving survival and local control of the disease has been investigated. IORT allows delivery of a single tumoricidal dose of radiation to areas of potential residual microscopic disease while minimizing doses to normal tissues...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27900811/exuberant-squamous-metaplasia-with-calcification-following-intraoperative-radiotherapy-for-breast-carcinoma-report-of-an-unusual-case-and-retrospective-review-of-cases-from-a-single-institution
#12
Paula S Ginter, John Ng, Rebecca Zhuo, Alexander J Swistel, Timothy M D'Alfonso
Intraoperative radiotherapy (IORT) is a novel and increasingly utilized radiation technique in the treatment of breast carcinoma. There are few reports on the histologic changes seen in breast tissue from patients who have undergone IORT. We sought to evaluate the histologic changes observed in specimens received following IORT, as well as report an unusual case which prompted our study. A retrospective review of patients who received IORT and subsequently had breast tissue histologically evaluated at our institution was performed...
November 30, 2016: Breast Journal
https://www.readbyqxmd.com/read/27900058/effect-of-surgical-wound-fluids-after-intraoperative-electron-radiotherapy-on-the-cancer-stem-cell-phenotype-in-a-panel-of-human-breast-cancer-cell-lines
#13
Karolina Zaleska, Wiktoria Maria Suchorska, Anna Przybyła, Dawid Murawa
The wound healing process after surgery alters the area surrounding the original tumor and around the scar, and the modified microenvironment is more favorable for tumor recurrence. Intraoperative radiotherapy (IORT) is one of the more novel strategies in breast cancer (BC) treatment. Irradiation during surgery has effects on the tumor microenvironment, abrogating the proliferative cascade induced by surgical wound healing. The aim of the present study was to determine the effect of surgical wound fluids from IOERT treatment (RT-WF) compared with wound fluids from conservative-breast surgery only (WF) on the cancer stem cell phenotype in a panel of BC cell lines...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27866865/accelerated-partial-breast-irradiation-executive-summary-for-the-update-of-an-astro-evidence-based-consensus-statement
#14
Candace Correa, Eleanor E Harris, Maria Cristina Leonardi, Benjamin D Smith, Alphonse G Taghian, Alastair M Thompson, Julia White, Jay R Harris
PURPOSE: To update the accelerated partial breast irradiation Consensus Statement published in 2009 and provide guidance on use of intraoperative radiation therapy (IORT) for partial breast irradiation in early-stage breast cancer, based on published evidence complemented by expert opinion. METHODS AND MATERIALS: A systematic PubMed search using the same terms as the original Consensus Statement yielded 419 articles; 44 articles were selected. The authors synthesized the published evidence and, through a series of conference calls and e-mails, reached consensus regarding the recommendations...
September 17, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/27861907/factors-predictive-of-failure-to-complete-planned-intraoperative-breast-radiation-using-the-intrabeam%C3%A2-system
#15
Lesly A Dossett, Andrea M Abbott, Weihong Sun, Loretta Loftus, Marie Catherine Lee, Roberto Diaz, Christine Laronga
PURPOSE: Intraoperative radiation therapy (IORT) is a form of breast irradiation that is delivered in a single session at the time of partial mastectomy. In up to 10% of patients, planned IORT is not completed; this leads to wasted resources and decreased patient satisfaction. Our objective was to evaluate factors associated with failure to complete planned IORT. METHODS AND MATERIALS: An IRB-approved review of planned IORT cases from 2011 to 2015 was conducted...
December 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27858093/targeted-intraoperative-radiotherapy-tumour-bed-boost-during-breast-conserving-surgery-after-neoadjuvant-chemotherapy
#16
Hans-Christian Kolberg, Gyoergy Loevey, Leyla Akpolat-Basci, Miltiades Stephanou, Peter A Fasching, Michael Untch, Cornelia Liedtke, Max Bulsara, Jayant S Vaidya
INTRODUCTION: The use of targeted intraoperative radiotherapy (TARGIT-IORT) as a tumour bed boost during breast-conserving surgery (BCS) for breast cancer has been reported since 1998. We present its use in patients undergoing breast conservation following neoadjuvant therapy (NACT). METHOD: In this retrospective study involving 116 patients after NACT we compared outcomes of 61 patients who received a tumour bed boost with IORT during lumpectomy versus 55 patients treated in the previous 13 months with external (EBRT) boost...
