Intraoperative radiation therapy as an "early boost" in locally advanced head and neck cancer: preliminary results of a feasibility study.
BACKGROUND
The acute toxicity of intraoperative radiation therapy (IORT) delivered as an "early boost" after tumor resection in patients with locally advanced head and neck cancer was evaluated.


METHODS
Twenty-five patients were enrolled in the study. All patients underwent surgery with radical intent, and 17 had microvascular flap reconstruction. The IORT was delivered in the operating room. Twenty patients received adjuvant external beam radiation therapy (EBRT).


RESULTS
Five patients experienced various degrees of complications in the postoperative period, all of which were treated conservatively. One patient had a partial flap necrosis after EBRT that was treated with flap removal. Six deaths were recorded during the mean follow-up period of 8 months; none of the deaths were related to radiation treatment.


CONCLUSIONS
This feasibility study shows that the use of IORT as an early boost is feasible with no increase in acute toxicity directly attributable to radiation.
Marucci
Laura
L
Department of Radiation Oncology, Regina Elena Institute, Rome, Italy. marucci_laura@yahoo.com
Pichi
Barbara
B
Iaccarino
Giuseppe
G
Ruscito
Paolo
P
Spriano
Giuseppe
G
Arcangeli
Giorgio
G
D000328:Adult; D000368:Aged; D044584:Carcinoma, Ductal / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods; D016896:Treatment Outcome