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https://www.readbyqxmd.com/read/28613934/standard-fractionation-external-beam-radiotherapy-with-and-without-intraoperative-radiotherapy-for-locally-recurrent-rectal-cancer-the-role-of-local-therapy-in-patients-with-a-high-competing-risk-of-death-from-distant-disease
#1
Amar U Kishan, Justin C Voog, Jonathan Wiseman, Ryan R Cook, Marek Ancukiewicz, Percy Lee, David P Ryan, Jeffrey W Clark, David L Berger, James C Cusack, Jennifer Y Wo, Theodore S Hong
OBJECTIVES: We sought to evaluate the effectiveness and safety of utilizing radiotherapy (RT) with standard fractionation, with or without intraoperative radiotherapy (IORT), to treat locally recurrent rectal cancer (LRRC). METHODS: Retrospective review of 25 patients with LRRC treated with standard fractionation RT from 2005-2011. Fifteen patients (60%) had prior pelvic RT and ten (40%) had synchronous metastases. The median equivalent dose in 2 Gy fractions was 30 Gy and 49...
June 14, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28608393/the-impact-of-the-use-of-intraoperative-radiotherapy-on-costs-travel-time-and-distance-for-women-with-breast-cancer-in-the-mexico-city-metropolitan-area
#2
Juan Enrique Bargallo-Rocha, Enrique Soto-Perez-de-Celis, Francisco Javier Picó-Guzmán, Carlos Eduardo Quintero-Rodríguez, David Almog, Gabriel Santiago-Concha, Christian Haydee Flores-Balcazar, Jaime Corona, Rafael Vazquez-Romo, Cynthia Villarreal-Garza, Alejandro Mohar
BACKGROUND AND OBJECTIVES: The low availability and poor access to external beam radiotherapy (EBRT) in developing countries makes it hard for women with breast cancer to receive breast conservation. We studied the effect of providing intraoperative radiotherapy (IORT) on the travel time, distance, and costs of in the Mexico City Metropolitan Area (MCMA). METHODS: Sixty-nine patients treated between January 2013 and September 2014 were analyzed. Travel distance and transit time was calculated using Google Maps...
June 12, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28608120/cosmetic-outcome-and-chronic-breast-toxicity-after-intraoperative-radiation-therapy-iort-as-a-single-modality-or-as-a-boost-using-the-intrabeam-%C3%A2-device-a-prospective-study
#3
Stéphane Key, Petra Miglierini, Pierre-François Dupré, Sandrine Guilbert, Anne-Sophie Lucia, Ronan Abgral, Virginie Conan-Charlet, Arnaud Uguen, Olivier Pradier, Ulrike Schick
PURPOSE: We aim to report our results in terms of chronic toxicities and cosmetic outcomes after intraoperative radiotherapy (IORT) using kV X-rays in women treated for early breast cancer at our institution. METHODS: Patients with early breast carcinoma were recruited between April 2011 and November 2014. After breast-conserving surgery, patients were treated with IORT using the Intrabeam(®) device. IORT was completed by whole-breast radiotherapy (WBRT) at a dose of 46-50...
June 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28597470/breast-conservation-for-male-breast-cancer-case-report-of-intraoperative-radiation
#4
Ameer Gomberawalla, Peter Liou, Rebecca Martinez, Raj Rajpara, Eileen Connolly, David Horowitz, Sheldon Feldman
Male breast cancer (MBC) comprises <1% of all breast cancers in the United States. MBC is typically treated with total mastectomy while the majority of female breast cancer is treated with breast conservation therapy combined with various forms of radiation. One method that has developed over the last two decades is the use of intraoperative radiation therapy (IORT) as a type of accelerated partial breast irradiation to direct the treatment field to the tumor bed. Since overall prognosis and systemic therapy recommendations for MBC are similar to breast cancer in women, we describe the first case of MBC treated with BCS and IORT...
