Skip to main content
main-content

2013 | OriginalPaper | Buchkapitel

35. Intraoperative Strahlentherapie

verfasst von: PD Dr. med. Andrea Wittig, Prof. Dr. rer. nat. Klemens Zink, Dr. med. Caroline Karpowitz, Prof. Dr. med. Rita Engenhart-Cabillic

Erschienen in: Operationsatlas Gynäkologische Onkologie

Verlag: Springer Berlin Heidelberg

Auszug

Die intraoperative Strahlentherapie (IORT) ist ein Verfahren, bei dem während eines chirurgischen Eingriffs eine Strahlentherapie durchgeführt wird. Dafür stehen verschiedene Techniken zur Verfügung, die in den letzten Jahren erheblich weiterentwickelt wurden und aller Voraussicht nach dazu führen werden, dass die IORT bei einigen Entitäten in zunehmendem Maße Anwendung findet. Die wichtigste technische Neuerung ist die Entwicklung relativ preisgünstiger, kompakter und mobiler Bestrahlungsgeräte, die für die intraoperative Strahlentherapie konstruiert sind und sich einfacher und mit weniger baulichem Aufwand im Operationssaal integrieren lassen als die Geräte der ersten Generation (z. B. Mevatron ME, Siemens), die eigene Bestrahlungsbunker benötigten. …
Literatur
[1]
Zurück zum Zitat Azinovic I, Calvo FA, Puebla F, Aristu J, Martínez-Monge R (2001) Long-term normal tissue effects of intraoperative electron radiation therapy (IOERT): late sequelae, tumor recurrence, and second malignancies. Int J Radiat Oncol Biol Phys 49:597–604 PubMedCrossRef Azinovic I, Calvo FA, Puebla F, Aristu J, Martínez-Monge R (2001) Long-term normal tissue effects of intraoperative electron radiation therapy (IOERT): late sequelae, tumor recurrence, and second malignancies. Int J Radiat Oncol Biol Phys 49:597–604 PubMedCrossRef
[2]
Zurück zum Zitat Barney BM, Petersen IA, Dowdy SC, Bakkum-Gamez JN, Haddock MG (2011) Intraoperative electron beam radiotherapy (IOERT) in the management of recurrent ovarian malignancies. Int J Gynecol Cancer 21:1225–1231 PubMed Barney BM, Petersen IA, Dowdy SC, Bakkum-Gamez JN, Haddock MG (2011) Intraoperative electron beam radiotherapy (IOERT) in the management of recurrent ovarian malignancies. Int J Gynecol Cancer 21:1225–1231 PubMed
[3]
Zurück zum Zitat Barney BM, Petersen IA, Dowdy SC, Bakkum-Gamez JN, Haddock MG (2011) Intraoperative electron beam radiotherapy (IOERT) in the management of recurrent ovarian malignancies. Int J Gynecol Cancer 21:1225–1231 PubMed Barney BM, Petersen IA, Dowdy SC, Bakkum-Gamez JN, Haddock MG (2011) Intraoperative electron beam radiotherapy (IOERT) in the management of recurrent ovarian malignancies. Int J Gynecol Cancer 21:1225–1231 PubMed
[4]
Zurück zum Zitat Barney BM, Petersen IA, Dowdy SC, Bakkum-Gamez JN, Haddock MG (2011) Long-Term Outcomes with Intraoperative Radiotherapy as a Component of Treatment for Locally Advanced or Recurrent Uterine Sarcoma. Int J Radiat Oncol Biol Phys 83:191–197 PubMedCrossRef Barney BM, Petersen IA, Dowdy SC, Bakkum-Gamez JN, Haddock MG (2011) Long-Term Outcomes with Intraoperative Radiotherapy as a Component of Treatment for Locally Advanced or Recurrent Uterine Sarcoma. Int J Radiat Oncol Biol Phys 83:191–197 PubMedCrossRef
[5]
Zurück zum Zitat Berek JS, Howe C, Lagasse LD, Hacker NF (2005) Pelvic exenteration for recurrent gynecologic malignancy: survival and morbidity analysis of the 45-year experience at UCLA. Gynecol Oncol 99:153–159 PubMedCrossRef Berek JS, Howe C, Lagasse LD, Hacker NF (2005) Pelvic exenteration for recurrent gynecologic malignancy: survival and morbidity analysis of the 45-year experience at UCLA. Gynecol Oncol 99:153–159 PubMedCrossRef
[6]
Zurück zum Zitat Chung YL, Jian JJ, Cheng SH, Hsieh CI, Tan TD, Chang HJ, Hung CF, Horng CF, Soong T, Tsou MH (2005) Extended-field radiotherapy and high-dose-rate brachytherapy with concurrent and adjuvant cisplatin-based chemotherapy for locally advanced cervical cancer: a phase I/II study. Gynecol Oncol 97:126–135 PubMedCrossRef Chung YL, Jian JJ, Cheng SH, Hsieh CI, Tan TD, Chang HJ, Hung CF, Horng CF, Soong T, Tsou MH (2005) Extended-field radiotherapy and high-dose-rate brachytherapy with concurrent and adjuvant cisplatin-based chemotherapy for locally advanced cervical cancer: a phase I/II study. Gynecol Oncol 97:126–135 PubMedCrossRef
[7]
Zurück zum Zitat del Carmen MG, McIntyre JF, Fuller AF, Nikrui N, Goodman A (2000) Intraoperative radiation therapy in the treatment of pelvic gynecologic malignancies: a review of fifteen cases. Gynecol Oncol 79:457–462 PubMedCrossRef del Carmen MG, McIntyre JF, Fuller AF, Nikrui N, Goodman A (2000) Intraoperative radiation therapy in the treatment of pelvic gynecologic malignancies: a review of fifteen cases. Gynecol Oncol 79:457–462 PubMedCrossRef
[8]
Zurück zum Zitat del Carmen MG, McIntyre JF, Goodman A (2000) The role of intraoperative radiation therapy (IORT) in the treatment of locally advanced gynecologic malignancies. Oncologist 5:18–25 PubMedCrossRef del Carmen MG, McIntyre JF, Goodman A (2000) The role of intraoperative radiation therapy (IORT) in the treatment of locally advanced gynecologic malignancies. Oncologist 5:18–25 PubMedCrossRef
[9]
Zurück zum Zitat del Carmen MG, McIntyre JF, Goodman A (2000) The role of intraoperative radiation therapy (IORT) in the treatment of locally advanced gynecologic malignancies. Oncologist 5:18–25 PubMedCrossRef del Carmen MG, McIntyre JF, Goodman A (2000) The role of intraoperative radiation therapy (IORT) in the treatment of locally advanced gynecologic malignancies. Oncologist 5:18–25 PubMedCrossRef
[10]
Zurück zum Zitat Dowdy SC, Mariani A, Cliby WA, Haddock MG, Petersen IA, Sim FH, Podratz KC (2006) Radical pelvic resection and intraoperative radiation therapy for recurrent endometrial cancer: technique and analysis of outcomes. Gynecol Oncol 101:280–286 PubMedCrossRef Dowdy SC, Mariani A, Cliby WA, Haddock MG, Petersen IA, Sim FH, Podratz KC (2006) Radical pelvic resection and intraoperative radiation therapy for recurrent endometrial cancer: technique and analysis of outcomes. Gynecol Oncol 101:280–286 PubMedCrossRef
[11]
