open access

Vol 23, No 6 (2018)
Special Issue Papers
Published online: 2018-11-01
Submitted: 2018-05-10
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Intraoperative radiation therapy in uterine cervical cancer: A review

Albert Biete, Gabriela Oses
DOI: 10.1016/j.rpor.2018.07.005
·
Rep Pract Oncol Radiother 2018;23(6):589-594.

open access

Vol 23, No 6 (2018)
Special Issue Papers
Published online: 2018-11-01
Submitted: 2018-05-10

Abstract

Locally advanced uterine cervical cancer continues to present a high number of pelvic relapses. Intraoperative radiation therapy (IORT) allows a precise therapeutic intensification in the surgical area in cases in which removal of the tumour recurrence is feasible. At the same time, IORT excludes the radiosensitive organs from the field of irradiation. While the first gynecological IORT took place in 1905, procedures have been limited over the years and the series are retrospective, including few patients. At the same, time recurrences are located at different pelvic areas. Both heterogeneity and the long recruiting time make it difficult to correctly interpret the published results. Despite this, we have reviewed the most relevant publications. Some institutions indicated IORT as a boost on the surgical bed of the excised tumor recurrence. In others, IORT permits an extra radiation dose after radical surgery of the primary tumor, usually in stage IIB. Most studies conclude that the addition of IORT increases the local control but probably with little impact on survival. On the other hand, there is a controversy in the indication of IORT in surgically resectable primary tumours. No clear advantage over the usual scheme of chemoradiation and brachytherapy has been detected. Randomized studies that allow a breakthrough in the conclusions are highly unlikely to be performed in this area.

Abstract

Locally advanced uterine cervical cancer continues to present a high number of pelvic relapses. Intraoperative radiation therapy (IORT) allows a precise therapeutic intensification in the surgical area in cases in which removal of the tumour recurrence is feasible. At the same time, IORT excludes the radiosensitive organs from the field of irradiation. While the first gynecological IORT took place in 1905, procedures have been limited over the years and the series are retrospective, including few patients. At the same, time recurrences are located at different pelvic areas. Both heterogeneity and the long recruiting time make it difficult to correctly interpret the published results. Despite this, we have reviewed the most relevant publications. Some institutions indicated IORT as a boost on the surgical bed of the excised tumor recurrence. In others, IORT permits an extra radiation dose after radical surgery of the primary tumor, usually in stage IIB. Most studies conclude that the addition of IORT increases the local control but probably with little impact on survival. On the other hand, there is a controversy in the indication of IORT in surgically resectable primary tumours. No clear advantage over the usual scheme of chemoradiation and brachytherapy has been detected. Randomized studies that allow a breakthrough in the conclusions are highly unlikely to be performed in this area.

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Keywords

Intraoperative radiotherapy; Cervix cancer; Cervical cancer recurrences

About this article
Title

Intraoperative radiation therapy in uterine cervical cancer: A review

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 23, No 6 (2018)

Pages

589-594

Published online

2018-11-01

DOI

10.1016/j.rpor.2018.07.005

Bibliographic record

Rep Pract Oncol Radiother 2018;23(6):589-594.

Keywords

Intraoperative radiotherapy
Cervix cancer
Cervical cancer recurrences

Authors

Albert Biete
Gabriela Oses

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