Skip to main content
SpringerLink
Log in

Electron or Orthovoltage IORT for Retroperitoneal Sarcomas

  • Chapter
Intraoperative Irradiation

Part of the book series: Current Clinical Oncology ((CCO))

Abstract

Despite impressive advances in surgery and radiation therapy, the management of patients with retroperitoneal sarcoma remains a therapeutic challenge. Published series of surgical resection alone for retroperitoneal sarcoma have shown poor local control and survival rates. Because of the infiltrative nature of these tumors and their anatomic origin, it is frequently difficult to obtain microscopically clear resection margins. The efficacy of postoperative external-beam irradiation (EBRT) after resection is unclear from published reports. Because of the large size of these tumors, significant volumes of normal tissue (liver, small bowel, stomach, kidney, or spinal cord) may be within the EBRT field, and treatment is frequently limited to 45–50 Gy in 1.8- or 2-Gy fractions. It is not surprising that the local failure rate remains unacceptably high after postoperative irradiation because of the dose limitations of normal tissue to EBRT and the likelihood of at least microscopic residual disease after resection. In an effort to improve the local control and survival in patients with retroperitoneal sarcoma, treatment strategies employing intraoperative electron beam irradiation (IOERT) with preoperative or postoperative EBRT and surgery have been explored. This chapter will summarize relevant data on the role of IOERT in the management of patients with retroperitoneal sarcoma.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Cody HS 3d, Turnbull AD, Fortner JG, and Hajdu SI. The continuing challenge of retroperitoneal sarcomas, Cancer, 47 (1981) 2147–52.

    Article  PubMed  Google Scholar 

  2. Dalton RR, Donohue JH, Mucha P Jr, et al. Management of retroperitoneal sarcomas, Surgery, 106 (1989) 725–33.

    PubMed  CAS  Google Scholar 

  3. Karakousis CP, Gerstenbluth R, Kontzoglou K, and Driscoll DL. Retroperitoneal sarcomas and their management, Arch. Surg., 130 (1995) 1104–1109.

    Article  PubMed  CAS  Google Scholar 

  4. Kilkenny JW 3rd, Bland KI, and Copeland EM 3rd. Retroperitoneal sarcoma: the University of Florida experience, J. Am. Coll. of Surg., 182 (1996) 329–39.

    Google Scholar 

  5. McGrath PC, Neifeld JP, Lawrence W Jr, et al. Improved survival following complete excision of retroperitoneal sarcomas, Ann. Surg., 200 (1984) 200–204.

    Article  PubMed  CAS  Google Scholar 

  6. Storm FK and Mahvi DM. Diagnosis and management of retroperitoneal soft-tissue sarcoma, [Review] Ann. Surg., 214 (1991) 2–10.

    PubMed  CAS  Google Scholar 

  7. Fein DA, Corn BW, Lanciano RM, et al. Management of retroperitoneal sarcomas: does dose escalation impact on locoregional control?, Int. J. Radiat. Oncol. Biol. Phys., 31 (1995) 129–134.

    Article  PubMed  CAS  Google Scholar 

  8. Tepper JE, Suit HD, Wood WC, et al. Radiation therapy of retroperitoneal soft tissue sarcomas, Int. J. Radiat. Oncol. Biol. Phys., 10 (1984) 825–830.

    Article  PubMed  CAS  Google Scholar 

  9. Suit HD and Spiro I. Role of radiation in the management of adult patients with sarcoma of soft tissue, Semin. Surg. Oncol., 10 (1994) 347–356.

    Article  PubMed  CAS  Google Scholar 

  10. Jaques DP, Coit DG, Hajdu SI, and Brennan MF. Management of primary and recurrent soft tissue sarcoma of the retroperitoneum, Ann. Surg., 212 (1990) 51–59.

    Article  PubMed  CAS  Google Scholar 

  11. Alvarenga JC, Ball ABS, Fisher C, et al. Limitations of surgery in the treatment of retroperitoneal sarcoma, Br. J. Surg., 78 (1991) 912–916.

    Article  PubMed  CAS  Google Scholar 

  12. Kinsella TJ, Sindelar WF, Lack E, et al. Preliminary results of a randomized study of adjuvant radiation therapy in resectable adult retroperitoneal soft tissue sarcomas., J. Clin. Oncol., 6 (1988) 18–25.

    PubMed  CAS  Google Scholar 

  13. Sindelar WF, Kinsella TJ, Chen PW, et al. Intraoperative radiotherapy in retroperitoneal sarcomas. Final results of a prospective, randomized, clinical trial, Arch. Surg., 128 (1993) 402–410.

    Article  PubMed  CAS  Google Scholar 

  14. LeCouteur RA, Gillette EL, Powers BE, et al. Peripheral neuropathies following experimental intraoperative radiation therapy (IORT), Int. J. Radiat. Oncol. Biol. Phys., 17 (1989) 583–590.

    Article  PubMed  CAS  Google Scholar 

  15. Kinsella TJ, DeLuca AM, Barnes M, et al. Threshold dose for peripheral neuropathy following intraoperative radiotherapy (IORT) in a large animal model, Int. J. Radiat. Oncol. Biol. Phys., 20 (1991) 697–701.