Zurück zum Zitat Dueñas-González A, Zarbá JJ, Patel F et al (2011) Phase III, Open-Label, Randomized Study Comparing Concurrent Gemcitabine Plus Cisplatin and Radiation Followed by Adjuvant Gemcitabine and Cisplatin Versus Concurrent Cisplatin and Radiation in Patients With Stage IIB to IVA Carcinoma of the Cervix. J Clin Oncol 29:1678–1685 PubMedCrossRef Dueñas-González A, Zarbá JJ, Patel F et al (2011) Phase III, Open-Label, Randomized Study Comparing Concurrent Gemcitabine Plus Cisplatin and Radiation Followed by Adjuvant Gemcitabine and Cisplatin Versus Concurrent Cisplatin and Radiation in Patients With Stage IIB to IVA Carcinoma of the Cervix. J Clin Oncol 29:1678–1685 PubMedCrossRef
[12]
Zurück zum Zitat Ferrandina G, Margariti PA, Smaniotto D, Petrillo M, Salerno MG, Fagotti A, Macchia G, Morganti AG, Cellini N, Scambia G (2010) Long-term analysis of clinical outcome and complications in locally advanced cervical cancer patients administered concomitant chemoradiation followed by radical surgery. Gynecol Oncol 119:404–410 PubMedCrossRef Ferrandina G, Margariti PA, Smaniotto D, Petrillo M, Salerno MG, Fagotti A, Macchia G, Morganti AG, Cellini N, Scambia G (2010) Long-term analysis of clinical outcome and complications in locally advanced cervical cancer patients administered concomitant chemoradiation followed by radical surgery. Gynecol Oncol 119:404–410 PubMedCrossRef
[13]
Zurück zum Zitat Fleisch MC, Pantke P, Beckmann MW, Schnuerch HG, Ackermann R, Grimm MO, Bender HG, Dall P (2007) Predictors for long-term survival after interdisciplinary salvage surgery for advanced or recurrent gynecologic cancers. J Surg Oncol 95:476–484 PubMedCrossRef Fleisch MC, Pantke P, Beckmann MW, Schnuerch HG, Ackermann R, Grimm MO, Bender HG, Dall P (2007) Predictors for long-term survival after interdisciplinary salvage surgery for advanced or recurrent gynecologic cancers. J Surg Oncol 95:476–484 PubMedCrossRef
[14]
Zurück zum Zitat Gao Y, Liu Z, Chen X, Luo W, Zhang L, Wang J (2011) Intraoperative radiotherapy electron boost in advanced and recurrent epithelial ovarian carcinoma: a retrospective study. BMC Cancer 11:439–445 PubMedCrossRef Gao Y, Liu Z, Chen X, Luo W, Zhang L, Wang J (2011) Intraoperative radiotherapy electron boost in advanced and recurrent epithelial ovarian carcinoma: a retrospective study. BMC Cancer 11:439–445 PubMedCrossRef
[15]
Zurück zum Zitat Garton GR, Gunderson LL, Webb MJ, Wilson TO, Cha SS, Podratz KC (1997) Intraoperative radiation therapy in gynecologic cancer: update of the experience at a single institution. Int J Radiat Oncol Biol Phys 37:839–843 PubMedCrossRef Garton GR, Gunderson LL, Webb MJ, Wilson TO, Cha SS, Podratz KC (1997) Intraoperative radiation therapy in gynecologic cancer: update of the experience at a single institution. Int J Radiat Oncol Biol Phys 37:839–843 PubMedCrossRef
[16]
Zurück zum Zitat Garton GR, Gunderson LL, Webb MJ, Wilson TO, Martenson JAJ, Cha SS, Podratz KC (1993) Intraoperative radiation therapy in gynecologic cancer: the Mayo Clinic experience. Gynecol Oncol 48:328–332 PubMedCrossRef Garton GR, Gunderson LL, Webb MJ, Wilson TO, Martenson JAJ, Cha SS, Podratz KC (1993) Intraoperative radiation therapy in gynecologic cancer: the Mayo Clinic experience. Gynecol Oncol 48:328–332 PubMedCrossRef
[17]
Zurück zum Zitat Gemignani ML, Alektiar KM, Leitao M, Mychalczak B, Chi D, Venkatraman E, Barakat RR, Curtin JP (2001) Radical surgical resection and high-dose intraoperative radiation therapy (HDR-IORT) in patients with recurrent gynecologic cancers. Int J Radiat Oncol Biol Phys 50:687–694 PubMedCrossRef Gemignani ML, Alektiar KM, Leitao M, Mychalczak B, Chi D, Venkatraman E, Barakat RR, Curtin JP (2001) Radical surgical resection and high-dose intraoperative radiation therapy (HDR-IORT) in patients with recurrent gynecologic cancers. Int J Radiat Oncol Biol Phys 50:687–694 PubMedCrossRef
[18]
Zurück zum Zitat Gillette SL, Gillette EL, Powers BE, Park RD, Withrow SJ (1989) Ureteral injury following experimental intraoperative radiation. 4:791–798 Gillette SL, Gillette EL, Powers BE, Park RD, Withrow SJ (1989) Ureteral injury following experimental intraoperative radiation. 4:791–798
[19]
Zurück zum Zitat Giorda G, Boz G, Gadducci A, Lucia E, De Piero G, De Paoli A, Innocente R, Trovò M, Sorio R, Campagnutta E (2011) Multimodality approach in extra cervical locally advanced cervical cancer: chemoradiation, surgery and intra-operative radiation therapy. A phase II trial. Eur J Surg Oncol 37:442–447 PubMedCrossRef Giorda G, Boz G, Gadducci A, Lucia E, De Piero G, De Paoli A, Innocente R, Trovò M, Sorio R, Campagnutta E (2011) Multimodality approach in extra cervical locally advanced cervical cancer: chemoradiation, surgery and intra-operative radiation therapy. A phase II trial. Eur J Surg Oncol 37:442–447 PubMedCrossRef
[20]
Zurück zum Zitat Goldberg GL, Sukumvanich P, Einstein MH, Smith HO, Anderson PS, Fields AL (2006) Total pelvic exenteration: the Albert Einstein College of Medicine/Montefiore Medical Center Experience (1987 to 2003). Gynecol Oncol 101:261–268 PubMedCrossRef Goldberg GL, Sukumvanich P, Einstein MH, Smith HO, Anderson PS, Fields AL (2006) Total pelvic exenteration: the Albert Einstein College of Medicine/Montefiore Medical Center Experience (1987 to 2003). Gynecol Oncol 101:261–268 PubMedCrossRef
[21]
Zurück zum Zitat Gunderson LL, Willet CG, Calvo FA, Harrison LB (Hrsg.) (2011) Intraoperative Irradiation, 2. Aufl. Springer, New York, Dordrecht, Heidelberg, London Gunderson LL, Willet CG, Calvo FA, Harrison LB (Hrsg.) (2011) Intraoperative Irradiation, 2. Aufl. Springer, New York, Dordrecht, Heidelberg, London
[22]
Zurück zum Zitat Gunderson LL, Willett CG, Calco CG, Harrison LB (Hrsg.) (2011) Intraoperative Irradiation, Techniques and Results: Gynecologic Malignancies, 2. Aufl. Humana Press, New York, Dordrecht, Heidelberg, London Gunderson LL, Willett CG, Calco CG, Harrison LB (Hrsg.) (2011) Intraoperative Irradiation, Techniques and Results: Gynecologic Malignancies, 2. Aufl. Humana Press, New York, Dordrecht, Heidelberg, London
[23]
Zurück zum Zitat Haddock MG, Petersen IA, Pritchard D, Gunderson LL (1997) IORT in the management of extremity and limb girdle soft tissue sarcomas. Front Radiat Ther Oncol 31:151–152 PubMedCrossRef Haddock MG, Petersen IA, Pritchard D, Gunderson LL (1997) IORT in the management of extremity and limb girdle soft tissue sarcomas. Front Radiat Ther Oncol 31:151–152 PubMedCrossRef
