Clinical feasibility of combining intraoperative electron radiation therapy with minimally invasive surgery: a potential for electron-FLASH clinical development Articles uri icon

authors

  • CALVO MANUEL, FELIPE ANGEL
  • SERRANO, JAVIER
  • SOLE, CLAUDIO
  • CAMBEIRO, MAURICIO
  • PALMA, JACOBO
  • ARISTU, JAVIER
  • GARCIA-SABRIDO, JOSE LUIS
  • CUESTA, MIGUEL ANGEL
  • DEL VALLE, EMILIO
  • LAPUENTE, FERNANDO
  • MIÑANA, BERNARDINO
  • MORCILLO, MIGUEL ÁNGEL
  • ASENCIO, JOSE MANUEL
  • PASCAU GONZALEZ GARZON, JAVIER

publication date

  • February 2023

start page

  • 429

end page

  • 439

issue

  • 2

volume

  • 25

abstract

  • 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.

subjects

  • Biology and Biomedicine
  • Materials science and engineering
  • Medicine
  • Telecommunications

keywords

  • intraoperative radiation therapy; electron beams; laparoscopic surgery; robotic surgery; cancer surgery; flash