High-dose-rate intraoperative radiation therapy: the nuts and bolts of starting a program.
High-dose-rate intraoperative radiation therapy (HDR-IORT) has historically provided effective local control (LC) for patients with unresectable and recurrent tumors. However, IORT is limited to only a few specialized institutions and it can be difficult to initiate an HDR-IORT program. Herein, we provide a brief overview on how to initiate and implement an HDR-IORT program for a selected group of patients with gastrointestinal and pelvic solid tumors using a multidisciplinary approach. Proper administration of HDR-IORT requires institutional support and a joint effort among physics staff, oncologists, surgeons, anesthesiologists, and nurses. In order to determine the true efficacy of IORT for various malignancies, collaboration among institutions with established IORT programs is needed.
Department of Radiation Oncology & Molecular Radiation Sciences, Baltimore, MD, USA.
Shalini
S
Moningi
Department of Radiation Oncology & Molecular Radiation Sciences, Baltimore, MD, USA.
Elwood P
EP
Armour
Department of Radiation Oncology & Molecular Radiation Sciences, Baltimore, MD, USA.
Stephanie A
SA
Terezakis
Department of Surgery, Baltimore, MD, USA.
Jonathan E
JE
Efron
Department of Surgery, Baltimore, MD, USA.
Susan L
SL
Gearhart
Department of Urology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD, USA.
Trinity J
TJ
Bivalacqua
Department of Radiation Oncology & Molecular Radiation Sciences, Baltimore, MD, USA.
Rachit
R
Kumar
Department of Radiation Oncology & Molecular Radiation Sciences, Baltimore, MD, USA.
Yi
Y
Le
Department of Radiation Oncology & Molecular Radiation Sciences, Baltimore, MD, USA.
Sook
S
Kien Ng
Department of Surgery, Baltimore, MD, USA.
Christopher L
CL
Wolfgang
Department of Radiation Oncology & Molecular Radiation Sciences, Baltimore, MD, USA.
Richard C
RC
Zellars
Department of Radiation Oncology & Molecular Radiation Sciences, Baltimore, MD, USA.
Susannah G
SG
Ellsworth
Department of Surgery, Baltimore, MD, USA.
Nita
N
Ahuja
Department of Radiation Oncology & Molecular Radiation Sciences, Baltimore, MD, USA.
Joseph M
JM
Herman
high-dose-rate brachytherapy; intraoperative radiation therapy; recurrent tumors; sarcoma