[24]
Zurück zum Zitat Haddock MG, Petersen IA, Webb MJ, Wilson TO, Podratz KC, Gunderson LL (1997) IORT for locally advanced gynecological malignancies. Front Radiat Ther Oncol 31:256–259 PubMedCrossRef Haddock MG, Petersen IA, Webb MJ, Wilson TO, Podratz KC, Gunderson LL (1997) IORT for locally advanced gynecological malignancies. Front Radiat Ther Oncol 31:256–259 PubMedCrossRef
[25]
Zurück zum Zitat LeCouteur RA, Gillette EL, Powers BE, Child G, McChesney SL, Ingram JT (1989) Peripheral neuropathies following experimental intraoperative radiation therapy (IORT). Int J Radiat Oncol Biol Phys 17:583–590 PubMedCrossRef LeCouteur RA, Gillette EL, Powers BE, Child G, McChesney SL, Ingram JT (1989) Peripheral neuropathies following experimental intraoperative radiation therapy (IORT). Int J Radiat Oncol Biol Phys 17:583–590 PubMedCrossRef
[26]
Zurück zum Zitat Martinez-Monge R, Jurado M, Aristu JJ, Moreno M, Cambeiro M, Perez-Ochoa A, Lopez-Garcia G, Alcazar JL (2001) Intraoperative electron beam radiotherapy during radical surgery for locally advanced and recurrent cervical cancer. Gynecol Oncol 82:538–543 PubMedCrossRef Martinez-Monge R, Jurado M, Aristu JJ, Moreno M, Cambeiro M, Perez-Ochoa A, Lopez-Garcia G, Alcazar JL (2001) Intraoperative electron beam radiotherapy during radical surgery for locally advanced and recurrent cervical cancer. Gynecol Oncol 82:538–543 PubMedCrossRef
[27]
Zurück zum Zitat Miller RC, Haddock MG, Petersen IA, Gunderson LL, Furth AF (2006) Intraoperative electron-beam radiotherapy and ureteral obstruction. Int J Radiat Oncol Biol Phys 64:792–798 PubMedCrossRef Miller RC, Haddock MG, Petersen IA, Gunderson LL, Furth AF (2006) Intraoperative electron-beam radiotherapy and ureteral obstruction. Int J Radiat Oncol Biol Phys 64:792–798 PubMedCrossRef
[28]
Zurück zum Zitat Nagi Y, Inamine M, Hirakawa M, Kamiyama K, Ogawa K, Toita T, Murayama S, Aoi Y (2007) Postoperative whole abdominal radiotherapy in clear cell adenocarcinoma of the ovary. Gynecol Oncol 107:469–473 CrossRef Nagi Y, Inamine M, Hirakawa M, Kamiyama K, Ogawa K, Toita T, Murayama S, Aoi Y (2007) Postoperative whole abdominal radiotherapy in clear cell adenocarcinoma of the ovary. Gynecol Oncol 107:469–473 CrossRef
[29]
Zurück zum Zitat NCCN (2011) Cervial Cancer Version 1.2011. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines TM). http://​www.​nccn.​org/​clinical.​asp NCCN (2011) Cervial Cancer Version 1.2011. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines TM). http://​www.​nccn.​org/​clinical.​asp
[30]
Zurück zum Zitat Park CC, Yom SS, Podgorsak MB, Harris E, Price RA, Bevan A, Pouliot J, Konski AA, Wallner PE, Group EBW (2010) American Society for Therapeutic Radiology and Oncology (ASTRO) Emerging Technology Committee report on electronic brachytherapy. Int J Radiat Oncol Biol Phys 76:963–972 PubMedCrossRef Park CC, Yom SS, Podgorsak MB, Harris E, Price RA, Bevan A, Pouliot J, Konski AA, Wallner PE, Group EBW (2010) American Society for Therapeutic Radiology and Oncology (ASTRO) Emerging Technology Committee report on electronic brachytherapy. Int J Radiat Oncol Biol Phys 76:963–972 PubMedCrossRef
