Clinical feasibility of combining intraoperative electron radiation therapy with minimally invasive surgery: a potential for electron-FLASH clinical development
Palabras clave : 
Intraoperative radiation therapy
Electron beams
Laparoscopic surgery
Robotic surgery
Cancer surgery
FLASH
Fecha de publicación : 
2022
Editorial : 
Springer
Proyecto: 
info:eu-repo/grantAgreement/ISCIII/Proyectos de programación conjunta internacional/AC20/001027ES/TRATAMIENTO PERSONALIZADO EN RADIOTERAPIA MEDIANTE MODELADO INTEGRADO DE NUEVAS RESTRICCIONES Y EFECTOS DOSIMETRICOS LOCALES/
ISSN : 
1699-3055
Nota: 
This article is licensed under a Creative Commons Attribution 4.0 International License
Cita: 
Calvo-Manuel, F.Á. (Felipe Ángel); Serrano, J. (Javier); Solé, C. (Claudio); et al. "Clinical feasibility of combining intraoperative electron radiation therapy with minimally invasive surgery: a potential for electron-FLASH clinical development". Clinical and Translational Oncology. (25), 2022, 429 - 439
Resumen
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 efective local therapeutic approach. Integrating the benefts from minimally invasive surgical techniques with the very precise delivery of intraoperative electron irradiation results in an efcient 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 diferences 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 efects. 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 ofers a new model explored with electron-FLASH beams.

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