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The Use of Intraoperative Radiation Therapy (IORT) in Multimodality Management of Cancer Patients: a Single Institution Experience

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Abstract

Background

Intraoperative radiation therapy (IORT) is a highly conformal type of radiation therapy given at time of surgery aiming for better tumor local control. It increases the tumor radiation dose without exceeding normal tissues tolerance doses.

Purpose

To assess the feasibility of IORT and short-term toxicities in patients with different cancer sites treated with multidisciplinary protocol including IORT.

Patients and Methods

Medical records of cancer patients who received IORT as a part of their multidisciplinary treatment at King Faisal Specialized Hospital and Research center (KFSH&RC), Riyadh, Saudi Arabia, from January 2013 until December 2017 were retrospectively reviewed.

Results

A total of 188 patients with 210 IORT applications were analyzed. Twenty-two patients had two applications at the same time. One hundred sixteen patients were males. Median age at time of diagnosis was 49.5 years (19–77). One hundred thirty-four patients had primary, while 54 cases had recurrent disease. Gastroesophageal cancer and soft tissue sarcoma were the most frequent diagnosis in 49 patients followed by colorectal cancer in 35 patients. Major surgeries with curative intent done in 183 patients (97.3%). Hyperthermic intraperitoneal chemotherapy (HIPEC) was performed in 118 (62.8%) patients. The 30-day postoperative mortality rate was 3.2%. Fifty-four (28.7%) patients develop grades III–IV complications according to Clavien-Dindo grading system.

Conclusion

The data presented discusses using of IORT treatment for different malignant tumors as a part of multimodality treatment. IORT seems safe and feasible; however, a longer follow-up period is needed for proper evaluation and to define the role of IORT in a tailored multimodality approach.

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Data Availability

All data are available with the corresponding author and can be provided upon request.

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Authors and Affiliations

  1. Section of Radiation Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

    Ahmed Elashwah & Rana Mahmood

  2. Department of Surgical Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

    Ali Alzahrani, Ayman Zaki Azzam, Mohammad Breakeit & Tarek Mahmoud Amin

  3. King Faisal Specialist Hospital & Research Centre, Department of medical physics, Riyadh, Saudi Arabia

    Belal Moftah, Muhammad Hussain, Shada ALramahi & Zeinab Hassan

  4. Department of Oncology, King Saud University, Riyadh, Saudi Arabia

    Abdullah Alsuhaibani

  5. Kasr Al-Eini Center of Clinical Oncology (NEMROCK), Cairo University, Cairo, Egypt

    Ahmed Elashwah

  6. Department of General Surgery, Alexandria University, Alexandria, Egypt

    Ayman Zaki Azzam

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  1. Ahmed Elashwah
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  2. Abdullah Alsuhaibani
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Ahmed Elashwah, Ali Alzahrani, and Mohammad Breakeit. Surgical management and postoperative follow-up were done by Tarek Mahmoud Amin and Ayman Zaki Azzam. The radiation therapy indications and all IORT parameters chosen for every patient were done by Abdullah Alsuhaibani, Rana Mahmood, and Ahmed Elashwah. The medical physics work were done by Belal Moftah, Muhammad Hussain, Shada ALramahi, and Zeinab Hassan. The first draft of the manuscript was written by Ahmed Elashwah, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ahmed Elashwah.

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This research has been approved by the Research Advisory Council (RAC) at the King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (RAC Project # 2161 246).

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The authors declare no competing interests.

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Elashwah, A., Alsuhaibani, A., Alzahrani, A. et al. The Use of Intraoperative Radiation Therapy (IORT) in Multimodality Management of Cancer Patients: a Single Institution Experience. J Gastrointest Canc 54, 433–441 (2023). https://doi.org/10.1007/s12029-021-00786-9

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