Intraoperative Irradiation: Techniques and Results

Description

The rationale for using intraoperative irradiation (IORT) is based on the realization that tolerable doses of eternal beam radiation are often insufficient to achieve control of locally advanced malignancies. In these instances, the IORT component of treatment becomes the optimal conformal technique of irradiation, since dose-limiting organs or structures can either be surgically displaced or protected by placement of lead shielding. This fully revised and expanded second edition is of interest to those with intraoperative electron (IOERT) capabilities, high-dose-rate brachytherapy (HDR-IORT) capabilities, or both. Techniques, indications, and results are discussed by disease site. Each chapter is dual authored by a radiation oncologist and a surgeon, giving a balanced presentation of clinical scenarios. Issues of basic science and physics are also covered, and a notable chapter on normal tissue tolerance is included. Intraoperative Irradiation: Techniques and Results, Second Edition is a superb compilation, providing essential cutting-edge knowledge. It is a foundation for physicians as IORT develops and becomes more widely available. Front Matter....Pages i-xvii Front Matter....Pages 1-1 Rationale and Historical Perspective of Intraoperative Irradiation....Pages 3-26 Biology of Large Dose per Fraction Irradiation....Pages 27-47 Front Matter....Pages 49-49 Intraoperative Electron Beam Irradiation: Physics and Techniques....Pages 51-72 HDR-IORT: Physics and Techniques....Pages 73-84 Electronic Brachytherapy/Low KV-IORT: Physics and Techniques....Pages 85-98 IORT with Electron-Beam, High-Dose-Rate Brachytherapy or Low-KV/Electronic Brachytherapy: Methodological Comparisons....Pages 99-115 Front Matter....Pages 117-117 Normal-Tissue Tolerance to IOERT, EBRT, or Both: Animal and Clinical Studies....Pages 119-138 Front Matter....Pages 139-139 Central Nervous System Tumors....Pages 141-161 Head and Neck Cancer....Pages 163-188 Breast Cancer....Pages 189-200 Lung Cancer....Pages 201-222 Gastric Cancer....Pages 223-248 Pancreas Cancer....Pages 249-271 Bile Duct and Gallbladder Cancer....Pages 273-295 Primary Colorectal Cancer....Pages 297-322 Recurrent Colorectal Cancer....Pages 323-351 Retroperitoneal Sarcomas....Pages 353-386 Extremity and Trunk Soft-Tissue Sarcomas....Pages 387-405 Bone Sarcomas....Pages 407-429 Gynecologic Malignancies....Pages 431-457 Front Matter....Pages 139-139 Genitourinary Cancer....Pages 459-479 Pediatric Malignancies....Pages 481-500 Front Matter....Pages 501-501 Conclusions and Future Possibilities: IORT....Pages 503-518 Back Matter....Pages 519-529