Sample records for iort iort iort

  1. Anesthesia for intraoperative radiation therapy in children

    SciTech Connect (OSTI)

    Friesen, R.H.; Morrison, J.E. Jr.; Verbrugge, J.J.; Daniel, W.E.; Aarestad, N.O.; Burrington, J.D.

    1987-06-01T23:59:59.000Z

    Intraoperative radiation therapy (IORT) is a relatively new mode of cancer treatment which is being used with increasing frequency. IORT presents several challenges to the anesthesiologist, including patients who are debilitated from their disease or chemotherapy, operations involving major tumor resections, intraoperative interdepartmental transport of patients, and remote monitoring of patients during electron beam therapy. This report discusses the anesthetic management of ten children undergoing IORT. With adequate preparation and interdepartmental communication, complications can be avoided during these challenging cases.

  2. Intraoperative radiation therapy using mobile electron linear accelerators: Report of AAPM Radiation Therapy Committee Task Group No. 72

    SciTech Connect (OSTI)

    Sam Beddar, A.; Biggs, Peter J.; Chang Sha; Ezzell, Gary A.; Faddegon, Bruce A.; Hensley, Frank W.; Mills, Michael D. [Department of Radiation Physics, Division of Radiation Oncology, Unit 94, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030 (United States); Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599 (United States); Department of Radiation Oncology, Mayo Clinic Scottsdale, Scottsdale, Arizona 85259 (United States); Department of Radiation Oncology, University of California San Francisco, San Francisco, California 94143 (United States); Department of Radiation Oncology, University of Heidelberg, 69120 Heidelberg (Germany); Department of Radiation Oncology, James Graham Brown Cancer Center, Louisville, Kentucky 40202 (United States)

    2006-05-15T23:59:59.000Z

    Intraoperative radiation therapy (IORT) has been customarily performed either in a shielded operating suite located in the operating room (OR) or in a shielded treatment room located within the Department of Radiation Oncology. In both cases, this cancer treatment modality uses stationary linear accelerators. With the development of new technology, mobile linear accelerators have recently become available for IORT. Mobility offers flexibility in treatment location and is leading to a renewed interest in IORT. These mobile accelerator units, which can be transported any day of use to almost any location within a hospital setting, are assembled in a nondedicated environment and used to deliver IORT. Numerous aspects of the design of these new units differ from that of conventional linear accelerators. The scope of this Task Group (TG-72) will focus on items that particularly apply to mobile IORT electron systems. More specifically, the charges to this Task Group are to (i) identify the key differences between stationary and mobile electron linear accelerators used for IORT (ii) describe and recommend the implementation of an IORT program within the OR environment, (iii) present and discuss radiation protection issues and consequences of working within a nondedicated radiotherapy environment, (iv) describe and recommend the acceptance and machine commissioning of items that are specific to mobile electron linear accelerators, and (v) design and recommend an efficient quality assurance program for mobile systems.

  3. Prospective Study of Local Control and Late Radiation Toxicity After Intraoperative Radiation Therapy Boost for Early Breast Cancer

    SciTech Connect (OSTI)

    Chang, David W., E-mail: David.Chang@petermac.org [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Marvelde, Luc te [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Chua, Boon H. [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria (Australia)

    2014-01-01T23:59:59.000Z

    Purpose: To report the local recurrence rate and late toxicity of intraoperative radiation therapy (IORT) boost to the tumor bed using the Intrabeam System followed by external-beam whole-breast irradiation (WBI) in women with early-stage breast cancer in a prospective single-institution study. Methods and Materials: Women with breast cancer ?3 cm were recruited between February 2003 and May 2005. After breast-conserving surgery, a single dose of 5 Gy IORT boost was delivered using 50-kV x-rays to a depth of 10 mm from the applicator surface. This was followed by WBI to a total dose of 50 Gy in 25 fractions. Patients were reviewed at regular, predefined intervals. Late toxicities were recorded using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring systems. Results: Fifty-five patients completed both IORT boost and external-beam WBI. Median follow-up was 3.3 years (range, 1.4-4.1 years). There was no reported locoregional recurrence or death. One patient developed distant metastases. Grade 2 and 3 subcutaneous fibrosis was detected in 29 (53%) and 8 patients (15%), respectively. Conclusions: The use of IORT as a tumor bed boost using kV x-rays in breast-conserving therapy was associated with good local control but a clinically significant rate of grade 2 and 3 subcutaneous fibrosis.

