title: Intraoperative radiation therapy for advanced cervical metastasis: a single institution experience.
abstract: BACKGROUND
  The purpose of this study is to review our experience with the use of IORT for patients with advanced cervical metastasis.
  
  
  METHODS
  Between August 1982 and July 2007, 231 patients underwent neck dissections as part of initial therapy or as salvage treatment for advanced cervical node metastases resulting from head and neck malignancies. IORT was administered as a single fraction to a dose of 15 Gy or 20 Gy in most pts. The majority was treated with 5 MeV electrons (112 pts, 50.5%).
  
  
  RESULTS
  1, 3, and 5 years overall survival (OS) after surgery + IORT was 58%, 34%, and 26%, respectively. Recurrence-free survival (RFS) at 1, 3, and 5 years was 66%, 55%, and 49%, respectively. Disease recurrence was documented in 83 (42.8%) pts. The majority of recurrences were regional (38 pts), as compared to local recurrence in 20 pts and distant failures in 25 pts. There were no perioperative fatalities.
  
  
  CONCLUSIONS
  IORT results in effective local disease control at acceptable levels of toxicity. Our results support the initiation of a phase III trial comparing outcomes for patients with cervical metastasis treated with or without IORT.
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA, USA. youssefzaidan@yahoo.com
authors.forename: Youssef H
authors.initials: YH
authors.lastname: Zeidan
authors.forename: Alex
authors.initials: A
authors.lastname: Yeh
authors.forename: Daniel
authors.initials: D
authors.lastname: Weed
authors.forename: Colin
authors.initials: C
authors.lastname: Terry
authors.forename: Stephen
authors.initials: S
authors.lastname: Freeman
authors.forename: Edward
authors.initials: E
authors.lastname: Krowiak
authors.forename: Robert
authors.initials: R
authors.lastname: Borrowdale
authors.forename: Tod
authors.initials: T
authors.lastname: Huntley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome