title: Intraoperative radiotherapy (IORT) with low-energy photons as a boost in patients with early-stage oral cancer with the indications for postoperative radiotherapy : treatment feasibility and preliminary results.
abstract: OBJECTIVE
  To evaluate the feasibility and preliminary results of intraoperative radiotherapy (IORT) with low-energy photons as a boost in patients with early-stage oral cancer with the indications for postoperative radiotherapy.
  
  
  METHODS
  Between 2003 and 2006, 16 patients with early-stage cancer of mobile tongue (n = 10 [63%]) or floor of the mouth (n = 6 [37%]) treated at Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland, were evaluated for IORT boost with the INTRABEAM®System (Carl Zeiss Surgical GmbH; IORT-PRS) because of the high risk of local recurrence due to positive margins on frozen pathologic section. After tumor resection, the applicator was positioned in the tumor bed. The applicator's diameter (range: 1.5-5 cm) was selected to encompass high-risk area of tumor recurrence. The dose (5 Gy, 7 Gy, or 7.5 Gy) was applied according to tumor volume and bone proximity. External-beam radiotherapy (EBRT) was provided to the tumor bed in all patients (50 Gy) and to the nodal area, when needed. Toxicity and local tumor control were assessed.
  
  
  RESULTS
  Median follow-up was 36 months. IORT did not increase acute mucosal reaction. Local tumor control was found in all cases. Early mucosal reaction did not exceed 3 according to the RTOG scale and healed in median time of 35 days after completion of EBRT. No late adverse effects were observed.
  
  
  CONCLUSIONS
  This preliminary report has demonstrated the feasibility of IORT-PRS for patients with early oral cancer with the indications for postoperative radiotherapy. This method may be considered an alternative boost technique, although additional studies are needed to establish long-term results in a larger group of patients.
authors.affiliation: Department of Radiation Oncology, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland. tomr22@tlen.pl
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rutkowski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wygoda
authors.forename: Marcin
authors.initials: M
authors.lastname: Hutnik
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Składowski
authors.forename: Jerzy
authors.initials: J
authors.lastname: Wydmański
authors.forename: Adam
authors.initials: A
authors.lastname: Maciejewski
authors.forename: Cezary
authors.initials: C
authors.lastname: Szymczyk
authors.forename: Janusz
authors.initials: J
authors.lastname: Wierzgoń
authors.forename: Andrzej
authors.initials: A
authors.lastname: Orlef
authors.forename: Bogusław
authors.initials: B
authors.lastname: Maciejewski
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D009367:Neoplasm Staging; D011184:Postoperative Period; D013997:Time Factors; D014062:Tongue Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*
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