  4. Long-Term Outcomes With Intraoperative Radiotherapy as a Component of Treatment for Locally Advanced or Recurrent Uterine Sarcoma

    SciTech Connect (OSTI)

    Barney, Brandon M., E-mail: barney.brandon@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Petersen, Ivy A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Dowdy, Sean C.; Bakkum-Gamez, Jamie N. [Division of Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota (United States); Haddock, Michael G. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

    2012-05-01T23:59:59.000Z

    Purpose: To report our institutional experience with intraoperative radiotherapy (IORT) as a component of treatment for women with locally advanced or recurrent uterine sarcoma. Methods and Materials: From 1990 to 2010, 16 women with primary (n = 3) or locoregionally recurrent (n = 13) uterine sarcoma received IORT as a component of combined modality treatment. Tumor histology studies found leiomyosarcoma (n = 9), endometrial stromal sarcoma (n = 4), and carcinosarcoma (n = 3). Surgery consisted of gross total resection in 2 patients, subtotal resection in 6 patients, and resection with close surgical margins in 8 patients. The median IORT dose was 12.5 Gy (range, 10-20 Gy). All patients received perioperative external beam radiotherapy (EBRT; median dose, 50.4 Gy; range, 20-62.5 Gy), and 6 patients also received perioperative systemic therapy. Results: Seven of the 16 patients are alive at a median follow-up of 44 months (range, 11-203 months). The 3-year Kaplan-Meier estimate of local relapse (within the EBRT field) was 7%, and central control (within the IORT field) was 100%. No local failures occurred in any of the 6 patients who underwent subtotal resection. The 3-year freedom from distant relapse was 48%, with failures occurring most frequently in the lungs or mediastinum. Median survival was 18 months, and 3-year Kaplan-Meier estimates of cause-specific and overall survival were 58% and 53%, respectively. Three patients (19%) experienced late Grade 3 toxicity. Conclusions: A combined modality approach with perioperative EBRT, surgery, and IORT for locally advanced or recurrent uterine sarcoma resulted in excellent local disease control with acceptable toxicity, even in patients with positive resection margins. With this approach, some patients were able to experience long-term freedom from recurrence.

  5. Cosmetic Outcome and Seroma Formation After Breast-Conserving Surgery With Intraoperative Radiation Therapy Boost for Early Breast Cancer

    SciTech Connect (OSTI)

    Senthi, Sashendra, E-mail: sashasenthi@msn.com [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne (Australia)] [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne (Australia); Link, Emma [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne (Australia)] [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne (Australia); Chua, Boon H. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne (Australia) [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne (Australia); University of Melbourne, Melbourne (Australia)

    2012-10-01T23:59:59.000Z

    Purpose: To evaluate cosmetic outcome and its association with breast wound seroma after breast-conserving surgery (BCS) with targeted intraoperative radiation therapy (tIORT) boost for early breast cancer. Methods and Materials: An analysis of a single-arm prospective study of 55 patients with early breast cancer treated with BCS and tIORT boost followed by conventional whole breast radiation therapy (WBRT) between August 2003 and January 2006 was performed. A seroma was defined as a fluid collection at the primary tumor resection site identified clinically or radiologically. Cosmetic assessments using the European Organization for Research and Treatment of Cancer rating system were performed at baseline before BCS and 30 months after WBRT was completed. Results: Twenty-eight patients (51%) developed a seroma, with 18 patients (33%) requiring at least 1 aspiration. Tumor location was significantly associated with seroma formation (P=.001). Ten of 11 patients with an upper inner quadrant tumor developed a seroma. Excellent or good overall cosmetic outcome at 30 months was observed in 34 patients (62%, 95% confidence interval 53%-80%). Seroma formation was not associated with the overall cosmetic result (P=.54). Conclusion: BCS with tIORT boost followed by WBRT was associated with an acceptable cosmetic outcome. Seroma formation was not significantly associated with an adverse cosmetic outcome.