    Article  PubMed  CAS  Google Scholar 

  16. Hoekstra HJ, Sindelar WF, and Kinsella TJ. Surgery with intraoperative radiotherapy for sarcomas of the pelvis girdle: a pilot experience, Int. J. Radiat. Oncol. Biol. Phys., 15 (1988) 1013–1016.

    Article  PubMed  CAS  Google Scholar 

  17. Willett CG, Suit HD, Tepper JE, et al. Intraoperative electron beam radiation therapy for retroperitoneal soft tissue sarcoma, Cancer, 68 (1991) 278–283.

    Article  PubMed  CAS  Google Scholar 

  18. Gunderson LL, Nagorney DM, Mcllrath DC, et al. External beam and intraoperative electron irradiation for locally advanced soft tissue sarcomas, Int. J. Radiat. Oncol. Biol. Phys., 25 (1993) 647–656.

    Article  PubMed  CAS  Google Scholar 

  19. Petersen I, Haddock M, Donohue J, et al. Use of intraoperative electron beam radiation therapy (IOERT) in the management of retroperitoneal and pelvic soft tissue sarcomas, ASTRO Abst. Int. J. Radiat. Oncol. Biol. Phys., 36 (1996) 184.

    Google Scholar 

  20. Kiel KD, Won WH, Witt RT, et al. Preliminary results of protocol RTOG 85–07: Phase II of intraoperative radiation for retroperitoneal sarcomas, In Abe M and Takahashi M (eds.),Intraoperative Radiation Therapy. Proceedings of the Third International Symposium of Intraoperative Radiation Therapy, Pergamon, New York, 1991, pp. 371–372.

    Google Scholar 

  21. Pelton JJ, Lanciano RM, Hoffman JP, et al. The influence of surgical margins in advanced cancer treated with intraoperative radiation therapy (IORT) and surgical resection, J. Surg. Oncol., 53 (1993) 60–65.

    Article  Google Scholar 

  22. Bussieres E, Stockle EP, Richaud PM, et al. Retroperitoneal soft tissue sarcomas: a pilot study of intraoperative radiation therapy, J. Surg. Oncol., 62 (1996) 49–56.

    Article  PubMed  CAS  Google Scholar 

  23. Dubois JB, Debrigode C, Hay M, et al. Intra-operative radiotherapy in soft tissue sarcomas, Radiother. Oncol., 34 (1995) 160–163.

    Article  PubMed  CAS  Google Scholar 

  24. Willeke F, Eble MJ, Lehnert T, et al. [Intraoperative radiotherapy within the treatment concept of retroperitoneal soft tissue sarcomas]. [German] Chirurg, 66 (9) (1995) 899–904.

    PubMed  CAS  Google Scholar 

  25. Calvo FA, Azinovic I, Martinez R, et al. IORT in soft tissue sarcomas: 10 years experience, HepatoGastroenterology, 41 (1994) 4.

    Google Scholar 

  26. Calvo FA, Azinovic I, Martinez R, et al. Intraoperative radiotherapy for the treatment of soft tissue sarcomas of central anatomical sites, Radiat. Oncol. Invest., 3 (1995) 90–96.

    Article  Google Scholar 

  27. Donath D, Clark B, Evans M, and Brown K. Postoperative adjuvant HDR brachytherapy in the treatment of poor prognosis soft tissue sarcoma (meeting abstract), Lyon Chirurgical 89 (1993)151.

    Google Scholar 

  28. Nag S, Olson T, Ruymann F, et al. High-dose-rate brachytherapy in childhood sarcomas: a local control strategy preserving bone growth and function, Med. Pediatr. Oncol., 25 (1995) 463–469.

    Article  PubMed  CAS  Google Scholar 

  29. Nambisan RN, Karakousis CP, Holyoke ED, and Dougherty TJ. Intraoperative photodynamic therapy for retroperitoneal sarcomas, Cancer, 61 (1988) 1248–1252.

    Article  PubMed  CAS  Google Scholar 

  30. Pieci P, Frustaci S, DePaoli, et al. (for the Italian Cooperative Group). Localized high grade soft tissue sarcomas of the extremities in adults: preliminary experience of the Italian Cooperative Study Group. Abstract in Proceedings of the Connective Tissue Oncology Society. April 1997.

    Google Scholar 

Download references

Authors
  1. Holger L. Gieschen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher G. Willett
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John Donohue
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ivy A. Petersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ira J. Spiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Felipe A. Calvo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Leonard L. Gunderson
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Mayo Clinic and Mayo Medical School, Rochester, MN, USA

    Leonard L. Gunderson MD, MS (Professor and Chair of Oncology) (Professor and Chair of Oncology)

  2. Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Christopher G. Willet MD

  3. Albert Einstein College of Medicine and Beth Israel Cancer Center, New York, NY, USA

    Louis B. Harrison MD

  4. University Hospital Gregorio Marañón, Madrid, Spain

    Felipe A. Calvo MD (Chair of Oncology) (Chair of Oncology)

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media New York

About this chapter

Cite this chapter

Gieschen, H.L. et al. (1999). Electron or Orthovoltage IORT for Retroperitoneal Sarcomas. In: Gunderson, L.L., Willet, C.G., Harrison, L.B., Calvo, F.A. (eds) Intraoperative Irradiation. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-696-6_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-696-6_18

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-5576-3

  • Online ISBN: 978-1-59259-696-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation