Clinical Feasibility of Combining Intraoperative Electron Radiation Therapy with Minimally Invasive Surgery: a Potential for Electron-FLASH Clinical Development

Overview

Journal Clin Transl Oncol

Specialty Oncology

Date 2022 Sep 28

PMID 36169803

Authors

Felipe Angel Calvo Manuel

Javier Serrano

Claudio Sole

Mauricio Cambeiro

Jacobo Palma

Javier Aristu

Jose Luis Garcia-Sabrido

Miguel Angel Cuesta

Emilio del Valle

Fernando Lapuente

Bernardino Minana

Miguel Angel Morcillo

Jose Manuel Asencio

Javier Pascau

Affiliations

Soon will be listed here.

Abstract

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: 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: 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: 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.

Citing Articles

Evaluating the efficacy of low-kV X-ray intraoperative radiotherapy in the treatment of locally advanced rectal cancer: a retrospective cohort study.

Li J, Zhang B, Guo J, Guo Y, Chang L, Wang S Quant Imaging Med Surg. 2024; 14(12):8538-8550.

PMID: 39698727 PMC: 11652056. DOI: 10.21037/qims-24-965.

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