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Frank A Giordano, Stefanie Brehmer, Bettina Mürle, Grit Welzel, Elena Sperk, Anke Keller, Yasser Abo-Madyan, Elisabeth Scherzinger, Sven Clausen, Frank Schneider, Carsten Herskind, Martin Glas, Marcel Seiz-Rosenhagen, Christoph Groden, Daniel Hänggi, Peter Schmiedek, Bahman Emami, Luis Souhami, Kevin Petrecca, Frederik Wenz
BACKGROUND: The median time to recurrence of glioblastoma (GB) following multimodal treatment is ∼7 mo. Nearly all cancers recur locally, suggesting that augmenting local treatments may improve outcomes. OBJECTIVE: To investigate whether intraoperative radiotherapy (IORT) to the resection cavity is safe and effective. METHODS: INTRAGO was a phase I/II trial to evaluate the safety and tolerability of IORT with 20 to 40 Gy of low-energy photons in addition to standard radiochemotherapy (ClinicalTrials...
March 8, 2018: Neurosurgery
Andreas Rothfuss, Oliver Oesterle, Daniel Bürgy, Charles Nwankwo, Frank Schneider, Auguste van Poelgeest, Frederik Wenz, Jan Stallkamp, Sven Clausen
OBJECTIVE: Intraoperative radiotherapy (IORT) after surgical resection using a low-kV-X-ray source is a proven method used in cancer treatment. However, the shape and size of the targeted surface area are limited to the size of the available applicators. This can lead to nonconformal and therefore suboptimal treatment for many patients. METHODS: A system is proposed comprising an X-ray source with an applicator for surface irradiation mounted on a robotic arm. This is controlled by an algorithm designed for planning the required continuous path, enabling irradiation of any desired shape with a controlled dose distribution...
February 27, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Thomas G Bird, Samuel Y Ngan, Julie Chu, René Kroon, Andrew C Lynch, Alexander G Heriot
PURPOSE: Radical management of locally recurrent rectal cancer (LRRC) can lead to prolonged survival. This study aims to assess outcomes and identify prognostic factors for patients with LRRC treated using a multimodality treatment protocol. METHODS: An analysis of a prospectively maintained institutional database of consecutive patients who underwent radical surgical resection for LRRC was performed. Potential prognostic factors were investigated using a Cox proportional hazards model...
February 21, 2018: International Journal of Colorectal Disease
D H M Jacobs, G Speijer, A L Petoukhova, E M A Roeloffzen, M Straver, A Marinelli, U Fisscher, A G Zwanenburg, J Merkus, C A M Marijnen, M E Mast, P C M Koper
BACKGROUND AND PURPOSE: We investigated the acute toxicity of accelerated partial breast irradiation using external beam (EB-APBI) or intraoperative radiotherapy (IORT) techniques in elderly breast cancer patients. MATERIALS AND METHODS: Women ≥ 60 years with unifocal breast tumors of ≤ 30 mm were eligible for this prospective multi-center cohort study. IORT was applied with electrons following lumpectomy (23.3 Gy). EB-APBI was delivered using 3D-CRT or IMRT in 10 daily fractions of 3...
February 19, 2018: Breast Cancer Research and Treatment
Benny Johnson, Zhaohui Jin, Michael G Haddock, Christopher L Hallemeier, James A Martenson, Rory L Smoot, David W Larson, Eric J Dozois, David M Nagorney, Axel Grothey
BACKGROUND: The purpose of this study was to define survival rates in patients with isolated advanced abdominal nodal metastases secondary to colorectal cancer (CRC), treated with curative-intent trimodality therapy. MATERIALS AND METHODS: Sixty-five patients received trimodality therapy, defined as chemotherapy delivered with external beam radiotherapy (EBRT) followed by lymphadenectomy and intraoperative radiotherapy (IORT). Infusional 5-fluorouracil was the most common radiosensitizer used (63%, 41 patients)...
February 14, 2018: Oncologist
Emanuela Esposito, Michael Douek
Intraoperative radiotherapy (IORT) for breast cancer has challenged the standard external beam radiotherapy (EBRT) and has been shown to be non-inferior for treating early breast cancer in the past decade. Several technologies have been tested for IORT and various randomised controlled trials are still ongoing. Different methods of application of IORT have also been evaluated, from early breast cancer to tumour bed boost radiotherapy amongst high risk women. TARGIT-A and ELIOT trials have reported a low incidence of local recurrence and good survival in both arms...
2018: Ecancermedicalscience
Julien Barrou, Agnes Tallet, Monique Cohen, Marie Bannier, Max Buttarelli, Laurence Gonzague, Camille Jauffret, Eric Lambaudie, Sandrine Rua, Margueritte Tyran, Leonel Varela, Gilles Houvenaeghel
The spread of systematic screening and the emergence of oncoplastic techniques allow more breast conservative treatment associating lumpectomy and external beam radiation therapy. In order to furthermore facilitate the patient's treatment, intraoperative radiation therapy (IORT) has been developed. The oncological safety of this technique has been studied, and is considered acceptable. Many questions remain unsolved in regard of the toxicity of this procedure as well as the patient's selection criteria. In this study, we present the first results and complications rate of patients treated by IORT in a single French institution...
