Introduction
IORT rationale
IORT for colon cancer
Primary locally advanced colon cancer
Group | # Patients | 5-year LR | 5-year DM | 5-year OS |
---|---|---|---|---|
R0 resection | 50 | 10% | ~30% | 66% |
R1 resection | 18 | 54% | ~57% | 47% |
R2 resection | 35 | 79% | ~68% | 23% |
p < 0.0001 |
p = 0.002 |
p = 0.0009 | ||
EBRT > 50 Gy | 73 | 36% | - | 50% |
EBRT ≤ 50 Gy | 30 | 50% | - | 45% |
p = 0.18 |
p = 0.16 | |||
R1-2 + IOERT | 9 | 11% | ~12% | 76% |
R1-2, no IOERT | 44 | 82% | ~76% | 26% |
p = 0.02 |
p = 0.01 |
p = 0.04 |
Locally advanced recurrent colon cancer
IORT for advanced regional nodal disease in colon cancer patients
IORT for rectal cancer
Primary locally advanced rectal cancer
Study | # Patients | Years | EBRT dose, Gy | Margins | IORT dose, Gy | 5-year LC | 5-year DM | 5-year OS |
---|---|---|---|---|---|---|---|---|
Willett, MGH [42] | 20 | 1978–1989 | 50.4 | R0 | 10–20 | 88% | - | 53%a
|
Valentini, Rome [43] | 29 | 1991–2006 | 45–55 | R0 | 10–15 | 100% | - | - |
Alberda, Rotterdam [44] | 31 | 1996–2012 | 45–50b
| R1 | 10c
| 84% | - | - |
Zhang, Shanghai [45] | 71 | 1994–2007 | 45–50.4 | R0-1 | 10–20 | 90% | 54% | 75% |
Sadahiro, Japan [46] | 99 | 1991–2001 | 20 | ns | 15–25 | 98% | 20% | 79% |
Mathis, Mayo Clinic [6] | 106 | 1981–2007 | 50.4 | R0-2 | 7.5–25 | 86%d
| 49%d
| 49% |
Roeder, Heidelberg [47] | 243 | 1991–2004 | 41.4 | R0-2 | 10–15 | 92% | - | - |
Sole, Madrid [23] | 335 | 1995–2010 | 45–50.4 | R0-1 | 10–15 | 92% | 25%e
| 75% |
Kusters, European pooled [24] | 605 | to 2005 | 45–50.4 | R0-2 | 10–12.5 | 88% | 29% | 67% |
Recurrent rectal cancer
Study | Years | # Patients | EBRT dose, Gy | IORT dose, Gy | IORT technique | 5-year LC | 5-year DM | 5-year OS |
---|---|---|---|---|---|---|---|---|
Alektiar, MSKCC [30] | 1992–1998 | 53 | 50.4a
| 10–18 | IOHDR | 43% | - | 36% |
Lindel, MGH [31] | 1978–1997 | 25 | 50.4b
| 10–15 | IOERT | 56% | - | 40% |
Wiig, Norway [33] | 1990–1999 | 18 | 46–50 | 15–20 | IOERT | 70% | - | 60% |
Eble, Heidelberg [33] c
| 1991–1995 | 14 | 41.4 | 10–20 | IOERT | 79% | 19% | 71%d
|
Dresen, Eindhoven [34] | 1994–2006 | 84 | 50.4e
| 10 | IOERT | 69% | 34% | 48% |
Haddock, Mayo Clinic [19] | 1981–2008 | 236 | 50.4f
| 12.5 | IOERT | 79% | 48% | 46% |
Study | Years | # Patients | EBRT dose, Gy | IORT dose, Gy | IORT technique | 5-year LC | 5-year DM | 5-year OS |
---|---|---|---|---|---|---|---|---|
Alektiar, MSKCC [30] | 1992–1998 | 21 | 50.4a
| 10–18 | IOHDR | 26% | - | 11% |
Wiig, Norway [33] | 1990–1999 | 29 | 46–50 | 15–20 | IOERT | 50% | - | 20% |
Eble, Heidelberg [33]b
| 1991–1995 | 9 | 41.4 | 10–20 | IOERT | 67% | 33% | 33%c
|
Dresen, Eindhoven [34]f
| 1994–2006 | 34 | 50.4d
| 12.5 | IOERT | 29% | 69% | 27% |
Haddock, Mayo Clinic [19] | 1981–2008 | 224 | 50.4e
| 15 | IOERT | 56% | 62% | 27% |
Study | Years | # Patients | EBRT dose, Gy | IORT dose, Gy | 5-year LC | 5-year DM | 5-year OS |
---|---|---|---|---|---|---|---|
Lindel, MGH [31] | 1978–1997 | 15 | 50.4a
| 15–20 | 12% | - | 13% |
Eble, Heidelberg [33]b
| 1991–1995 | 8 | 41.4 | 10–20 | 60% | 75% | 25%c
|
Dresen, Eindhoven [34] | 1994–2006 | 29 | 50.4d
| 15–17.5 | 29% | 71% | 24% |
Haddock, Mayo Clinic [19] | 1981–2008 | 156 | 50.4e
| 20 | 49% | 73% | 16% |