TY - JOUR
T1 - Narrowing the difference in dose delivery for IOERT and IOBT for locally advanced and locally recurrent rectal cancer
AU - Verrijssen, An-Sofie E
AU - Dries, Wim J F
AU - Cnossen, Jeltsje S
AU - Theuws, Jacqueline
AU - Peulen, Heike M U
AU - van den Berg, Hetty A
AU - Rijkaart, Dorien C
AU - Voogt, Eva L K
AU - Kolkman-Deurloo, Inger-Karine
AU - Nuyttens, Joost
AU - Rutten, Harm J T
AU - Burger, Jacobus W A
AU - Bimmel-Nagel, Cathryn Huibregtse
N1 - Copyright © 2022 Termedia.
PY - 2022/8
Y1 - 2022/8
N2 - Purpose: Intra-operative radiotherapy (IORT) has been used as a tool to provide a high-dose radiation boost to a limited volume of patients with fixed tumors with a likelihood of microscopically involved resection margins, in order to improve local control. Two main techniques to deliver IORT include high-dose-rate (HDR) brachytherapy, termed 'intra-operative brachytherapy' (IOBT), and electrons, termed 'intra-operative electron radiotherapy' (IOERT), both having very different dose distributions. A recent paper described an improved local recurrence-free survival favoring IOBT over IOERT for patients with locally advanced or recurrent rectal cancer and microscopically irradical resections. Although several factors may have contributed to this result, an important difference between the two techniques was the higher surface dose delivered by IOBT. This article described an adaptation of IOERT technique to achieve a comparable surface dose as dose delivered by IOBT.Material and methods: Two steps were taken to increase the surface dose for IOERT: 1. Introducing a bolus to achieve a maximum dose on the surface, and 2. Re-normalizing to allow for the same prescribed dose at reference depth.Conclusions: We describe and propose an adaptation of IOERT technique to increase surface dose, decreasing the differences between these two techniques, with the aim of further improving local control. In addition, an alternative method of dose prescription is suggested, to consider improved comparison with other techniques in the future.
AB - Purpose: Intra-operative radiotherapy (IORT) has been used as a tool to provide a high-dose radiation boost to a limited volume of patients with fixed tumors with a likelihood of microscopically involved resection margins, in order to improve local control. Two main techniques to deliver IORT include high-dose-rate (HDR) brachytherapy, termed 'intra-operative brachytherapy' (IOBT), and electrons, termed 'intra-operative electron radiotherapy' (IOERT), both having very different dose distributions. A recent paper described an improved local recurrence-free survival favoring IOBT over IOERT for patients with locally advanced or recurrent rectal cancer and microscopically irradical resections. Although several factors may have contributed to this result, an important difference between the two techniques was the higher surface dose delivered by IOBT. This article described an adaptation of IOERT technique to achieve a comparable surface dose as dose delivered by IOBT.Material and methods: Two steps were taken to increase the surface dose for IOERT: 1. Introducing a bolus to achieve a maximum dose on the surface, and 2. Re-normalizing to allow for the same prescribed dose at reference depth.Conclusions: We describe and propose an adaptation of IOERT technique to increase surface dose, decreasing the differences between these two techniques, with the aim of further improving local control. In addition, an alternative method of dose prescription is suggested, to consider improved comparison with other techniques in the future.
U2 - 10.5114/jcb.2022.118305
DO - 10.5114/jcb.2022.118305
M3 - Article
C2 - 36199944
SN - 1689-832X
VL - 14
SP - 370
EP - 378
JO - Journal of Contemporary Brachytherapy
JF - Journal of Contemporary Brachytherapy
IS - 4
ER -