Intraoperative high-dose-rate brachytherapy using dose painting technique: Evaluation of safety and preliminary clinical outcomes Journal Article
| Authors: | Morikawa, L. K.; Zelefsky, M. J.; Cohen, G. N.; Zaider, M.; Chiu, J.; Mathur, N.; Worman, M. F.; Goodman, K. A. |
| Article Title: | Intraoperative high-dose-rate brachytherapy using dose painting technique: Evaluation of safety and preliminary clinical outcomes |
| Abstract: | Purpose: Intraoperative radiation therapy (IORT) allows delivery of tumoricidal doses of radiation to areas of potential residual microscopic disease while minimizing doses to normal tissues. IORT using high-dose-rate (HDR) brachytherapy allows dose modulation and delivery of concomitant boosts to high-risk areas. This study describes a novel technique of HDR-IORT with dose painting (DP) (HDR-IORT-DP) and evaluates the clinical outcomes. Methods and Materials: Sixteen patients with recurrent cancers received HDR-IORT-DP at the time of radical resection. Of these patients, 13 had colorectal cancer, 2 had head and neck cancer, and 1 had a gynecologic malignancy. All received external beam radiation previously. Negative margin (R0) was obtained in 12 patients (75%) and microscopically positive margins (R1) in 4 patients (25%). Results: The median total target and boost area were 45 and 8.5cm2, and HDR-IORT and boost dose were 1500 and 1750cGy, respectively. Median followup was 14.9 months. The 2-year local control and overall survival were 80% and 20%, respectively. Eleven patients (69%) developed distant metastasis and were deceased at the time of the last followup. A total of 13 patients (19%) developed Grade 3 toxicity related to HDR-IORT; no grade 4+ toxicities were observed. Conclusions: HDR-IORT-DP technique is feasible, safe, and allows for dose escalation in locally advanced or recurrent previously irradiated tumors. To our knowledge, this is the first clinical report on HDR-IORT-DP. Further studies are warranted to evaluate efficacy in a larger patient cohort. Local control was encouraging in our patients. © 2013 American Brachytherapy Society. |
| Keywords: | intraoperative radiotherapy; high-dose-rate brachytherapy; reirradiation; dose painting |
| Journal Title: | Brachytherapy |
| Volume: | 12 |
| Issue: | 1 |
| ISSN: | 1538-4721 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2013-01-01 |
| Start Page: | 1 |
| End Page: | 7 |
| Language: | English |
| DOI: | 10.1016/j.brachy.2012.04.011 |
| PROVIDER: | scopus |
| PUBMED: | 23167979 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 February 2013" - "CODEN: BRACC" - "Source: Scopus" |
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