[31]
Zurück zum Zitat Pectasides D, Kamposioras K, Papaxoinis G, Pectasides E (2008) Chemotherapy for recurrent cervical cancer. Cancer Treat Rev 34:603–613 PubMedCrossRef Pectasides D, Kamposioras K, Papaxoinis G, Pectasides E (2008) Chemotherapy for recurrent cervical cancer. Cancer Treat Rev 34:603–613 PubMedCrossRef
[32]
Zurück zum Zitat Pötter R, Haie-Meder C, Van Limbergen E et al (2006) Recommendations from gynaecological (GYN) GEC ESTRO working group (II): concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology. Radiother Oncol 78:67–77 PubMedCrossRef Pötter R, Haie-Meder C, Van Limbergen E et al (2006) Recommendations from gynaecological (GYN) GEC ESTRO working group (II): concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology. Radiother Oncol 78:67–77 PubMedCrossRef
[33]
Zurück zum Zitat Rose PG, Ali S, Whitney CW, Lanciano R, Stehman FB (2011) Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation: A Gynecologic Oncology Group study. Gynecol Oncol 121:542–545 PubMedCrossRef Rose PG, Ali S, Whitney CW, Lanciano R, Stehman FB (2011) Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation: A Gynecologic Oncology Group study. Gynecol Oncol 121:542–545 PubMedCrossRef
[34]
Zurück zum Zitat Stelzer KJKW, Greer BE, Cain JM, Tamimi HK, Figge DC, Goff BA, Griffin TW (1995) The use of intraoperative radiation therapy in radical salvage for recurrent cervical cancer: outcome and toxicity. Am J Obstst Gynecol 172:1881–1886 CrossRef Stelzer KJKW, Greer BE, Cain JM, Tamimi HK, Figge DC, Goff BA, Griffin TW (1995) The use of intraoperative radiation therapy in radical salvage for recurrent cervical cancer: outcome and toxicity. Am J Obstst Gynecol 172:1881–1886 CrossRef
[35]
Zurück zum Zitat Tran PT, Su Z, Hara W, Husain A, Teng N, Kapp DS (2007) Long-term survivors using intraoperative radiotherapy for recurrent gynecologic malignancies. Int J Radiat Oncol Biol Phys 69:504–511 PubMedCrossRef Tran PT, Su Z, Hara W, Husain A, Teng N, Kapp DS (2007) Long-term survivors using intraoperative radiotherapy for recurrent gynecologic malignancies. Int J Radiat Oncol Biol Phys 69:504–511 PubMedCrossRef
[36]
Zurück zum Zitat Willett CG, Czito BG, Tyler DS (2007) Intraoperative Radiation Therapy. J Clin Oncol 9:971–977 CrossRef Willett CG, Czito BG, Tyler DS (2007) Intraoperative Radiation Therapy. J Clin Oncol 9:971–977 CrossRef
[37]
Zurück zum Zitat Yap OW, Kapp DS, Teng NN, Husain A (2005) Intraoperative radiation therapy in recurrent ovarian cancer. Int J Radiat Biol Phys 63:1114–1121 CrossRef Yap OW, Kapp DS, Teng NN, Husain A (2005) Intraoperative radiation therapy in recurrent ovarian cancer. Int J Radiat Biol Phys 63:1114–1121 CrossRef
Metadaten
Titel
Intraoperative Strahlentherapie
verfasst von
PD Dr. med. Andrea Wittig
Prof. Dr. rer. nat. Klemens Zink
Dr. med. Caroline Karpowitz
Prof. Dr. med. Rita Engenhart-Cabillic
Copyright-Jahr
2013
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-642-35128-0_35

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Gynäkologie und bleiben Sie gut informiert – ganz bequem per eMail.