Clinical feasibility of combining intraoperative electron radiation therapy with minimally invasive surgery: a potential for electron-FLASH clinical development.
Cancer surgery
Electron beams
FLASH
Intraoperative radiation therapy
Laparoscopic surgery
Robotic surgery
Journal
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
ISSN: 1699-3055
Titre abrégé: Clin Transl Oncol
Pays: Italy
ID NLM: 101247119
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
31
08
2022
accepted:
14
09
2022
pubmed:
29
9
2022
medline:
27
1
2023
entrez:
28
9
2022
Statut:
ppublish
Résumé
Local cancer therapy by combining real-time surgical exploration and resection with delivery of a single dose of high-energy electron irradiation entails a very precise and effective local therapeutic approach. Integrating the benefits from minimally invasive surgical techniques with the very precise delivery of intraoperative electron irradiation results in an efficient combined modality therapy. Patients with locally advanced disease, who are candidates for laparoscopic and/or thoracoscopic surgery, received an integrated multimodal management. Preoperative treatment included induction chemotherapy and/or chemoradiation, followed by laparoscopic surgery and intraoperative electron radiation therapy. In a period of 5 consecutive years, 125 rectal cancer patients were treated, of which 35% underwent a laparoscopic approach. We found no differences in cancer outcomes and tolerance between the open and laparoscopic groups. Two esophageal cancer patients were treated with IOeRT during thoracoscopic resection, with the resection specimens showing intense downstaging effects. Two oligo-recurrent prostatic cancer patients (isolated nodal progression) had a robotic-assisted surgical resection and post-lymphadenectomy electron boost on the vascular and lateral pelvic wall. Minimally invasive and robotic-assisted surgery is feasible to combine with intraoperative electron radiation therapy and offers a new model explored with electron-FLASH beams.
Sections du résumé
BACKGROUND
BACKGROUND
Local cancer therapy by combining real-time surgical exploration and resection with delivery of a single dose of high-energy electron irradiation entails a very precise and effective local therapeutic approach. Integrating the benefits from minimally invasive surgical techniques with the very precise delivery of intraoperative electron irradiation results in an efficient combined modality therapy.
METHODS
METHODS
Patients with locally advanced disease, who are candidates for laparoscopic and/or thoracoscopic surgery, received an integrated multimodal management. Preoperative treatment included induction chemotherapy and/or chemoradiation, followed by laparoscopic surgery and intraoperative electron radiation therapy.
RESULTS
RESULTS
In a period of 5 consecutive years, 125 rectal cancer patients were treated, of which 35% underwent a laparoscopic approach. We found no differences in cancer outcomes and tolerance between the open and laparoscopic groups. Two esophageal cancer patients were treated with IOeRT during thoracoscopic resection, with the resection specimens showing intense downstaging effects. Two oligo-recurrent prostatic cancer patients (isolated nodal progression) had a robotic-assisted surgical resection and post-lymphadenectomy electron boost on the vascular and lateral pelvic wall.
CONCLUSIONS
CONCLUSIONS
Minimally invasive and robotic-assisted surgery is feasible to combine with intraoperative electron radiation therapy and offers a new model explored with electron-FLASH beams.
Identifiants
pubmed: 36169803
doi: 10.1007/s12094-022-02955-z
pii: 10.1007/s12094-022-02955-z
pmc: PMC9873754
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
429-439Subventions
Organisme : Ministerio de Ciencia e Innovación
ID : PID 2019-104558RB-100
Organisme : Instituto de Salud Carlos III
ID : AC20/00103
Organisme : Instituto de Salud Carlos III
ID : AC20/00102
Organisme : Instituto de Salud Carlos III
ID : 2020-110-1
Informations de copyright
© 2022. The Author(s).