January 22, 2018: Breast Journal
Falk Roeder, Ingo Alldinger, Matthias Uhl, Ladan Saleh-Ebrahimi, Simon Schimmack, Gunhild Mechtersheimer, Markus W Büchler, Jürgen Debus, Robert Krempien, Alexis Ulrich
PURPOSE: To report our experience with surgery, intraoperative radiation therapy (IORT), and external beam radiation therapy (EBRT) in retroperitoneal soft-tissue sarcoma. METHODS AND MATERIALS: We conducted a retrospective evaluation of 156 patients (69 primary, 87 recurrent) treated with IORT since 1991. The dominant histology was dedifferentiated liposarcoma (49%); 89% of lesions were high grade. Median tumor size was 11 cm. Surgery resulted in gross complete resection in 92%, and 65% had microscopically positive margins...
February 1, 2018: International Journal of Radiation Oncology, Biology, Physics
F Thangarajah, J Heilmann, W Malter, S Kunze, S Marnitz, P Mallmann, F Wenz, E Sperk
PURPOSE: Mastectomy is the standard procedure in patients with in-breast tumor recurrence (IBTR) or breast cancer after irradiation of the chest due to Hodgkin's disease. In certain cases a second breast conserving surgery (BCS) in combination with intraoperative radiotherapy (IORT) is possible. To date, data concerning BCS in combination with IORT in pre-irradiated patients are limited. This is the first pooled analysis of this special indication with a mature follow-up of 5 years. METHODS: Patients with IBTR after external beam radiotherapy (EBRT; treated in two centers) for breast cancer were included...
January 15, 2018: Breast Cancer Research and Treatment
Tohid Emami Meybodi, Masoumeh Najafi, Ali Keipourfard, Amir Nikouei, Afsoun Seddighi
OBJECTIVE: Intra-operative Radiation Therapy (IORT) is gaining popularity as an adjuvant option to surgical resection, in treatment of glioblastoma multiforme (GBM) for increasing survival rate, which a highly aggressive cerebral tumor with poor prognosis. Τhe authors plan to investigate the effects of IORT combined with surgical resection on the psychological status of these patients based on tumor location. SUBJECT AND METHODS: From December 2013 to February 2017, we have enrolled 109 patients with high grade cerebral gliomas, documented by Magnetic Resonance Spectroscopy (MRS)...
September 2017: Hellenic Journal of Nuclear Medicine
Bridget A Oppong, Surupa Sen Gupta, Monique Gary, Patricia Wehner, Mihriye Mete, Danjing Zhao, Sulakshana Seevaratnam, Sonali Rudra, Shawna C Willey
Background: Intraoperative radiotherapy (IORT) has gained momentum for early stage and favorable breast cancers (BC). The 21-gene recurrence assay guides treatment of hormone positive and node-negative BC. Methods: Analysis of 82 invasive BC treated with breast conservation surgery (BCS) and IORT 2013-2015. Data collection included patient demographics, tumor characteristics, nodal status, recurrence test (RS) and adjuvant therapy. Results: The mean age was 68 years...
December 2017: Gland Surgery
Hans-Christian Kolberg, György Lövey, Leyla Akpolat-Basci, Miltiades Stephanou, Peter Fasching, Michael Untch, Oliver Hoffmann, Max Bulsara, Jayant Vaidya, Cornelia Liedtke
Introduction: In a previous study our group showed a beneficial effect of targeted intraoperative radiotherapy (TARGIT-IORT) as an intraoperative boost on overall survival after neoadjuvant chemotherapy (NACT) compared to an external boost (EBRT). In this study we present the results of a detailed subgroup analysis of the hormone receptor (HR)-positive HER2-negative patients. Methods: In this cohort study involving 46 patients with HR-positive HER2-negative breast cancer after NACT, we compared the outcomes of 21 patients who received an IORT boost to those of 25 patients treated with an EBRT boost...
October 2017: Breast Care
Gage Redler, Alistair Templeton, Heming Zhen, Julius Turian, Damian Bernard, James C H Chu, Katherine L Griem, Yixiang Liao
PURPOSE: The Xoft Axxent Electronic Brachytherapy System (Xoft, Inc., San Jose, CA) is a viable option for intraoperative radiation therapy (IORT) treatment of early-stage breast cancer. The low-energy (50-kVp) X-ray source simplifies shielding and increases relative biological effectiveness but increases dose distribution sensitivity to medium composition. Treatment planning systems typically assume homogenous water for brachytherapy dose calculations, including precalculated atlas plans for Xoft IORT...
