TY - JOUR
T1 - Clinical feasibility of combining intraoperative electron radiation therapy with minimally invasive surgery
T2 - a potential for electron-FLASH clinical development
AU - Calvo Manuel, Felipe Ángel
AU - Serrano, Javier
AU - Solé, Claudio
AU - Cambeiro, Mauricio
AU - Palma, Jacobo
AU - Aristu, Javier
AU - Garcia-Sabrido, Jose Luis
AU - Cuesta, Miguel Angel
AU - del Valle, Emilio
AU - Lapuente, Fernando
AU - Miñana, Bernardino
AU - Morcillo, Miguel Ángel
AU - Asencio, Jose Manuel
AU - Pascau, Javier
N1 - Funding Information: Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. This research was funded in part by grants from: Instituto de Salud Carlos III, Asociación Española Contra el Cáncer, ERAPERMED PerPlanRT, AC20/00103, AC20/00102, 2020–110-1), Ministry of Science, Innovation and Education PID 2019-104558RB-100. Publisher Copyright: © 2022, The Author(s).
PY - 2022
Y1 - 2022
N2 - 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 effective local therapeutic approach. Integrating the benefits from minimally invasive surgical techniques with the very precise delivery of intraoperative electron irradiation results in an efficient 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 differences 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 effects. 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 offers a new model explored with electron-FLASH beams.
AB - 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 effective local therapeutic approach. Integrating the benefits from minimally invasive surgical techniques with the very precise delivery of intraoperative electron irradiation results in an efficient 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 differences 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 effects. 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 offers a new model explored with electron-FLASH beams.
KW - Cancer surgery
KW - Electron beams
KW - FLASH
KW - Intraoperative radiation therapy
KW - Laparoscopic surgery
KW - Robotic surgery
UR - http://www.scopus.com/inward/record.url?scp=85139095971&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s12094-022-02955-z
DO - https://doi.org/10.1007/s12094-022-02955-z
M3 - Article
C2 - 36169803
SN - 1699-048X
JO - Clinical and Translational Oncology
JF - Clinical and Translational Oncology
ER -