Conclusions and Future Possibilities: IORT

Gunderson, Leonard L.; Willett, Christopher G.; Harrison, Louis B.

doi:10.1007/978-1-61779-015-7_23

Cited by 3 publications

(6 citation statements)

References 58 publications

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“…In the last 30 years, significant progress has been achieved and expert multi-specialist hospital-based groups have proven the feasibility of IORT as a component of multimodal cancer therapy (14). The first pioneers in the field of IORT are Spain, Italy, Austria, and Germany (15). Although in the 1980s and the mid-1990s, the US was more active in formalizing IORT, Europe has concentrated on this subject since 2000 by grouping homogeneous cases (12).…”

Section: Contextmentioning

confidence: 99%

“…uncertainty in the electron therapy is between 5.3% (22) and 10.8% (15)(16)(17) and in X-ray therapy systems such as Intrabeam and Papillon, estimated to be about 10% continuously. Comparing four Photon RadioSurgery PRS sources, Armoogum et al reported an internal radiation monitor reproducibility of 0.23% with mean dose differences of 0.49% at differential angles (16).…”

Section: Pre-planned Dose In Iort Uncertainties and Deviationsmentioning

confidence: 99%

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Intra-Operative Radiotherapy in Breast Cancer Treatment: A Literature Review

Yazdi¹,

Setayeshi²

2019

Iran Red Crescent Med J

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Context: The process of direct radiation to the tumor or tumor residue during surgery known as Intraoperative Radiation Therapy (IORT) is a new promising technique in the treatment of different cancers. For a detailed review of IORT application and effectiveness in breast cancer, we conducted a review of the present literature in the field. Evidence Acquisition: In this study, the most important technologies for IORT were identified through a comprehensive study. Relevant, critical, and highly cited articles and studies were selected based on experts' opinions. Data were summarized in sections of technology and physics, protocols, and treatment outcomes. Results: Electron beam and low-energy X-ray technologies were explained, and the physique of IORT was discussed. Due to the uncertainties of this modality and geometric complexities of post-excision treatment site, specialized treatment planning systems for IORT are necessary. In breast cancer treatment, regardless of the employed technology, IORT is applied with two main protocols: Partial Breast Irradiation and Intraoperative Boost Irradiation, each with their own advantages and disadvantages. Conclusions: Despite the controversies in acceptance and effectiveness of IORT, this technique seems to be promising for increased survival of breast cancer patients.

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Section: Contextmentioning

confidence: 99%

Section: Pre-planned Dose In Iort Uncertainties and Deviationsmentioning

confidence: 99%

Intra-Operative Radiotherapy in Breast Cancer Treatment: A Literature Review

Yazdi¹,

Setayeshi²

2019

Iran Red Crescent Med J

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“…Intraoperative electron radiotherapy (IOERT) is a technique that is gaining popularity because of advancements in portable electron linear accelerators with sufficient self-shielding capabilities [1]. This allows IOERT to be used in conventional operating rooms, which make it a convenient option for patients.…”

Section: Introductionmentioning

confidence: 99%

“…A bleeding detector for flat translucent polymethyl methacrylate applicators (PMMA) has been proposed by Sanchis et al [18,19], and García-Gil et al [20,21], where a threshold for fluid detection of 5 mm was considered according to Gunderson et al [1]. The dosimetric effects of adding 5 mm to the Rt depend on both the energy and the bevel used.…”

Section: Introductionmentioning

confidence: 99%

Calibration and validation of a bleeding detector for beveled PMMA applicators in electron intraoperative radiotherapy

Garcia-Gil,

Casans,

Navarro-Antón

et al. 2024

Meas. Sci. Technol.

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Purpose: This study aimed to calibrate and validate a capacitive-sensor bleeding detector, originally designed for flat applicators, with beveled applicators (bPMMA), which are among the most commonly used applicators in intraoperative radiotherapy with electron mobile linacs. The detector will help prevent dose misadministration during irradiation in the event of fluid accumulation in the applicator, thus allowing for appropriate intervention. The handicap with employing this detector for bPMMA stems from the fact that the level of accumulated fluid depends on both the tilting angle and orientation of the applicator. Furthermore, the fluid remains accumulated at the bottom corner of the applicator, reducing the sensitivity of the sensor. Methods: A 5-strip capacitive sensor has been used, attached to a 4 cm diameter 30º beveled applicator with a tilting angle range from 0º to 30º. The sensor is read out using dedicated electronics, including a Wheatstone bridge circuit, amplifier, filter stages, and microcontroller. To calculate the sensitivity of the sensor, a prior calibration of the circuit has been carried out in order to obtain the relationship between the output voltage of the conditioning circuit and the height of the fluid present in the applicator for different inclinations. Results: Using the average sensitivity over the inclination range of interest can provide accurate measurements of the estimated fluid height up to 12 mm, with a maximum deviation of approximately 2.0 mm and less than 1.0 mm for the 5 mm clinic threshold. Conclusions: The use of the mean sensitivity is a practical approach for detecting bleeding in beveled applicators because it simplifies the measurement process by avoiding the need to obtain detector sensitivity for each inclination and orientation of the applicator, which would be complex if not impractical in clinical use.

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“…The pre-, intra-, and post-planning tools will help tackle clinical and technical challenges as well as being appropriate tools in the virtual training of expert groups. RADIANCE is a European research project initially based on a scientific partnership between the Gregorio Marañón University Hospital (HGUGM) and GMV [3, 4]. …”

Section: Introductionmentioning

confidence: 99%

ecancermedicalscience

Sole

Herranz

et al.

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Rationale and objectivesTo analyse the programme activity and clinical innovation and/or technology developed over a period of 17 years with regard to the introduction and the use of intraoperative radiotherapy (IORT) as a therapeutic component in a medical–surgical multidisciplinary cancer hospital.Material and methodsTo standardise and record this procedure, the Radiation Oncology service has an institutional programme and protocols that must be completed by the different specialists involved. For 17 years, IORT procedures were recorded on a specific database that includes 23 variables with information recorded on institutional protocols.As part of the development and innovation activity, two technological tools were implemented (RADIANCE and MEDTING) in line with the standardisation of this modality in clinical practice.ResultsDuring the 17 years studied, 1,004 patients were treated through 1,036 IORT procedures. The state of the disease at the time of IORT was 77% primary and 23% recurrent. The origin and distribution of cancers were 62% gastrointestinal, 18% sarcomas, 5% pancreatic, 2% paediatric, 3% breast, 7% less common locations, and 2% others. The research and development projects have generated a patent on virtual planning (RADIANCE) and proof of concept to explore as a professional social network (MEDTING).During 2012, there were 69 IORT procedures. There was defined treatment volume (target or target region) in all of them, and 43 were conducted by the virtual planning RADIANCE system. Eighteen have been registered on the platform MEDTING as clinical cases.ConclusionThe IORT programme, developed in a university hospital with an academic tradition, and interdisciplinary surgical oncology, is a feasible care initiative, able to generate the necessary intense clinical activity for tending to the cancer patient. Moreover, it is a competitive source for research, development, and scientific innovation.

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Conclusions and Future Possibilities: IORT

Cited by 3 publications

References 58 publications

Intra-Operative Radiotherapy in Breast Cancer Treatment: A Literature Review

Intra-Operative Radiotherapy in Breast Cancer Treatment: A Literature Review

Calibration and validation of a bleeding detector for beveled PMMA applicators in electron intraoperative radiotherapy

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