Intraoperative radiotherapy: review of techniques and results
Identifieur interne : 009285 ( Ncbi/Checkpoint ); précédent : 009284; suivant : 009286Intraoperative radiotherapy: review of techniques and results
Auteurs : Avinash Pilar ; Meetakshi Gupta ; Sarbani Ghosh Laskar ; Siddhartha LaskarSource :
- ecancermedicalscience [ 1754-6605 ] ; 2017.
Abstract
Intraoperative radiotherapy (IORT) is a technique that involves precise delivery of a large dose of ionising radiation to the tumour or tumour bed during surgery. Direct visualisation of the tumour bed and ability to space out the normal tissues from the tumour bed allows maximisation of the dose to the tumour while minimising the dose to normal tissues. This results in an improved therapeutic ratio with IORT. Although it was introduced in the 1960s, it has seen a resurgence of popularity with the introduction of self-shielding mobile linear accelerators and low-kV IORT devices, which by eliminating the logistical issues of transport of the patient during surgery for radiotherapy or building a shielded operating room, has enabled its wider use in the community.
Electrons, low-kV X-rays and HDR brachytherapy are all different methods of IORT in current clinical use. Each method has its own unique set of advantages and disadvantages, its own set of indications where one may be better suited than the other, and each requires a specific kind of expertise.
IORT has demonstrated its efficacy in a wide variety of intra-abdominal tumours, recurrent colorectal cancers, recurrent gynaecological cancers, and soft-tissue tumours. Recently, it has emerged as an attractive treatment option for selected, early-stage breast cancer, owing to the ability to complete the entire course of radiotherapy during surgery. IORT has been used in a multitude of roles across these sites, for dose escalation (retroperitoneal sarcoma), EBRT dose de-escalation (paediatric tumours), as sole radiation modality (early breast cancers) and as a re-irradiation modality (recurrent rectal and gynaecological cancers).
This article aims to provide a review of the rationale, techniques, and outcomes for IORT across different sites relevant to current clinical practice.
Url:
DOI: 10.3332/ecancer.2017.750
PubMed: 28717396
PubMed Central: 5493441
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Intraoperative radiotherapy: review of techniques and results</title><author><name sortKey="Pilar, Avinash" sort="Pilar, Avinash" uniqKey="Pilar A" first="Avinash" last="Pilar">Avinash Pilar</name></author><author><name sortKey="Gupta, Meetakshi" sort="Gupta, Meetakshi" uniqKey="Gupta M" first="Meetakshi" last="Gupta">Meetakshi Gupta</name></author><author><name sortKey="Ghosh Laskar, Sarbani" sort="Ghosh Laskar, Sarbani" uniqKey="Ghosh Laskar S" first="Sarbani" last="Ghosh Laskar">Sarbani Ghosh Laskar</name></author><author><name sortKey="Laskar, Siddhartha" sort="Laskar, Siddhartha" uniqKey="Laskar S" first="Siddhartha" last="Laskar">Siddhartha Laskar</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28717396</idno><idno type="pmc">5493441</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5493441</idno><idno type="RBID">PMC:5493441</idno><idno type="doi">10.3332/ecancer.2017.750</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">004979</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004979</idno><idno type="wicri:Area/Pmc/Curation">004978</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004978</idno><idno type="wicri:Area/Pmc/Checkpoint">000225</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000225</idno><idno type="wicri:Area/Ncbi/Merge">009285</idno><idno type="wicri:Area/Ncbi/Curation">009285</idno><idno type="wicri:Area/Ncbi/Checkpoint">009285</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Intraoperative radiotherapy: review of techniques and results</title><author><name sortKey="Pilar, Avinash" sort="Pilar, Avinash" uniqKey="Pilar A" first="Avinash" last="Pilar">Avinash Pilar</name></author><author><name sortKey="Gupta, Meetakshi" sort="Gupta, Meetakshi" uniqKey="Gupta M" first="Meetakshi" last="Gupta">Meetakshi Gupta</name></author><author><name sortKey="Ghosh Laskar, Sarbani" sort="Ghosh Laskar, Sarbani" uniqKey="Ghosh Laskar S" first="Sarbani" last="Ghosh Laskar">Sarbani Ghosh Laskar</name></author><author><name sortKey="Laskar, Siddhartha" sort="Laskar, Siddhartha" uniqKey="Laskar S" first="Siddhartha" last="Laskar">Siddhartha Laskar</name></author></analytic><series><title level="j">ecancermedicalscience</title><idno type="eISSN">1754-6605</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Intraoperative radiotherapy (IORT) is a technique that involves precise delivery of a large dose of ionising radiation to the tumour or tumour bed during surgery. Direct visualisation of the tumour bed and ability to space out the normal tissues from the tumour bed allows maximisation of the dose to the tumour while minimising the dose to normal tissues. This results in an improved therapeutic ratio with IORT. Although it was introduced in the 1960s, it has seen a resurgence of popularity with the introduction of self-shielding mobile linear accelerators and low-kV IORT devices, which by eliminating the logistical issues of transport of the patient during surgery for radiotherapy or building a shielded operating room, has enabled its wider use in the community.</p><p>Electrons, low-kV X-rays and HDR brachytherapy are all different methods of IORT in current clinical use. Each method has its own unique set of advantages and disadvantages, its own set of indications where one may be better suited than the other, and each requires a specific kind of expertise.</p><p>IORT has demonstrated its efficacy in a wide variety of intra-abdominal tumours, recurrent colorectal cancers, recurrent gynaecological cancers, and soft-tissue tumours. Recently, it has emerged as an attractive treatment option for selected, early-stage breast cancer, owing to the ability to complete the entire course of radiotherapy during surgery. IORT has been used in a multitude of roles across these sites, for dose escalation (retroperitoneal sarcoma), EBRT dose de-escalation (paediatric tumours), as sole radiation modality (early breast cancers) and as a re-irradiation modality (recurrent rectal and gynaecological cancers).</p><p>This article aims to provide a review of the rationale, techniques, and outcomes for IORT across different sites relevant to current clinical practice.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Abe, M" uniqKey="Abe M">M Abe</name></author><author><name sortKey="Shibamoto, Y" uniqKey="Shibamoto Y">Y Shibamoto</name></author><author><name sortKey="Ono, K" uniqKey="Ono K">K Ono</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abe, M" uniqKey="Abe M">M Abe</name></author><author><name sortKey="Takahashi, M" uniqKey="Takahashi M">M 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Hackert</name></author><author><name sortKey="Sachsenmaier, M" uniqKey="Sachsenmaier M">M Sachsenmaier</name></author><author><name sortKey="Hinz, U" uniqKey="Hinz U">U Hinz</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list></list><tree><noCountry><name sortKey="Ghosh Laskar, Sarbani" sort="Ghosh Laskar, Sarbani" uniqKey="Ghosh Laskar S" first="Sarbani" last="Ghosh Laskar">Sarbani Ghosh Laskar</name><name sortKey="Gupta, Meetakshi" sort="Gupta, Meetakshi" uniqKey="Gupta M" first="Meetakshi" last="Gupta">Meetakshi Gupta</name><name sortKey="Laskar, Siddhartha" sort="Laskar, Siddhartha" uniqKey="Laskar S" first="Siddhartha" last="Laskar">Siddhartha Laskar</name><name sortKey="Pilar, Avinash" sort="Pilar, Avinash" uniqKey="Pilar A" first="Avinash" last="Pilar">Avinash Pilar</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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