Intraoperative radiation therapy (IORT) for head and neck cancer

Toita, Takafumi; Nakano, Masao; Takizawa, Yoshikazu; Sueyama, Hiroo; Kakihana, Yasumasa; Kushi, Akira; Ogawa, Kazuhiko; Hara, Ryusuke; Sunakawa, Hajime; Arasaki, Akira; Koja, S

doi:10.1016/0360-3016(94)90332-8

Cited by 45 publications

(28 citation statements)

References 16 publications

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“…Therefore, we felt that the treatment related toxicity at one year was acceptable when examining the benefit that these patients received from IORT. Reports of higher rates of IORT related toxicity are found in the literature; however, the doses used in those series often greatly exceed those now used in the context of salvage reirradiation (12). In the HDR-IORT experience reported by Nag et al, no major intraoperative or acute postoperative complications were seen, and no increased acute or late side effects were noted in previously irradiated patients with recurrent disease (11).…”

Section: Discussionmentioning

confidence: 95%

“…Published experiences are primarily from single institutions, and mainly involve the use of IORT with electrons (IOERT). Local control rates range from 11% to 87% (9)(10)(11)(12)(13). Parameters predictive for the efficacy of IORT have been limited; however, margin status in the IORT field has been significantly linked to local control and overall survival with negative or close margins proving superior to positive margins (8,12).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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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“…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%

“…As for survival outcomes, in a study, by Teckie et al, on 57 patients who received 15 Gy of HDR IORT, 3-year OS reached 50% in patients who had in-field control vs. 32% in those not achieving in-field control (10). Survival was also superior for patients with clear margins; where 2-year OS reached 70% in patients with clear margins in a study by Toita et al which included 17 patients with 22 treated sites (19). In summary, IORT, with a median dose of 15–20 Gy, results in very good LC in patients with neck recurrences and can improve survival outcomes, especially in those who attain negative surgical margins.…”

Section: Role Of Iort In Head and Neck Tumorsmentioning

confidence: 99%

“…With a median follow up of 2 years, 2-year local control (LC) and OS were 68 and 45%, respectively, for all 75 patients (18). Most of the other series on IORT for neck recurrences, listed in Table 1, included between 17 and 84 patients (10, 14, 15, 19). The majority used IOERT while two of the studies used high dose radiation brachytherapy known as HDR IORT.…”

Section: Role Of Iort In Head and Neck Tumorsmentioning

confidence: 99%

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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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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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Intraoperative radiation therapy (IORT) for head and neck cancer

Cited by 45 publications

References 16 publications

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

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

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

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

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