Literature DB >> 28252805

Postoperative complications following intraoperative radiotherapy in abdominopelvic malignancy: A single institution analysis of 113 consecutive patients.

Eihab Abdelfatah1, Andrew Page1, Justin Sacks2, Phillip Pierorazio3, Trinity Bivalacqua3, Jonathan Efron1, Stephanie Terezakis4, Susan Gearhart1, Sandy Fang1, Bashar Safar1, Timothy M Pawlik1, Elwood Armour4, Amy Hacker-Prietz4, Joseph Herman4, Nita Ahuja1,3,5.   

Abstract

BACKGROUND: Intraoperative radiotherapy (IORT) has advantages over external beam radiation therapy (EBRT). Few studies have described side effects associated with its addition. We evaluated our institution's experience with abdominopelvic IORT to assess safety by postoperative complication rates.
METHODS: Prospectively collected IRB-approved database of all patients receiving abdominopelvic IORT (via high dose rate brachytherapy) at Johns Hopkins Hospital between November 2006 and May 2014 was reviewed. Patients were discussed in multidisciplinary conferences. Those selected for IORT were patients for whom curative intent resection was planned for which IORT could improve margin-negative resection and optimize locoregional control. Perioperative complications were classified via Clavien-Dindo scale for postoperative surgical complications.
RESULTS: A total of 113 patients were evaluated. Most common diagnosis was sarcoma (50/113, 44%) followed by colorectal cancer (45/113, 40%), most of which were recurrent (84%). There were no perioperative deaths. A total of 57% of patients experienced a complication Grade II or higher: 24% (27/113) Grade II; 27% (30/113) Grade III; 7% (8/113) Grade IV. Wound complications were most common (38%), then gastrointestinal (25%). No radiotherapy variables were significantly associated with complications on uni/multi-variate analysis.
CONCLUSIONS: Our institution's experience with IORT demonstrated historically expected postoperative complication rates. IORT is safe, with acceptable perioperative morbidity.
© 2017 Wiley Periodicals, Inc.

Entities:  

Keywords:  colorectal cancer; high dose rate brachytherapy; radiation therapy; rectal cancer; sarcoma

Mesh:

Year:  2017        PMID: 28252805      PMCID: PMC5572190          DOI: 10.1002/jso.24597

Source DB:  PubMed          Journal:  J Surg Oncol        ISSN: 0022-4790            Impact factor:   3.454


  33 in total

1.  Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer.

Authors:  E Kapiteijn; C A Marijnen; I D Nagtegaal; H Putter; W H Steup; T Wiggers; H J Rutten; L Pahlman; B Glimelius; J H van Krieken; J W Leer; C J van de Velde
Journal:  N Engl J Med       Date:  2001-08-30       Impact factor: 91.245

Review 2.  Integration of radiation oncology with surgery as combined-modality treatment.

Authors:  Leonard L Gunderson; Jonathan B Ashman; Michael G Haddock; Ivy A Petersen; Adyr Moss; Jacques Heppell; Richard J Gray; Barbara A Pockaj; Heidi Nelson; Christopher Beauchamp
Journal:  Surg Oncol Clin N Am       Date:  2013-03-13       Impact factor: 3.495

Review 3.  intraoperative radiation therapy part 2. Clinical results.

Authors:  Felipe A Calvo; Rosa M Meirino; Roberto Orecchia
Journal:  Crit Rev Oncol Hematol       Date:  2006-07-21       Impact factor: 6.312

Review 4.  Radiation-induced cell death mechanisms.

Authors:  David Eriksson; Torgny Stigbrand
Journal:  Tumour Biol       Date:  2010-05-20

5.  Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control.

Authors:  Sylvie Bonvalot; Michel Rivoire; Marine Castaing; Eberhard Stoeckle; Axel Le Cesne; Jean Yves Blay; Agnès Laplanche
Journal:  J Clin Oncol       Date:  2008-12-01       Impact factor: 44.544

6.  Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial.

Authors:  M Kusters; C A M Marijnen; C J H van de Velde; H J T Rutten; M J Lahaye; J H Kim; R G H Beets-Tan; G L Beets
Journal:  Eur J Surg Oncol       Date:  2010-01-21       Impact factor: 4.424

7.  Intraoperative irradiation after palliative surgery for locally recurrent rectal cancer.

Authors:  K Suzuki; L L Gunderson; R M Devine; A L Weaver; R R Dozois; D M Ilstrup; J A Martenson; M J O'Connell
Journal:  Cancer       Date:  1995-02-15       Impact factor: 6.860

8.  Intraoperative radiation therapy for locally advanced recurrent rectal or rectosigmoid cancer.

Authors:  H J Wallace; C G Willett; P C Shellito; J J Coen; H C Hoover
Journal:  J Surg Oncol       Date:  1995-10       Impact factor: 3.454

Review 9.  High-dose-rate intraoperative radiation therapy: the nuts and bolts of starting a program.

Authors:  Shalini Moningi; Elwood P Armour; Stephanie A Terezakis; Jonathan E Efron; Susan L Gearhart; Trinity J Bivalacqua; Rachit Kumar; Yi Le; Sook Kien Ng; Christopher L Wolfgang; Richard C Zellars; Susannah G Ellsworth; Nita Ahuja; Joseph M Herman
Journal:  J Contemp Brachytherapy       Date:  2014-04-03

10.  Clinical phase I/II trial to investigate preoperative dose-escalated intensity-modulated radiation therapy (IMRT) and intraoperative radiation therapy (IORT) in patients with retroperitoneal soft tissue sarcoma: interim analysis.

Authors:  Falk Roeder; Alexis Ulrich; Gregor Habl; Matthias Uhl; Ladan Saleh-Ebrahimi; Peter E Huber; Daniela Schulz-Ertner; Anna V Nikoghosyan; Ingo Alldinger; Robert Krempien; Gunhild Mechtersheimer; Frank W Hensley; Juergen Debus; Marc Bischof
Journal:  BMC Cancer       Date:  2014-08-27       Impact factor: 4.430

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  2 in total

Review 1.  ESTRO/ACROP IORT recommendations for intraoperative radiation therapy in locally recurrent rectal cancer.

Authors:  Felipe A Calvo; Claudio V Sole; Harm J Rutten; Wim J Dries; Miguel A Lozano; Mauricio Cambeiro; Philip Poortmans; Luis González-Bayón
Journal:  Clin Transl Radiat Oncol       Date:  2020-06-17

2.  Surgical Resection with Neoadjuvant Chemotherapy for Locoregionally Recurrent Appendiceal Cancer Invading the External Iliac Vessels.

Authors:  Jun Takahashi; Shingo Tsujinaka; Nao Kakizawa; Noriya Takayama; Erika Machida; Kazuki Iseya; Fumi Hasegawa; Rina Kikugawa; Yasuyuki Miyakura; Koichi Suzuki; Toshiki Rikiyama
Journal:  Case Rep Surg       Date:  2018-08-02
  2 in total

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