Références
J Gastrointest Oncol. 2016 Dec;7(6):903-916
pubmed: 28078113
Br J Surg. 2013 Jan;100(1):75-82
pubmed: 23132548
Radiother Oncol. 2014 Jul;112(1):52-8
pubmed: 24997989
Ann Surg Oncol. 2013 Jun;20(6):1962-9
pubmed: 23254690
Int J Radiat Oncol Biol Phys. 1992;22(1):65-9
pubmed: 1309205
Clin Transl Radiat Oncol. 2020 Jun 17;24:41-48
pubmed: 32613091
Radiother Oncol. 2012 Jan;102(1):51-5
pubmed: 22178689
BJU Int. 2009 Dec;104(11):1624-30
pubmed: 19624597
Colorectal Dis. 2021 Aug;23(8):1998-2006
pubmed: 33905599
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014 Sep;158(3):447-50
pubmed: 23128826
Gen Thorac Cardiovasc Surg. 2016 Jul;64(7):380-5
pubmed: 27130186
Int J Radiat Oncol Biol Phys. 1989 Sep;17(3):583-90
pubmed: 2550397
Surg Endosc. 2014 Jan;28(1):297-306
pubmed: 24013470
J Surg Oncol. 1992 Jun;50(2):81-8
pubmed: 1593890
Investig Clin Urol. 2021 Nov;62(6):631-640
pubmed: 34729963
Surgery. 2021 Dec;170(6):1692-1701
pubmed: 34389164
Cancer. 1999 Jul 1;86(1):6-13
pubmed: 10391557
Scand J Urol. 2021 Aug;55(4):287-292
pubmed: 34196594
Minerva Med. 2017 Feb;108(1):74-83
pubmed: 27701375
Surg Endosc. 2007 Feb;21(2):330-2
pubmed: 17139455
Oncol Hematol Rev. 2020 Spring;16(1):43-51
pubmed: 32832093
Lancet Oncol. 2010 Jul;11(7):637-45
pubmed: 20610322
Semin Thorac Cardiovasc Surg. 2016 Spring;28(1):160-9
pubmed: 27568155
Int J Radiat Oncol Biol Phys. 2008 Mar 1;70(3):715-21
pubmed: 18164840
Radiology. 2003 Jul;228(1):139-43
pubmed: 12750456
Clin Transl Radiat Oncol. 2020 Sep 11;25:29-36
pubmed: 33005755
Ann Med Surg (Lond). 2016 Dec 27;13:38-41
pubmed: 28070329
Int J Radiat Oncol Biol Phys. 1987 Mar;13(3):371-8
pubmed: 3104247
Med Phys. 2022 Mar;49(3):2082-2095
pubmed: 34997969
Eur J Surg Oncol. 2017 Jan;43(1):107-117
pubmed: 27659000
Front Oncol. 2020 Jan 17;9:1563
pubmed: 32010633
Ann Oncol. 2006 Jul;17(7):1103-10
pubmed: 16670204
Br J Surg. 2021 Sep 27;108(9):1026-1033
pubmed: 34491293
J Radiat Res. 2012 Nov 1;53(6):882-91
pubmed: 22872778
J Clin Oncol. 2015 Jun 1;33(16):1754-9
pubmed: 25918302
Radiology. 2004 Mar;230(3):753-60
pubmed: 14764888
World J Gastrointest Oncol. 2021 Jan 15;13(1):69-86
pubmed: 33510850
Investig Clin Urol. 2021 Jan;62(1):111-120
pubmed: 33381928
Surgery. 2000 Oct;128(4):564-71
pubmed: 11015089
J Cancer Res Clin Oncol. 2013 Nov;139(11):1825-33
pubmed: 24005420
J Pers Med. 2021 Jul 06;11(7):
pubmed: 34357107
J Clin Oncol. 2007 Jul 20;25(21):3061-8
pubmed: 17634484
Eur J Surg Oncol. 2022 May;48(5):1133-1143
pubmed: 34794842
Clin Transl Oncol. 2013 Jun;15(6):443-9
pubmed: 23143948
Minerva Chir. 2009 Apr;64(2):121-33
pubmed: 19365313
Int J Radiat Oncol Biol Phys. 1989 Sep;17(3):559-67
pubmed: 2506159
Int J Radiat Oncol Biol Phys. 2010 Mar 15;76(4):1073-7
pubmed: 19625135
Dis Esophagus. 1999;12(4):270-5
pubmed: 10770361
Eur J Surg Oncol. 2022 Mar;48(3):473-481
pubmed: 34955315
BMC Surg. 2022 Feb 23;22(1):63
pubmed: 35197022
Lancet Oncol. 2013 Mar;14(3):210-8
pubmed: 23395398
J Invest Surg. 2005 Nov-Dec;18(6):305-13
pubmed: 16319051
J Surg Res. 1992 Sep;53(3):287-92
pubmed: 1382153
Int J Radiat Oncol Biol Phys. 1985 Sep;11(9):1579-85
pubmed: 4030429
Mol Clin Oncol. 2015 Jan;3(1):185-189
pubmed: 25469292
Int J Radiat Oncol Biol Phys. 1994 Sep 30;30(2):339-45
pubmed: 7928460
Int J Radiat Oncol Biol Phys. 1988 Dec;15(6):1401-6
pubmed: 3198439
Dis Esophagus. 2006;19(6):487-95
pubmed: 17069594
Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Apr 25;23(4):377-383
pubmed: 32306606
Ann Surg. 2017 Aug;266(2):232-236
pubmed: 28187044
Int J Radiat Oncol Biol Phys. 2008 Dec 1;72(5):1488-94
pubmed: 18538489