January 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/27853900/risk-factors-leading-to-complications-in-early-stage-breast-cancer-following-breast-conserving-surgery-and-intraoperative-radiotherapy
#17
Sunpreet Rakhra, Kevin Bethke, Jonathan Strauss, John P Hayes, Nora Hansen, Seema A Khan, Irene Helenowski, Eric D Donnelly
OBJECTIVE: The aim of this study was to evaluate outcomes after breast-conserving surgery (BCS) and intraoperative radiotherapy (IORT), and to identify risk factors associated with complications. MATERIALS/METHODS: We evaluated patients with early-stage breast cancer treated from January 1, 2011 to January 31, 2014 with BCS and IORT at a single institution. The presence of breast cancer recurrences, complications, or fat necrosis were assessed at subsequent follow-up visits using physical examination and breast imaging...
November 16, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27846840/exclusive-intraoperative-radiotherapy-for-invasive-breast-cancer-in-elderly-patients-70%C3%A2-years-proportion-of-eligible-patients-and-local-recurrence-free-survival
#18
MULTICENTER STUDY
Eric Lambaudie, Gilles Houvenaeghel, Amira Ziouèche, Sophie Knight, François Dravet, Jean Remy Garbay, Sylvie Giard, Hélène Charitansky, Monique Cohen, Christelle Faure, Delphine Hudry, Paul Azuar, Richard Villet, Pierre Gimbergues, Christine Tunon de Lara, Agnès Tallet, Marie Bannier, Mathieu Minsat, Michel Resbeut
BACKGROUND: To estimate the proportion of elderly patients (>70 years) with breast cancer eligible for an Exclusive IntraOperative RadioTherapy (E-IORT) and to evaluate their local recurrence-free survival rate. METHODS: This retrospective study examining two cohorts focuses on patients over 70 years old: a multi-centric cohort of 1411 elderly patients and a mono-centric cohort of 592 elderly patients. All patients underwent conservative surgery followed by external radiotherapy for T0-T3 N0-N1 invasive breast cancer, between 1980 and 2008...
November 15, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27816540/frequency-of-whole-breast-radiation-therapy-after-intraoperative-radiation-therapy-due-to-criteria-identified-by-lumpectomy
#19
Eric A Mellon, Amber Orman, Luis E Joya, Michael E Montejo, Christine Laronga, Susan J Hoover, M Catherine Lee, Nazanin Khakpour, Pamela F Kubal, Roberto Diaz
PURPOSE: For selected early breast cancers, intraoperative radiation therapy (IORT) at the time of lumpectomy can be an efficient alternative to fractionated whole breast radiation therapy (WBRT). However, some patients are later recommended WBRT after IORT due to surgical pathologic findings. To understand risk factor identification rates triggering WBRT recommendation, we analyzed adverse prognostic features based on multiple international criteria for suitability for accelerated partial breast irradiation...
November 2, 2016: Brachytherapy
https://www.readbyqxmd.com/read/27807777/micro-invasive-surgery-combined-with-intraoperative-radiotherapy-for-the-treatment-of-spinal-metastasis
#20
Keng Chen, Lin Huang, Zhaopeng Cai, Juntian Shi, Kaiyun You, Huiyong Shen
PURPOSE: This is a retrospective analysis of the strategy and clinical results of surgery combined with intraoperative radiotherapy (IORT) to treat spinal metastases. METHODS: We delivered tumour-conformal IORT in 40 patients with 52 metastatic vertebrae based on our surgical classification system. The strategies were evaluated with respect to neurologic function and spinal stability. The EORTC QLQ-BM22, visual analogue scale (VAS) and the Frankel Scale were used to assess quality of life, pain and neurologic function...
November 2, 2016: European Spine Journal
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