Experimental and clinical studies with intraoperative radiotherapy

Journal Article · Thu Sep 01 04:00:00 EDT 1983 · Surg. Gynecol. Obstet.; (United States)

OSTI ID:5392895

Sindelar, W F; Kinsella, T; Tepper, J; Travis, E L; Rosenberg, S A; Glatstein, E

Studies of normal tissue tolerance to intraoperative radiotherapy were done upon 65 dogs subjected to laparotomy and 11 million electron volt electron irradiation in doses ranging from zero to 5,000 rads. Results of studies indicated that intact aorta and vena cava tolerate up to 5,000 rads without loss of structural integrity. Ureteral fibrosis and stenosis develop at doses of 3,000 rads or more. Arterial anastomoses heal after doses of 4,500 rads, but fibrosis can lead to occlusion. Intestinal suture lines heal after doses of 4,500 rads. Bile duct fibrosis and stenosis develop at doses of 2,000 rads or more. Biliary-enteric anastomoses fail to heal at any dose level. A clinical trial of intraoperative radiotherapy combined with radical surgery was performed upon 20 patients with advanced malignant tumors which were considered unlikely to be cured by conventional therapies and which included carcinomas of the stomach, carcinomas of the pancreas, carcinomas involving the hilus of the liver, retroperitoneal sarcomas and osteosarcomas of the pelvis. All patients underwent resection of gross tumor, followed by intraoperative irradiation of the tumor bed and regional nodal basins. Some patients received additional postoperative external beam radiotherapy. Treatment mortality for combined operation and radiotherapy occurred in four of 20 patients. Postoperative complications occurred in four of the 16 surviving patients. Local tumor control was achieved in 11 of the 16 surviving patients, with an over-all median follow-up period of 18 months. The clinical trial suggested that intraoperative radiotherapy is a feasible adjunct to resection in locally advanced tumors, that the resulting mortality and morbidity is similar to that expected from operation alone and that local tumor control may be improved.

• Research Organization: Surgery Branch, Clinical Oncology Program, National Cancer Institute, Bethesda, Maryland
• OSTI ID: 5392895
• Journal Information: Surg. Gynecol. Obstet.; (United States), Journal Name: Surg. Gynecol. Obstet.; (United States) Vol. 157:3; ISSN SGOBA
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANIMALS
BILIARY TRACT
BODY
DIGESTIVE SYSTEM
DISEASES
DOGS
DOSE-RESPONSE RELATIONSHIPS
ENDOCRINE GLANDS
EVALUATION
GASTROINTESTINAL TRACT
GLANDS
LIVER
MAMMALS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
OSTEOSARCOMAS
PANCREAS
PATIENTS
RADIOLOGY
RADIOTHERAPY
SARCOMAS
SKELETAL DISEASES
STOMACH
SURGERY
THERAPY
URETERS
URINARY TRACT
VERTEBRATES