Akrami Majid, Nasrollahi Hamid, Vahabi Mostafa, Hamedi Seyed Hassan, Tahmasebi Sedigheh, Karbasi Sareh, Pashnesaz Mehran, Zangouri Vahid, Karami Mohammad Yasin, Mosallaei Ahmad, Talei Abdolrasoul
Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran.
Radiation Oncology Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Med J Islam Repub Iran. 2020 May 20;34:50. doi: 10.34171/mjiri.34.50. eCollection 2020.
Intraoperative radiation therapy (IORT) is the delivery of radiation at the time of surgery. Whereas the dose delivered by external beam radiation therapy (EBRT) is limited by the tolerance of the surrounding normal tissues, IORT allows exclusion of a part or all of the dose-limiting sensitive structures by operative mobilization and/or direct shielding of these structures. The aim of the present study was to report the non-breast cancer patients' outcomes after receiving IORT in Shiraz, Iran. In this retrospective study, all cases who had received IORT and had non-breast malignancies were selected. Diagnosis was confirmed by biopsy. Additional imaging was done by sonography, magnetic resonance imaging (MRI) and computed tomography (CT). IORT was applied by self-shielded, LIAC 6-12 MeV Sordina mobile linear accelerator. Typically, a single dose of 10-21 Gy was given for maximally resected tumors. The statistical analyses were carried out using SPSS (version 21). Twenty-six patients were treated with IORT alone or combined with EBRT. Different tumors were treated, including colorectal adenocarcinoma (10 cases, 38.4 %), Soft Tissue Sarcomas (STS, 11 cases, 42.3 %), head and neck cancers (3 cases, 11.5 %), one cervix malignancy case and one paravertebral fibromatosis case. Mean ± SD overall survival was 15±14.89 (0-38) and 34.3±15.72 (14-53) months for colorectal cancer and STS, respectively. IORT is mostly useful for pelvic and abdominal malignancies where normal bowel limits the dose that can be delivered with EBRT. However, the dose delivered in a single fraction with IORT is rarely sufficient for tumor control; therefore, IORT is usually preceded or followed by additional EBRT which should be further evaluated preferably in prospective randomized trials.
术中放射治疗（IORT）是在手术时进行放射治疗。外照射放射治疗（EBRT）所给予的剂量受到周围正常组织耐受性的限制，而IORT通过手术移动和/或直接屏蔽这些结构，允许排除部分或全部剂量限制敏感结构。本研究的目的是报告伊朗设拉子非乳腺癌患者接受IORT后的结果。在这项回顾性研究中，选择了所有接受IORT且患有非乳腺恶性肿瘤的病例。通过活检确诊。通过超声、磁共振成像（MRI）和计算机断层扫描（CT）进行额外的成像检查。IORT采用自屏蔽的LIAC 6 - 12 MeV Sordina移动直线加速器进行。通常，对于最大程度切除的肿瘤给予单次剂量10 - 21 Gy。使用SPSS（版本21）进行统计分析。26例患者接受了单独的IORT或联合EBRT治疗。治疗了不同的肿瘤，包括结肠腺癌（10例，38.4%）、软组织肉瘤（STS，11例，42.3%）、头颈癌（3例，11.5%）、1例宫颈癌病例和1例椎旁纤维瘤病例。结肠癌和STS的平均±标准差总生存期分别为15±14.89（0 - 38）个月和34.3±15.72（14 - 53）个月。IORT对于盆腔和腹部恶性肿瘤最为有用，因为正常肠组织限制了EBRT可给予的剂量。然而，IORT单次分割给予的剂量很少足以控制肿瘤；因此，IORT通常在额外的EBRT之前或之后进行，这最好在前瞻性随机试验中进一步评估。
