Complications of intraoperative radiation therapy

Tepper, Joel E.; Gunderson, Leonard L.; Orlow, Erica L.; Cohen, Alfred M.; Hedberg, Stephen E.; Shipley, William U.; Blitzer, Peter H.; Rich, Tyvin A.

doi:10.1016/0360-3016(84)90258-x

Cited by 118 publications

(28 citation statements)

References 16 publications

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“…In other institutions, opera tion and irradiation take place in different standard units while the patient is transported from one place to the oth er. In agreement with other authors, our results concern ing peri-and post-operative complications clearly demon strate that transportation of the patient does not cause any additional problems if the sterility of the IORT field is ensured [15,24]. Moreover, the use of this procedure in our department made it possible to perform IORT several times spontaneously according to intra-operative find ings.…”

Section: Discussionsupporting

confidence: 77%

Intra-Operative Radiotherapy – 5 Years of Experience in the Palliative Treatment of Recurrent and Advanced Head and Neck Cancers

Spaeth¹,

Andreopoulos²,

Unger³

et al. 1997

Oncology

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Recurrent and advanced cancer in the head and neck region is usually associated with limited therapeutic concepts and a dismal prognosis. Efforts mainly focus on palliative treatment in order to improve the patient’s quality of life. From May 1989 to December 1994, a total of 120 intra-operative radiotherapy (IORT) procedures with high-energy electron beams (mean energy: 7 MeV; mean dose: 20 Gy) were performed in 95 patients. Therapy was usually performed under endotracheal anaesthesia (84%). There were 91 cases (75.8%) of recurrence in the lymph nodes of the neck and 14 cases (11.7%) of local recurrence. 15 patients (12.5%) received IORT as part of the initial treatment. Considering the palliative nature of IORT in these patients, only an R2 resection (gross residual tumour) was achieved in 71.7%. Local tumour control was nonetheless possible in 17% (R2 resection) to 64% (complete Ro resection), with a mean 11-month follow-up period for survivors (mean for deceased patients: 8 months). Regarding palliative criteria, IORT proved to be feasible since patients profited from short hospitalisation (median: 10 days), a low complication rate (27 instances; e.g. tracheostomy: 11; necrosis: 8, or fistula: 3) and, in part, a substantial reduction of pain (73.8%). Most of them regained physical and psychic integrity for weeks to months and were able to take part in social life during the final stage of their disease.

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Section: Discussionsupporting

confidence: 77%

Intra-Operative Radiotherapy – 5 Years of Experience in the Palliative Treatment of Recurrent and Advanced Head and Neck Cancers

Spaeth¹,

Andreopoulos²,

Unger³

et al. 1997

Oncology

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“…Complications were noted in 35% of patients receiving preoperative EBRT only. This was comparable to a 32% associated risk in those women receiving EBRT and IORT [7]. Table 4 lists the most common toxicities of IORT.…”

Section: Toxicitymentioning

confidence: 65%

“…In women with no previous irradiation history, median doses ranging from 45-54 Gy have been given. This dose has been delivered in 1.8 Gy fractions, five days per week, over a five-to six-week course [3,4,7].…”

Section: Treatment Techniquementioning

confidence: 99%

The Role of Intraoperative Radiation Therapy (IORT) in the Treatment of Locally Advanced Gynecologic Malignancies

Carmen¹,

McIntyre

Goodman³

2000

The Oncologist

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The prognosis in women with locally advanced primary or recurrent gynecologic malignancies is rather poor. Doses of external beam radiation necessary to treat gross or microscopic recurrence among patients surgically treated or previously irradiated exceed what is tolerated by normal structures. In this group of patients, intraoperative radiation therapy (IORT) can be utilized to maximize local tumor control, minimizing the radiation exposure of dose-limiting surrounding structures. Review of the available literature indicates that IORT may improve long-term local control and overall survival in women with pelvic sidewall and/or para-aortic nodal recurrence. The most encouraging results have been reported in the cases of microscopic residual disease, following surgical debulking. The

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“…The toxicity is mainly of the late type [7][8][9] . In fact the procedures to guarantee the sterility of the operating field are clearly planned and easily observed.…”

Section: Introduction To Intra-operative Radiotherapymentioning

confidence: 99%