The Use of Intraoperative Radiation Therapy (IORT) in Multimodality Management of Cancer Patients: a Single Institution Experience.

Ahmed Elashwah,Belal Moftah,Tarek Mahmoud Amin,Zeinab Hassan,Muhammad Hussain,Ayman Zaki Azzam,Shada Alramahi,Ali Alzahrani,Rana Mahmood,Mohammad Breakeit,Abdullah Alsuhaibani

doi:10.1007/s12029-021-00786-9

Abstract

Intraoperative radiation therapy (IORT) is a highly conformal type of radiation therapy given at time of surgery aiming for better tumor local control. It increases the tumor radiation dose without exceeding normal tissues tolerance doses. To assess the feasibility of IORT and short-term toxicities in patients with different cancer sites treated with multidisciplinary protocol including IORT. Medical records of cancer patients who received IORT as a part of their multidisciplinary treatment at King Faisal Specialized Hospital and Research center (KFSH&RC), Riyadh, Saudi Arabia, from January 2013 until December 2017 were retrospectively reviewed. A total of 188 patients with 210 IORT applications were analyzed. Twenty-two patients had two applications at the same time. One hundred sixteen patients were males. Median age at time of diagnosis was 49.5years (19-77). One hundred thirty-four patients had primary, while 54 cases had recurrent disease. Gastroesophageal cancer and soft tissue sarcoma were the most frequent diagnosis in 49 patients followed by colorectal cancer in 35 patients. Major surgeries with curative intent done in 183 patients (97.3%). Hyperthermic intraperitoneal chemotherapy (HIPEC) was performed in 118 (62.8%) patients. The 30-day postoperative mortality rate was 3.2%. Fifty-four (28.7%) patients develop grades III-IV complications according to Clavien-Dindo grading system. The data presented discusses using of IORT treatment for different malignant tumors as a part of multimodality treatment. IORT seems safe and feasible; however, a longer follow-up period is needed for proper evaluation and to define the role of IORT in a tailored multimodality approach.

Highlights

Intraoperative irradiation (IORT) is a highly conformal radiation therapy modality entailing the delivery of radiation at the time of surgery to increase the tumor radiation dose, aiming to improve tumor local control rate with respect to surrounding normal tissue tolerance doses [1].The Intraoperative radiation therapy (IORT) as a technique is not a new modality, but it was first used about 100 years ago [2]
Gastro esophageal cancer and soft tissue sarcoma were the most frequent diagnosis in 49 patients followed by colorectal cancer in 35 patients
Major surgeries with curative intent done in 183 patients (97.3%) and 118 patients (62.8%) had hyperthermic intraperitoneal chemotherapy (HIPEC) in addition to IORT

Summary

Introduction

Intraoperative irradiation (IORT) is a highly conformal radiation therapy modality entailing the delivery of radiation at the time of surgery to increase the tumor radiation dose, aiming to improve tumor local control rate with respect to surrounding normal tissue tolerance doses [1].The IORT as a technique is not a new modality, but it was first used about 100 years ago [2]. Intraoperative irradiation (IORT) is a highly conformal radiation therapy modality entailing the delivery of radiation at the time of surgery to increase the tumor radiation dose, aiming to improve tumor local control rate with respect to surrounding normal tissue tolerance doses [1]. We retrospectively evaluate the feasibility and short-term complications for patients treated with IORT in our Center King Faisal. Intraoperative radiation therapy (IORT) is a highly conformal technique given in the operating room in many cancer sites for better tumor local control by increasing the tumor radiation dose without exceeding normal tissues tolerance doses. Assess the feasibility of Intra operative radiation therapy (IORT) and short-term toxicity in patients with different cancer sites treated with a multidisciplinary protocols including IORT

Methods

Results

Conclusion