Intraoperative radiotherapy during lung cancer surgery: Technical description and early clinical results

Journal Article · Sun Jul 01 04:00:00 EDT 1990 · International Journal of Radiation Oncology, Biology and Physics; (USA)

DOI:https://doi.org/10.1016/0360-3016(90)90141-6· OSTI ID:6791338

Calvo, F A; Ortiz de Urbina, D; Abuchaibe, O; Azinovic, I; Aristu, J; Santos, M; Escude, L; Herreros, J; Llorens, R ^[1]

---

1. Univ. of Navarra, Pamplona (Spain)

A phase I-II study of intraoperative radiotherapy (IORT) for Stage III lung cancer was performed in 34 patients during a period of 58 months. Loco-regional treatment included tumor resection if technically feasible, IORT boost of electron beams using moderate single doses (10-15 Gy) to tumor bearing areas and external photon beam irradiation (46-50 Gy in 5 weeks) using conventional fields. Indications for this study were unresectable hiliar tumors (14, 41%), and mediastinal, hiliar and/or chest wall residual disease following resection (20, 59%). Thirty-four procedures, with 40 IORT fields, have been analyzed to describe the relevant technical aspects and the toxicity. IORT was delivered using acrylic transparent cones of different diameters. Surgical approach consisted in a lateral thoracotomy in all patients (21 right side and 13 left side). Tissues included within the IORT field were: tumor or residual tumor tissues (34, 100%), collapsed lung parenchyma and main bronchus not surgically manipulated (14, 41%), bronchial stump and vascular suture following resection (19, 55%), mediastinal structures (20, 58%), and brachial plexus (1, 3%). The bronchial suture was covered with pleural or pericardial flap after IORT in 10 cases (29%). Life threatening toxicity related to IORT consisted in broncho-pleural fistula (1, 3%) and massive hemoptysis (1, 3%). Other reversible toxic events were acute pneumonitis (12, 85%) and esophagitis (10, 50%). Long term asymptomatic lung fibrosis was detected in 11 cases (32%). Median survival time for the entire group has been 12 months. With a median follow-up time of 12 months the freedom from thoracic recurrence rate is 30% (65% in cases with tumor resection). Projected actuarial survival rates at 4 years were 28% for resected group and 7% for unresected cases.

• OSTI ID: 6791338
• Journal Information: International Journal of Radiation Oncology, Biology and Physics; (USA), Journal Name: International Journal of Radiation Oncology, Biology and Physics; (USA) Vol. 19:1; ISSN IOBPD; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

550600 -- Medicine
550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BEAMS
BODY
DISEASES
DOSES
ELECTRON BEAMS
IRRADIATION PROCEDURES
LEPTON BEAMS
LUNGS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PARTICLE BEAMS
PATIENTS
PHOTON BEAMS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SURGERY
SURVIVAL CURVES
THERAPY