March 2018: Brachytherapy
Mehmet Ali Gülçelik, Lütfi Doğan, Niyazi Karaman, Müjdat Turan, Yavuz Selim Kahraman, Gökhan Giray Akgül, Cihangir Özaslan
Background/aim: Intraoperative radiation therapy (IORT) may pose a risk for wound complications. All technical aspects of IORT regarding early wound complications were evaluated. Materials and methods: Ninety-three consecutive patients operated on with the same surgical technique and given (study group) or not given (control group) IORT were included. Wound complications were evaluated in two groups. Results: Forty-three patients were treated with boost dose IORT and 50 patients were treated with breast-conserving surgery without IORT...
August 23, 2017: Turkish Journal of Medical Sciences
Rakesh Patel, Olga Ivanov, Jeff Voigt
Background: To date no one has examined the quality of life and direct costs of care in treating early stage breast cancer with adjunct intraoperative radiation therapy (IORT) versus external beam radiation therapy (EBRT) over the life of the patient. As well no one has examined the effects of radiation exposure with both therapies on the longer term sequelae. The purpose of this analysis was to examine the cost-effectiveness of IORT vs. EBRT over the life of the patient. Methods: A Markov decision-analytic model evaluated these treatment strategies in terms of the direct costs in treating patients over their lifetime (including the downstream costs associated with radiation exposure) and the resultant quality of life of these patients...
2017: Cost Effectiveness and Resource Allocation: C/E
Kelsey E Larson, Stephanie A Valente, Chirag Shah, Rahul D Tendulkar, Sheen Cherian, Courtney Yanda, Chao Tu, Jessica Echle, Stephen R Grobmyer
Purpose: One benefit of intraoperative radiation therapy (IORT) is that it usually requires a single treatment, thus potentially eliminating distance as a barrier to receipt of whole breast irradiation. The aim of this study was to evaluate the distance traveled by IORT patients at our institution. Methods: Our institutional prospective registry was used to identify IORT patients from 10/2011 to 2/2017. Patient's home zip code was compared to institution zip code to determine travel distance...
2017: International Journal of Breast Cancer
Stephanie A Valente, Alicia Fanning, Robyn A Stewart, Sharon Grundfest, Rahul D Tendulkar, Sheen Cherian, Chirag Shah, Chao Tu, Courtney Yanda, Diane Radford, Zahraa Al-Hilli, Stephen R Grobmyer
Introduction: Intraoperative radiation with Intrabeam™ (IORT) for breast cancer is a newer technology recently implemented into the operating room (OR). This procedure requires time and coordination between the surgeon and radiation oncologist, who both perform their treatments in a single operative setting. We evaluated the surgeons at our center, who perform IORT and their OR times to examine changes in OR times following implementation of this new surgical procedure. We hypothesized that IORT is a technique for which timing could be improved with the increasing number of cases performed...
2017: Frontiers in Oncology
Jackline Odhiambo, Cheryl L Amoroso, Peter Barebwanuwe, Christine Warugaba, Bethany L Hedt-Gauthier
BACKGROUND: Promoting national health research agendas in low- and middle-income countries (LMICs) requires adequate numbers of individuals with skills to initiate and conduct research. Recently, non-governmental organizations (NGOs) have joined research capacity building efforts to increase research leadership by LMIC nationals. Partners In Health, an international NGO operating in Rwanda, implemented its first Intermediate Operational Research Training (IORT) course to cultivate Rwandan research talent and generate evidence to improve health care delivery...
2017: Global Health Action
Jay K Harness, Kalatu Davies, Christina Via, Elizabeth Brooks, April Zambelli-Weiner, Chirag Shah, Frank Vicini
BACKGROUND: Electron intraoperative radiotherapy (IORT) can be used during breast conserving surgery to treat early-stage invasive breast cancer. Using data from current clinical and observational studies, this study aimed to assess the impact of single-fraction electron IORT on local recurrence rates. METHODS: Studies on single-fraction electron IORT during breast conserving surgery were identified through a search of PubMed and Google Scholar, as well as through secondary referencing...
November 6, 2017: Annals of Surgical Oncology
Hung-Wen Lai, Liang-Chih Liu, Fu Ouyang, Chung-Chin Yao, Hsiang-Chun Jan, Ya-Herng Chang, Chi-Wen Tu, Dar-Ren Chen, Tsui-Fen Cheng, Yen-Dun Tzeng, Huan-Ming Hsu, Ming-Hsin Yeh, Yao-Chung Wu, Po-Sheng Yang, Hung-Bun Lam, Ming-Feng Hou, Fang-Ming Chen
BACKGROUND: In this multi-center study, we report the patient selection criteria for and preliminary oncologic outcomes associated with intraoperative radiotherapy (IORT) delivered by the Xoft Axxent® eBx® system for early-stage breast cancer in Taiwan. METHODS: Patients with early breast cancer in Taiwan received breast conserving surgery and received IORT with Xoft Axxent® eBx® System during 2013-2015 was search from database of Taiwan IORT study cooperative group (T-IORTSCG)...
2017: PloS One
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