Intraoperative radiotherapy for the treatment of resectable locally advanced gastric adenocarcinoma: topography of locoregional recurrences and long-term outcomes

Abstract

It is feasible to integrate IORT as a component of radiotherapy in combined modality therapy of gastric cancer. Local control is high in the radiation boosted area, but marginal regional extension (in particular, involving the hepatic hilum) might be considered as part of the anatomic IORT target volume at risk in pN+ patients.

Benefits from adjuvant intraoperative radiotherapy treatment for gastric cancer: A meta-analysis

“…However, owing to the dose-limiting surrounding tissues in the planning treatment volume, including small intestine, pancreas, bile ducts and spinal cord, the higher doses that are necessary for disease control cannot be safely delivered with conventional external-beam radiotherapy (EBRT) (5). Intraoperative radiotherapy (IORT) allows the delivery of a boost of radiation to a localized area in a single fraction without affecting the surrounding tissues (6). An IORT boost component has also been included in the context of surgical resection, adjuvant EBRT and chemotherapy, with acceptable tolerance and improved locoregional control (7,8).…”

Intraoperative radiation therapy opportunities for clinical practice normalization: Data recording and innovative development

“…Our group has recently reported favourable results both in gastric and in gastro-oesophageal cancer treated with IORTcontaining multimodal therapy. 14,15 According to the data, all treatments were performed with a curative intention and the surgery involved radical resection almost exclusively. The dose delivered was up to 12.5 Gy with relatively low predominating energies.…”

Intraoperative Radiotherapy for Gastrointestinal Malignancies: Contemporary Outcomes With Multimodality Therapy

“…Na podstawie obu badań stwierdzono jednak, że wyniki leczenia skojarzonego są nadal suboptymalne, a odsetki miejscowych i regionalnych nawrotów wyniosły odpowiednio 19% i 65% [6,7]. Dodatkowe zastosowanie IORT w miejscowo zaawansowanym raku żołądka wiązało się z poprawą wyleczalności miejscowej, jednak dotychczas nie wykazano korzyści w zakresie przeżycia całkowitego (OS, overall survival) [8,9]. Zhang i wsp.…”