Quality control parameters of intraoperative radiation therapy

Tepper, Joel E.; Gunderson, Leonard L.; Goldson, Alfred L.; Kinsella, Timothy J.; Shipley, William U.; Sindelar, William F.; Wood, William C.; Martin, J. Kirk

doi:10.1016/0360-3016(86)90298-1

Cited by 48 publications

(15 citation statements)

References 13 publications

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“…The tolerance of the tissues as well as the toxicity and late morbidity of IORT trials must be carefully evaluated and reported [41]. This is of particular importance in pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative radiotherapy in the multidisciplinary treatment of bone sarcomas in children and adolescents

Urbina

Sierrasesúmaga

Abuchaibe

et al. 1991

Med. Pediatr. Oncol.

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From September 1984 to December 1989, 38 patients of pediatric age with localized bone sarcomas received intraoperative radiotherapy (IORT) as part of a multidisci plinary treatment program. The age ranged from 6 to 21 years. The tumor histologies were 22 osteosarcomas and 16 Ewing's sarcomas.Thirty‐four had initial primary disease (90%) and 4 were treated for local recurrence (10%). IORT was used on 32 untreated patients and in 6 previously treated with external beam radiotherapy (EBR). The IORT field included the surgically exposed tumor bed area. Single radiation doses ranging from 10 to 20 Gy were delivered, using 6–20 MeV electron beams. The median follow‐up time for the entire group is 25 months (2–65+ months). The projected 5‐year disease‐free and overall survival rates are 65% and 69%, respectively. One patient developed a local recurrence in each histological group: one chondroblastic osteosarcoma and one cervical Ewing's sarcoma. Six patients died from metastatic progression: 3 initially recurrent tumors and three primary disease cases. Severe neuropathy and soft tissue necrosis were seen in some patients as IORT related complications.IORT is a feasible technique to be integrated in multidisciplinary programs that may promote local control in pediatric and adolescent patients with bone sarcomas. Peripheral nerves are dose‐limiting tissue structures for IORT.

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Section: Discussionmentioning

confidence: 99%

Intraoperative radiotherapy in the multidisciplinary treatment of bone sarcomas in children and adolescents

Urbina

Sierrasesúmaga

Abuchaibe

et al. 1991

Med. Pediatr. Oncol.

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“…The definition of the roles and the corresponding responsibilities of the different professional figures is formulated on the base of available national and international documents on quality assurance in radiotherapy 18,19 and adapted to the IORT procedure according to the indications reported in different publications 16,20 . We would like to underline that, besides the operational group for the IORT treatment, it is essential the institution of a group for the quality assurance, formed by physician-physical-technical-nursing personnel identified inside every department involved in the programme IORT (Surgery, Radiotherapy, Medical Physics and Anaesthesia), in order to favour the multidisciplinary integration that characterises this procedure and to define and to supervise the programme of quality assurance for the different strategies of treatment.…”

Section: Professional Figures (Roles and Responsibilities) And Equipmmentioning

confidence: 99%

“…Defining the physical characteristics of the electron beams used for IORT requires an accurate initial dosimetric study 14 , particularly with the new mobile accelerator 15 ; moreover, an accurate protocol for a regular quality control of the equipment based on international recommendations has to be prepared 16 . The definition of the procedures to be followed during the execution of IORT and its documentation is essential for the optimisation of the programme of quality assurance in this radiotherapy treatment.…”

Section: Introduction To Intra-operative Radiotherapymentioning

confidence: 99%

Guidelines for quality assurance in intra-operative radiation therapy

Rosi¹,

Viti²

2004

Oncología (Barc.)

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“…The ongoing clinical testing will continue collecting users' experience, which will allow adapting and improving the system capabilities. The introduction of the pre planning phase in IOERT guarantees documentation of the procedure and facilitates quality assurance (18). It may also support the main factors limiting the adoption of this technique by reducing the learning curve of the RO and improving communi cation with the surgical team.…”

Section: Discussionmentioning

confidence: 99%

An Innovative Tool for Intraoperative Electron Beam Radiotherapy Simulation and Planning: Description and Initial Evaluation by Radiation Oncologists

Pascau

Miranda

Calvo

et al. 2012

International Journal of Radiation Oncology*Biology*Physics

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SummaryThe lack of specific treatment planning tools limits the spread of Intraoperative Electron Radiation Therapy. An innovative simulation and planning tool is presented. Applicator positioning, isodose curves, and dose volume histograms can be estimated for previously segmented regions to treat/protect. Evaluation by three radiation oncologists on 15 patients showed high parameter agreement in nine cases, demonstrating the possibilities in cases involving different anatomical locations, and Purpose: Intraoperative electron beam radiation therapy (IOERT) involves a modified strategy of conventional radiation therapy and surgery. The lack of specific planning tools limits the spread of this technique. The purpose of the present study is to describe a new simulation and planning tool and its initial evaluation by clinical users. Methods and Materials: The tool works on a preoperative computed tomography scan. A physi cian contours regions to be treated and protected and simulates applicator positioning, calcu lating isodoses and the corresponding doseevolume histograms depending on the selected electron energy. Three radiation oncologists evaluated data from 15 IOERT patients, including different tumor locations. Segmentation masks, applicator positions, and treatment parameters were compared. Results: High parameter agreement was found in the following cases: three breast and three rectal cancer, retroperitoneal sarcoma, and rectal and ovary monotopic recurrences. All radiation oncologists performed similar segmentations of tumors and high risk areas. The average appli cator position difference was 1.2 AE 0.95 cm. The remaining cancer sites showed higher devia tions because of differences in the criteria for segmenting high risk areas (one rectal, one pancreas) and different surgical access simulated (two rectal, one Ewing sarcoma). Conclusions:The results show that this new tool can be used to simulate IOERT cases involving different anatomic locations, and that preplanning has to be carried out with specialized surgical input.

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Quality control parameters of intraoperative radiation therapy

Cited by 48 publications

References 13 publications

Intraoperative radiotherapy in the multidisciplinary treatment of bone sarcomas in children and adolescents

Intraoperative radiotherapy in the multidisciplinary treatment of bone sarcomas in children and adolescents

Guidelines for quality assurance in intra-operative radiation therapy

An Innovative Tool for Intraoperative Electron Beam Radiotherapy Simulation and Planning: Description and Initial Evaluation by Radiation Oncologists

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