Feasibility of Flap Reconstruction in Conjunction With Intraoperative Radiation Therapy for Advanced and Recurrent Head and Neck Cancer

Most, Michael; Allori, Alexander C.; Hu, Kenneth; Urken, Mark L.; Persky, Mark S.; Sessions, Roy B.; Nussbaum, Moses; Harrison, Louis B.; Frank, Douglas K.; Smith, Mark L.

doi:10.1097/mlg.0b013e3181559ff7

Cited by 13 publications

(9 citation statements)

References 25 publications

(45 reference statements)

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“…This technique replaces previously irradiated tissue with a healthy well‐vascularized radiation‐naive flap. Our group has published initial results with this technique 17. Wound healing was noted to be excellent in 76% of patients.…”

Section: Discussionmentioning

confidence: 93%

Health professional and consumer views on involving breast cancer patients in the multidisciplinary discussion of their disease and treatment plan

Butow

Harrison

Choy

et al. 2007

Cancer

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BACKGROUND.The aim was to obtain the views of health professionals and patients about the concept of involving breast cancer patients in the multidisciplinary (MD) treatment planning meeting.METHODS.Breast cancer surgeons, nurses, oncologists, and patient advocates completed a mailed questionnaire.RESULTS.The majority of breast cancer health professionals and patient advocates support shared decision‐making (58%–62%). However, less than a third of surgeons (32%), medical (25%), and radiation oncologists (24%) were supportive of involving women in the MD treatment planning meeting. In contrast, 93% of breast cancer advocates and 73% of breast cancer nurses were supportive of this approach. Patient advocates were significantly more in favor than all other groups (χ2 = 148.8, df = 4, P < .001). The common reasons for supporting patient involvement included that it would lead to patients being more informed and empowered, provide them with an opportunity to ask questions, facilitate decision‐making, and improve communication between the patient and the medical team. Health professionals stated that attendance would make patients anxious and that they would have to modify their medical language. Suggestions about how to manage patient involvement included the patient being supported by a breast nurse and pre‐education before the meeting. Patient advocates were significantly more willing to participate in a randomized controlled trial of this process compared with all other groups. (χ2 = 155.15, df = 4, P < .001).CONCLUSIONS.Despite health professional's reservations, patient advocates were highly supportive of including women in the MD meeting. Such a high demand justifies consideration of this option. Cancer 2007. © 2007 American Cancer Society.

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Section: Discussionmentioning

confidence: 93%

Health professional and consumer views on involving breast cancer patients in the multidisciplinary discussion of their disease and treatment plan

Butow

Harrison

Choy

et al. 2007

Cancer

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“…Recently, Most et al [ 40 ] evaluated the feasibility of flap reconstruction, after submitting 21 patients (receiving 22 treatments) to IORT for advanced and recurrent head and neck cancer. Sixteen patients had SCC of the upper aerodigestive tract or cervical nodes, 2 had poorly differentiated parotid adenocarcinoma, 1 had high-grade parotid mucoepidermoid carcinoma, 1 patient had a recurrent synovial cell sarcoma of the parapharyngeal space, and 1 patient had an advanced cutaneous SCC of the nape of the neck.…”

Section: Resultsmentioning

confidence: 99%

Intraoperative radiation therapy (IORT) in head and neck cancer

Kyrgias¹,

Hajiioannou

Tolia³

et al. 2016

Medicine

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Background:Multimodality therapy constitutes the standard treatment of advanced and recurrent head and neck cancer. Since locoregional recurrence comprises a major obstacle in attaining cure, the role of intraoperative radiation therapy (IORT) as an add-on in improving survival and local control of the disease has been investigated. IORT allows delivery of a single tumoricidal dose of radiation to areas of potential residual microscopic disease while minimizing doses to normal tissues. Advantages of IORT include the conformal delivery of a large dose of radiation in an exposed and precisely defined tumor bed, minimizing the risk of a geographic miss creating the potential for subsequent dose reduction of external beam radiation therapy (EBRT). This strategy allows for shortening overall treatment time and dose escalation. The aim of this review is to summarize recent published work on the use of IORT as an adjuvant modality to treat common head and neck cancer in the primary or recurrent setting.Methods:We searched the Medline, Scopus, Ovid, Cochrane, Embase, and ISI Web of Science databases for articles published from 1980 up to March 2016.Results:Based on relevant publications it appears that including IORT in the multimodal treatment may contribute to improved local control. However, the benefit in overall survival is not so clear.Conclusion:IORT seems to be a safe, promising adjunct in the management of head and neck cancer and yet further well organized clinical trials are required to determine its role more precisely.

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“…The median IORT dose was 12.5 Gy. This study demonstrated that head and neck flap reconstruction can be performed in the setting of high cumulative doses of radiation with the expectation of good wound healing (28).…”

Section: Discussionmentioning

confidence: 96%

High-Dose-Rate Intraoperative Radiation Therapy for Recurrent Head-and-Neck Cancer

Perry

Chan

Wolden

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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Feasibility of Flap Reconstruction in Conjunction With Intraoperative Radiation Therapy for Advanced and Recurrent Head and Neck Cancer

Abstract: Reconstruction using flaps in the context of IORT can be achieved with expectation of good wound healing in the majority of cases despite heavy cumulative doses of radiation to recipient wound beds.

Cited by 13 publications

References 25 publications

Health professional and consumer views on involving breast cancer patients in the multidisciplinary discussion of their disease and treatment plan

Health professional and consumer views on involving breast cancer patients in the multidisciplinary discussion of their disease and treatment plan

Intraoperative radiation therapy (IORT) in head and neck cancer

High-Dose-Rate Intraoperative Radiation Therapy for Recurrent Head-and-Neck Cancer

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