June 8, 2017: Breast Journal
https://www.readbyqxmd.com/read/28578507/breast-cancer-electron-intraoperative-radiotherapy-assessment-of-preoperative-selection-factors-from-a-retrospective-analysis-of-758-patients-and-review-of-literature
#5
REVIEW
S Takanen, A Gambirasio, G Gritti, M Källi, S Andreoli, M Fortunato, L Feltre, F R Filippone, E Iannacone, L Maffioletti, R Muni, F Piccoli, E M P Mauri, A Paludetti, M Giovanelli, L Burgoa, C Valerii, F Palamara, M Ferro, P Fenaroli, C A Tondini, L F Cazzaniga
PURPOSE: To report our experience with full-dose 21 Gy IORT in early breast cancer patients after breast-conserving surgery to define most important selection factors. METHODS: Seven hundred and fifty eight patients, subjected to conserving surgery and IORT, were retrospectively analyzed evaluating most important clinical outcomes. RESULTS: Median follow up was 5.2 years. Results from Cox analyses defined 2 groups of patients, "suitable" (age > 50 years, non lobular histology, tumour size ≤ 2 cm, pN0 or pNmic, ki67 ≤ 20%, non triple negative receptor status and G1-G2) and "unsuitable" for IORT, with a higher rate of breast related events moving from "suitable" to "unsuitable" group...
June 3, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28559768/intraoperative-radiotherapy-of-breast-cancer-and-its-biological-effects
#6
REVIEW
Igor Piotrowski, Katarzyna Kulcenty, Mateusz Wichtowski, Dawid Murawa, Wiktoria Suchorska
Conservative breast cancer surgery followed by radiation therapy is the standard treatment for this type of cancer. Numerous studies demonstrate that 90% of local recurrences after traditional surgery occur in the same quadrant as the primary cancer. The published data suggest that the wound healing process after surgery alters the area surrounding the original tumor and the modified microenvironment is more favorable for the tumor to recur. The majority of metastases within scar initiated much research, and the consequences of these studies led to clinical trials aimed at assessing whether localized radiotherapy, such as intraoperative radiotherapy (IORT), would be more effective in inhibiting formation of local recurrence than the standard postoperative whole breast radiotherapy...
May 2017: Breast Care
https://www.readbyqxmd.com/read/28535919/precision-iort-image-guided-intraoperative-radiation-therapy-igiort-using-online-treatment-planning-including-tissue-heterogeneity-correction
#7
Frank Schneider, Frederic Bludau, Sven Clausen, Jens Fleckenstein, Udo Obertacke, Frederik Wenz
BACKGROUND: To the present date, IORT has been eye and hand guided without treatment planning and tissue heterogeneity correction. This limits the precision of the application and the precise documentation of the location and the deposited dose in the tissue. Here we present a set-up where we use image guidance by intraoperative cone beam computed tomography (CBCT) for precise online Monte Carlo treatment planning including tissue heterogeneity correction. MATERIALS AND METHODS: An IORT was performed during balloon kyphoplasty using a dedicated Needle Applicator...
May 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28507456/adjuvant-intraoperative-radiotherapy-for-selected-breast-cancers-in-previously-irradiated-women-evidence-for-excellent-feasibility-and-favorable-outcomes
#8
Gladys Blandino, Marina Guenzi, Liliana Belgioia, Elisabetta Bonzano, Elena Configliacco, Elena Tornari, Francesca Cavagnetto, Davide Bosetti, Alessandra Fozza, Daniele Friedman, Renzo Corvò
BACKGROUND: The present report provides preliminary outcomes with intraoperative radiotherapy delivered to women with breast cancer included in a re-irradiation program. MATERIALS AND METHODS: From October 2010 to April 2014, thirty women were included in a re-irradiation protocol by exploiting IORT technique. The median time between the two irradiations was 10 years (range 3-50). All patients underwent conservative surgery, sentinel lymph node excision and IORT with electron beam delivered by a mobile linear accelerator...
July 2017: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/28458578/intraoperative-radiation-therapy-for-breast-cancer-patients-current-perspectives
#9
REVIEW
Sunil W Dutta, Shayna L Showalter, Timothy N Showalter, Bruce Libby, Daniel M Trifiletti
Accelerated partial breast irradiation (APBI) provides an attractive alternative to whole breast irradiation (WBI) through normal tissue radiation exposure and reduced treatment duration. Intraoperative radiation therapy (IORT) is a form of APBI with the shortest time interval, as it delivers the entirety of a planned radiation course at the time of breast surgery. However, faster is not always better, and IORT has been met with healthy skepticism. Patients treated with IORT have an increased compliance and overall satisfaction when compared to patients treated with WBI...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28252805/postoperative-complications-following-intraoperative-radiotherapy-in-abdominopelvic-malignancy-a-single-institution-analysis-of-113-consecutive-patients
#10
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
#11
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...
May 2017: Brachytherapy
https://www.readbyqxmd.com/read/28193241/present-state-and-issues-in-iort-physics
#12
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
#13
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...
March 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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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