Three different intraoperative radiation modalities (electron beam, high-dose-rate brachytherapy, and iodine-125 brachytherapy) in the adjuvant treatment of patients with recurrent colorectal adenocarcinoma

Martı́nez-Monge, Rafael; Nag, Subir; Martin, Edward W.

doi:10.1002/(sici)1097-0142(19990715)86:2<236::aid-cncr7>3.0.co;2-9

Cited by 40 publications

(18 citation statements)

References 23 publications

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“…For recurrent tumours, 15% (187/1211 patients) had locally recurrent colon cancer, compared with 80% (973/1211 patients) with LRRC. One study provided data on 51 patients with pelvic recurrence following previous CRC resection, but recurrences were not classified distinctly as colonic or rectal in origin (51/1211; 5%) [50]. The technique used for intraoperative irradiation was IOERT in 2765 patients (92%) and HDR-IORT in the remaining 238 patients (8%).…”

Section: Resultsmentioning

confidence: 99%

“…The indication was close or positive margins in 7 studies (positive/<5mm [33, 44]; positive/<2mm [27, 48]; positive/<1mm [50]; positive/<10mm [43]; positive/unspecified ‘close’ [35]). In the remaining four studies, all patients underwent treatment with IORT, with the dose of irradiation increased incrementally in cases of residual tumour (R0<R1<R2) [36, 47, 49, 51].…”

Section: Resultsmentioning

confidence: 99%

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Intraoperative radiotherapy in colorectal cancer: Systematic review and meta-analysis of techniques, long-term outcomes, and complications

et al. 2013

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Background The precise contribution of IORT to the management of locally advanced and recurrent colorectal cancer (CRC) remains uncertain. We performed a systematic review and meta-analysis to assess the value of IORT in this setting. Methods Studies published between 1965 and 2011 that reported outcomes after IORT for advanced or recurrent CRC were identified by an electronic literature search. Studies were assessed for methodological quality and design, and evaluated for technique of IORT delivery, oncological outcomes, and complications following IORT. Outcomes were analysed with fixed-effect and random-effect model meta-analyses and heterogeneity and publication bias examined. Results 29 studies comprising 14 prospective and 15 retrospective studies met the inclusion criteria and were assessed, yielding a total of 3003 patients. The indication for IORT was locally advanced disease in 1792 patients and locally recurrent disease in 1211 patients. Despite heterogeneity in methodology and reporting practice, IORT is principally applied for the treatment of close or positive margins. When comparative studies were evaluated, a significant effect favouring improved local control (OR 0.22; 95% CI=0.05-0.86; p=0.03), disease free survival (HR 0.51; 95% CI=0.31-0.85; p=0.009), and overall survival (HR 0.33; 95% CI=0.2-0.54; p=0.001) was noted with no increase in total (OR 1.13; 95% CI=0.77-1.65; p=0.57), urologic (OR 1.35; 95% CI=0.84-2.82; p=0.47), or anastomotic complications (OR 0.94; 95% CI=0.42-2.1; p=0.98). Increased wound complications were noted after IORT (OR 1.86; 95% CI=1.03-3.38; p=0.049). Conclusions Despite methodological weaknesses in the studies evaluated, our results suggest that IORT may improve oncological outcomes in advanced and recurrent CRC.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Intraoperative radiotherapy in colorectal cancer: Systematic review and meta-analysis of techniques, long-term outcomes, and complications

et al. 2013

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“…Uniformly poor survival and local control can occur after IOERT without additional EBRT (38,39,44,46). Many investigators have excluded previously irradiated patients when evaluating curative-intent therapy.…”

Section: Intraoperative Radiation Therapy As a Component Of Treatmentmentioning

confidence: 99%

Combined Modality Therapy Including Intraoperative Electron Irradiation for Locally Recurrent Colorectal Cancer

Haddock

Miller

Pembérton

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

118

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“…Martinez-Monge and colleagues have suggested that in recurrent rectal cancer the availability of IOERT, HDR brachytherapy and Iodine-125 permanent implants seed is ideal in terms of dosimetry optimization [45]. HDR-IORT does not seem to have methodological or dosimetric limitations to treat recurrent rectal cancer after resection even in case of close or positive margins [46].…”

Section: Locally Recurrent Cancersmentioning

confidence: 99%

Intraoperative radiation therapy

Meiriño

Orecchia

2006

Critical Reviews in Oncology/Hematology

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Three different intraoperative radiation modalities (electron beam, high-dose-rate brachytherapy, and iodine-125 brachytherapy) in the adjuvant treatment of patients with recurrent colorectal adenocarcinoma

Cited by 40 publications

References 23 publications

Intraoperative radiotherapy in colorectal cancer: Systematic review and meta-analysis of techniques, long-term outcomes, and complications

Intraoperative radiotherapy in colorectal cancer: Systematic review and meta-analysis of techniques, long-term outcomes, and complications

Combined Modality Therapy Including Intraoperative Electron Irradiation for Locally Recurrent Colorectal Cancer

Intraoperative radiation therapy

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