eprintid: 20476
rev_number: 12
eprint_status: archive
userid: 1589
dir: disk0/00/02/04/76
datestamp: 2016-04-07 08:51:00
lastmod: 2024-03-09 08:31:42
status_changed: 2016-04-07 08:51:00
type: article
metadata_visibility: show
creators_name: Habl, Gregor
creators_name: Uhl, Matthias
creators_name: Hensley, Frank
creators_name: Pahernik, Sascha
creators_name: Debus, Jürgen
creators_name: Röder, Falk
title: Intraoperative electron radiation therapy (IOERT) in patients with locally recurrent renal cell carcinoma
subjects: ddc-610
divisions: i-910200
divisions: i-911400
abstract: Background: To analyze our experience with intraoperative electron radiation therapy (IOERT) followed by moderate doses of external beam radiation therapy (EBRT) in patients with locally recurrent renal cell carcinoma.   Methods: From 1992 to 2010, 17 patients with histologically proven, locally recurrent renal cell carcinoma (median tumor size 7 cm) were treated by surgery and IOERT with a median dose of 15 Gy. All patients met the premise of curative intent including 7 patients with oligometastases at the time of recurrent surgery, which were resected and/or irradiated. The median time interval from primary surgery to local recurrence was 26 months. Eleven patients received additional 3D-conformal EBRT with a median dose of 40 Gy.   Results: Surgery resulted in free but close margins in 6 patients (R0), while 9 patients suffered from microscopic (R1) and 2 patients from macroscopic (R2) residual disease. After a median follow-up of 18 months, two local recurrences were observed, resulting in an actuarial 2-year local control rate of 91%. Eight patients developed distant failures, predominantly to liver and bone, resulting in an actuarial 2-year progression free survival of 32%. An improved PFS rate was found in patients with a larger time interval between initial surgery and recurrence (> 26 months). The actuarial 2-year overall survival rate was 73%. Lower histological grading (G1/2) was the only factor associated with improved overall survival. Perioperative complications were found in 4 patients. No IOERT specific late toxicities were observed.   Conclusions: Combination of surgery, IOERT and EBRT resulted in high local control rates with low toxicity in patients with locally recurrent renal cell cancer despite an unfavorable surgical outcome in the majority of patients. However, progression-free and overall survival were still limited due to a high distant failure rate, indicating the need for intensified systemic treatment especially in patients with high tumor grading and short interval to recurrence.
date: 2013
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1656511185
own_urn: urn:nbn:de:bsz:16-heidok-204769
language: eng
bibsort: HABLGREGORINTRAOPERA2013
full_text_status: public
publication: Radiation Oncology
volume: 8
number: 282
place_of_pub: London
pagerange: 1-6
issn: 1748-717X
citation:   Habl, Gregor ; Uhl, Matthias ; Hensley, Frank ; Pahernik, Sascha ; Debus, Jürgen ; Röder, Falk  (2013) Intraoperative electron radiation therapy (IOERT) in patients with locally recurrent renal cell carcinoma.  Radiation Oncology, 8 (282).  pp. 1-6.  ISSN 1748-717X     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/20476/1/13014_2013_Article_1248.pdf