  6. EBT2 Dosimetry of X-rays produced by the electron beam from PFMA-3, a Plasma Focus for medical applications

    E-Print Network [OSTI]

    Elisa Ceccolini; Federico Rocchi; Domiziano Mostacci; Marco Sumini; Agostino Tartari

    2011-12-09T23:59:59.000Z

    The electron beam emitted from the back of Plasma Focus devices is being studied as a radiation source for IORT (IntraOperative Radiation Therapy) applications. A Plasma Focus device is being developed to this aim, to be utilized as an X-ray source. The electron beam is driven to impinge on 50 {\\mu}m brass foil, where conversion X-rays are generated. Measurements with gafchromic film are performed to analyse the attenuation of the X-rays beam and to predict the dose given to the culture cell in radiobiological experiments to follow.

  7. EBT2 Dosimetry of X-rays produced by the electron beam from PFMA-3, a Plasma Focus for medical applications

    E-Print Network [OSTI]

    Ceccolini, Elisa; Mostacci, Domiziano; Sumini, Marco; Tartari, Agostino

    2011-01-01T23:59:59.000Z

    The electron beam emitted from the back of Plasma Focus devices is being studied as a radiation source for IORT (IntraOperative Radiation Therapy) applications. A Plasma Focus device is being developed to this aim, to be utilized as an X-ray source. The electron beam is driven to impinge on 50 {\\mu}m brass foil, where conversion X-rays are generated. Measurements with gafchromic film are performed to analyse the attenuation of the X-rays beam and to predict the dose given to the culture cell in radiobiological experiments to follow.

  8. Prognostic Value of External Beam Radiation Therapy in Patients Treated With Surgical Resection and Intraoperative Electron Beam Radiation Therapy for Locally Recurrent Soft Tissue Sarcoma: A Multicentric Long-Term Outcome Analysis

    SciTech Connect (OSTI)

    Calvo, Felipe A. [Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); School of Medicine, Complutense University, Madrid (Spain); Sole, Claudio V., E-mail: cvsole@uc.cl [Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); School of Medicine, Complutense University, Madrid (Spain); Service of Radiation Oncology, Instituto de Radiomedicina, Santiago (Chile); Cambeiro, Mauricio [Service of Radiation Oncology, Clínica Universitaria, Universidad de Navarra, Pamplona (Spain); Montero, Angel; Polo, Alfredo [Service of Radiation Oncology, Hospital Universitario Ramón y Cajal, Universidad de Alcala, Madrid (Spain); Gonzalez, Carmen [School of Medicine, Complutense University, Madrid (Spain); Service of Radiation Oncology, Instituto de Radiomedicina, Santiago (Chile); Service of Radiation Oncology, Clínica Universitaria, Universidad de Navarra, Pamplona (Spain); Service of Radiation Oncology, Hospital Universitario Ramón y Cajal, Universidad de Alcala, Madrid (Spain); Service of Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); Cuervo, Miguel [Service of Orthopedics and Traumatology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); San Julian, Mikel [Service of Orthopedics and Traumatology, Clínica Universitaria, Universidad de Navarra, Pamplona (Spain); and others

