Intraoperative Radiotherapy for Parotid Cancer: A Single-Institution Experience

Zeidan, Youssef H.; Shiue, Kevin; Weed, Daniel; Johnstone, Peter A.S.; Terry, Colin; Freeman, Stephen B.; Krowiak, Edward; Borrowdale, Robert; Huntley, Tod; Yeh, Alex

doi:10.1016/j.ijrobp.2011.02.033

Cited by 14 publications

(22 citation statements)

References 27 publications

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“…Scala et al reported that 1-year in-field control for patients with negative margins was 82% compared to 56% in those with a positive margin (9). At least five other studies also showed that positive margins (more so for gross residual than microscopic residual) at the time of IORT significantly predicted for in-field failure when compared to close or clear margins (2, 11, 13, 18, 19). In addition, doses of IORT of more than 15 Gy were shown to be associated with better LC (10, 12).…”

Section: Role Of Iort In Head and Neck Tumorsmentioning

confidence: 93%

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Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

et al. 2017

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Every year, almost 62,000 are diagnosed with a head and neck cancer (HNC) and 13,000 will succumb to their disease. In the primary setting, intraoperative radiation therapy (IORT) can be used as a boost in select patients in order to optimize local control. Addition of external beam radiation to limited volumes results in improved disease control over surgery and IORT alone. In the recurrent setting, IORT can improve outcomes from salvage surgery especially in patients previously treated with external beam radiation. The use of IORT remains limited to select institutions with various modalities being currently employed including orthovoltage, electrons, and high-dose rate brachytherapy. Practically, execution of IORT requires a coordinated effort and careful planning by a multidisciplinary team involving the head and neck surgeon, radiation oncologist, and physicist. The current review summarizes common uses, outcomes, toxicities, and technical aspects of IORT in HNC patients.

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Section: Role Of Iort In Head and Neck Tumorsmentioning

confidence: 93%

“…Favorable outcomes were observed with a relatively long follow-up of 5.6 years. For those with recurrent tumors, 5-year RFS and 5-year OS were both 48% (11). The second study included 37 patients with recurrent SGT who received a median dose of 15 Gy IOERT in addition to EBRT (54 Gy) in 15%.…”

Section: Role Of Iort In Head and Neck Tumorsmentioning

confidence: 99%

Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

et al. 2017

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“…Most studies have shown effective local control with acceptable complications [17, 19–22]. Resection status at salvage was the most important factor determining local control [17, 19, 21]. Microscopically residual tumours did better with IORT [23], gross residual disease however did not [20, 23].…”

Section: Clinical Results With Iortmentioning

confidence: 99%

Intraoperative radiotherapy: review of techniques and results

Pilar¹,

Gupta²,

Laskar³

et al. 2017

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Intraoperative radiotherapy (IORT) is a technique that involves precise delivery of a large dose of ionising radiation to the tumour or tumour bed during surgery. Direct visualisation of the tumour bed and ability to space out the normal tissues from the tumour bed allows maximisation of the dose to the tumour while minimising the dose to normal tissues. This results in an improved therapeutic ratio with IORT. Although it was introduced in the 1960s, it has seen a resurgence of popularity with the introduction of self-shielding mobile linear accelerators and low-kV IORT devices, which by eliminating the logistical issues of transport of the patient during surgery for radiotherapy or building a shielded operating room, has enabled its wider use in the community.Electrons, low-kV X-rays and HDR brachytherapy are all different methods of IORT in current clinical use. Each method has its own unique set of advantages and disadvantages, its own set of indications where one may be better suited than the other, and each requires a specific kind of expertise.IORT has demonstrated its efficacy in a wide variety of intra-abdominal tumours, recurrent colorectal cancers, recurrent gynaecological cancers, and soft-tissue tumours. Recently, it has emerged as an attractive treatment option for selected, early-stage breast cancer, owing to the ability to complete the entire course of radiotherapy during surgery. IORT has been used in a multitude of roles across these sites, for dose escalation (retroperitoneal sarcoma), EBRT dose de-escalation (paediatric tumours), as sole radiation modality (early breast cancers) and as a re-irradiation modality (recurrent rectal and gynaecological cancers).This article aims to provide a review of the rationale, techniques, and outcomes for IORT across different sites relevant to current clinical practice.

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“…Опубликованы результаты свыше двадцати рандоми-зированных исследований, в которых показано, что при-менение ИОЛТ у пациентов со злокачественными ново-образованиями различных локализаций в области головы и шеи приводит к улучшению локорегионарного контроля без повышения токсичности [15][16][17][18][19][20][21][22][23][24]. Авторы заключают, что ИОЛТ, используемый в дозах менее 20 Гр, безопасен при лечении рака головы и шеи даже у ранее облученных пациентов.…”

Section: Introductionunclassified

“…Это может быть полезно в случаях прогрес-сирования, особенно у больных опухолями, поражающи-ми основание черепа, где микроскопическая остаточная опухоль вероятна даже после «полной» хирургической резекции [15]. Тем не менее дальнейшие исследования необходимы для определения идеальной дозы и других факторов, способствующих минимизации частоты ослож-нений [23,24].…”

Section: Introductionunclassified