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https://www.readbyqxmd.com/read/28252805/postoperative-complications-following-intraoperative-radiotherapy-in-abdominopelvic-malignancy-a-single-institution-analysis-of-113-consecutive-patients
#1
Eihab Abdelfatah, Andrew Page, Justin Sacks, Phillip Pierorazio, Trinity Bivalacqua, Jonathan Efron, Stephanie Terezakis, Susan Gearhart, Sandy Fang, Bashar Safar, Timothy M Pawlik, Elwood Armour, Amy Hacker-Prietz, Joseph Herman, Nita Ahuja
BACKGROUND: Intraoperative radiotherapy (IORT) has advantages over external beam radiation therapy (EBRT). Few studies have described side effects associated with its addition. We evaluated our institution's experience with abdominopelvic IORT to assess safety by postoperative complication rates. METHODS: Prospectively collected IRB-approved database of all patients receiving abdominopelvic IORT (via high dose rate brachytherapy) at Johns Hopkins Hospital between November 2006 and May 2014 was reviewed...
March 2, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28237430/evaluation-of-impact-of-an-external-breast-shield-flexishield-in-electronic-brachytherapy-for-breast-iort-a-phantom-study
#2
Yongbok Kim, Jason Wei-Yeong Huynh, Victor J Gonzalez
PURPOSE: To investigate Axxent (iCAD, Inc., San Jose, CA) electronic brachytherapy balloon deformation and its dosimetric impact because of an external flexible shield (FlexiShield [FS]; iCAD, Inc.). METHODS AND MATERIALS: Prostheses breast tissue phantom overlaid three spherical balloon applicators to simulate three clinical scenarios depending on minimum skin-to-balloon surface spacing (SS): balloon with SS of 2 cm, 1 cm, and balloon with 1 cm SS and touching the chest wall...
February 23, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28193241/present-state-and-issues-in-iort-physics
#3
REVIEW
Frank W Hensley
Literature was reviewed to assess the physical aspects governing the present and emerging technologies used in intraoperative radiation therapy (IORT). Three major technologies were identified: treatment with electrons, treatment with external generators of kV X-rays and electronic brachytherapy. Although also used in IORT, literature on brachytherapy with radioactive sources is not systematically reviewed since an extensive own body of specialized literature and reviews exists in this field. A comparison with radioactive sources is made in the use of balloon catheters for partial breast irradiation where these are applied in almost an identical applicator technique as used with kV X-ray sources...
January 27, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28160966/influence-of-intraoperative-radiation-therapy-on-locally-advanced-and-recurrent-colorectal-tumors-a-16-year-experience
#4
Justin T Brady, Benjamin P Crawshaw, Barrington Murrell, Eslam M G Dosokey, Murad A Jabir, Scott R Steele, Sharon L Stein, Harry L Reynolds
BACKGROUND: Intraoperative radiation therapy (IORT) has been proposed as a tool to improve local control in patients with locally advanced primary or recurrent colorectal cancer. METHODS: A retrospective review (1999-2015) of all patients undergoing IORT for locally advanced or recurrent colorectal cancer at a single academic center was performed. Patient demographics, oncologic staging, short-term and long-term outcomes were reviewed. RESULTS: There were 77 patients (mean age 63 ± 11 years) identified, of whom 19 had colon cancer, 57 had rectal cancer, and 2 had appendiceal cancers...
January 3, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28155607/targeted-intraoperative-radiotherapy-tumour-bed-boost-during-breast-conserving-surgery-after-neoadjuvant-chemotherapy-in-her2-positive-and-triple-negative-breast-cancer
#5
Hans-Christian Kolberg, Gyoergy Loevey, Leyla Akpolat-Basci, Miltiades Stephanou, Peter A Fasching, Michael Untch, Max Bulsara, Jayant S Vaidya, Cornelia Liedtke
INTRODUCTION: Targeted intraoperative radiotherapy (TARGIT - IORT) as a tumour bed boost after breast conserving surgery is well established for women with early breast cancer. A previous study from our group shows a beneficial effect of TARGIT-IORT on overall survival (OS) but not disease-free survival (DFS) after neoadjuvant chemotherapy compared to an external boost suggesting a potential non-inferiority of TARGIT-IORT. In this study we present results regarding the high-risk subset of patients (i...
February 1, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28107823/biology-of-high-single-doses-of-iort-rbe-5-r-s-and-other-biological-aspects
#6
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
#7
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
#8
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/28100249/intraoperative-radiation-therapy-iort-in-soft-tissue-sarcoma
#9
REVIEW
Falk Roeder, Robert Krempien
Soft-tissue sarcoma (STS) represent a rare tumor entity, accounting for less than 1% of adult malignancies. The cornerstone of curative intent treatment is surgery with free margins, although the extent of the surgical approach has been subject to change in the last decades. Multimodal approaches usually including radiation therapy have replaced extensive surgical procedures in order to preserve functionality while maintaining adequate local control. However, the possibility to apply adequate radiation doses by external beam radiation therapy (EBRT) can be limited in some situation especially in case of directly adjacent organs at risk with low radiation tolerance...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28100242/intraoperative-radiotherapy-in-gynaecological-and-genito-urinary-malignancies-focus-on-endometrial-cervical-renal-bladder-and-prostate-cancers
#10
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/28077144/intraoperative-radiation-therapy-for-colon-and-rectal-cancers-a-clinical-review
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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