    2014-01-01T23:59:59.000Z

    Background: A joint analysis of data from centers involved in the Spanish Cooperative Initiative for Intraoperative Electron Radiotherapy was performed to investigate long-term outcomes of locally recurrent soft tissue sarcoma (LR-STS) patients treated with a multidisciplinary approach. Methods and Materials: Patients with a histologic diagnosis of LR-STS (extremity, 43%; trunk wall, 24%; retroperitoneum, 33%) and no distant metastases who underwent radical surgery and intraoperative electron radiation therapy (IOERT; median dose, 12.5 Gy) were considered eligible for participation in this study. In addition, 62% received external beam radiation therapy (EBRT; median dose, 50 Gy). Results: From 1986 to 2012, a total of 103 patients from 3 Spanish expert IOERT institutions were analyzed. With a median follow-up of 57 months (range, 2-311 months), 5-year local control (LC) was 60%. The 5-year IORT in-field control, disease-free survival (DFS), and overall survival were 73%, 43%, and 52%, respectively. In the multivariate analysis, no EBRT to treat the LR-STS (P=.02) and microscopically involved margin resection status (P=.04) retained significance in relation to LC. With regard to IORT in-field control, only not delivering EBRT to the LR-STS retained significance in the multivariate analysis (P=.03). Conclusion: This joint analysis revealed that surgical margin and EBRT affect LC but that, given the high risk of distant metastases, DFS remains modest. Intensified local treatment needs to be further tested in the context of more efficient concurrent, neoadjuvant, and adjuvant systemic therapy.

  9. Measurement of the neutron leakage from a dedicated intraoperative radiation therapy electron linear accelerator and a conventional linear accelerator for 9, 12, 15(16), and 18(20) MeV electron energies

    SciTech Connect (OSTI)

    Jaradat, Adnan K.; Biggs, Peter J. [Department of Physics, University of Massachusetts Lowell, One University Avenue, Lowell, Massachusetts 01854 (United States); Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114 (United States)

    2008-05-15T23:59:59.000Z

    The issue of neutron leakage has recently been raised in connection with dedicated electron-only linear accelerators used for intraoperative radiation therapy (IORT). In particular, concern has been expressed about the degree of neutron production at energies of 10 MeV and higher due to the need for additional, perhaps permanent, shielding in the room in which the device is operated. In particular, three mobile linear accelerators available commercially offer electron energies at or above the neutron threshold, one at 9 MeV, one at 10 MeV, and the third at 12 MeV. To investigate this problem, neutron leakage has been measured around the head of two types of electron accelerators at a distance of 1 m from the target at azimuthal angles of 0 deg., 45 deg., 90 deg., 135 deg., and 180 deg. The first is a dedicated electron-only (nonmobile) machine with electron energies of 6 (not used here), 9, 12, 15, and 18 MeV and the second a conventional machine with electron energies of 6 (also not used here), 9, 12, 16, and 20 MeV. Measurements were made using neutron bubble detectors and track-etch detectors. For electron beams from a conventional accelerator, the neutron leakage in the forward direction in Sv/Gy is 2.1x10{sup -5} at 12 MeV, 1.3x10{sup -4} at 16 MeV, and 4.2x10{sup -4} at 20 MeV, assuming a quality factor (RBE) of 10. For azimuthal angles >0 deg., the leakage is almost angle independent [2x10{sup -6} at 12 MeV; (0.7-1.6)x10{sup -5} at 16 MeV, and (1.6-2.9)x10{sup -5} at 20 MeV]. For the electron-only machine, the neutron leakage was lower than for the conventional linac, but also independent of azimuthal angle for angles >0 deg. : ([0 deg. : 7.7x10{sup -6} at 12 MeV; 3.0x10{sup -5} at 15 MeV; 1.0x10{sup -4} at 18 MeV]; [other angles: (2.6-5.9)x10{sup -7} at 12 MeV; (1.4-2.2)x10{sup -6} at 15 MeV; (2.7-4.7)x10{sup -6} at 18 MeV]). Using the upper limit of 6x10{sup -7} Sv/Gy at 12 MeV for the IORT machine for azimuthal angles >0 deg. and assuming a workload of 200 Gy/wk and an inverse square factor of 10, the neutron dose equivalent is calculated to be 0.012 mSv/wk. For the primary beam at 12 MeV (0 deg. ), the 10x higher dose would be compensated by the attenuation of a primary beam stopper in a mobile linear accelerator. These neutron radiation levels are below regulatory values (National Council on Radiation Protection and Measurements, 'Limitation of exposure to ionizing radiation', NCRP Report No. 116, NCRP Bethesda, MD, 1993)