Experimental and clinical studies with intraoperative radiotherapy

W. F. Sindelar, T. Kinsella, J. Tepper, E. L. Travis, S. A. Rosenberg, E. Glatstein

Research output: Contribution to journalArticle

Abstract

Studies of normal tissue tolerance to intraoperative radiotherapy were done upon 65 dogs subjected to laparotomy and 11 million electron volt electron irradiation in doses ranging from zero to 5,000 rads. Results of studies indicated that intact aorta and vena cava tolerate up to 5,000 rads without loss of structural integrity. Ureteral fibrosis and stenosis develop at doses of 3,000 rads or more. Arterial anastomoses heal after doses of 4,500 rads, but fibrosis can lead to occlusion. Intestinal suture lines heal after doses of 4,500 rads. Bile duct fibrosis and stenosis develop at doses of 2,000 rads or more. Biliary-enteric anastomoses fail to heal at any dose level. A clinical trial of intraoperative radiotherapy combined with radical surgery was performed upon 20 patients with advanced malignant tumors which were considered unlikely to be cured by conventional therapies and which included carcinomas of the stomach, carcinomas of the pancreas, carcinoma involving the hilus of the liver, retroperitoneal sarcomas and osteosarcomas of the pelvis. All patients underwent resection of gross tumor, followed by intraoperative irradiation of the tumor bed and regional nodal basins. Some patients received additional postoperative external beam radiotherapy. Treatment mortality for combined operation and radiotherapy occurred in four of 20 patients. Postoperative complication occurred in four of the 16 surviving patients. Local tumor control was achieved in 11 of the 16 surviving patients, with an over-all median follow-up period of 18 months. The clinical trial suggested that intraoperative radiotherapy is a feasible adjunct to resection in locally advanced tumors, that the resulting mortality and morbidity is similar to that expected from operation alone and that local tumor control may be improved.

Original languageEnglish (US)
Pages (from-to)205-219
Number of pages15
JournalSurgery Gynecology and Obstetrics
Volume157
Issue number3
StatePublished - 1983
Externally publishedYes

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Radiotherapy
Neoplasms
Fibrosis
Carcinoma
Pathologic Constriction
Clinical Trials
Electrons
Venae Cavae
Mortality
Osteosarcoma
Bile Ducts
Pelvis
Sarcoma
Laparotomy
Sutures
Aorta
Clinical Studies
Pancreas
Stomach
Dogs

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology

Cite this

Sindelar, W. F., Kinsella, T., Tepper, J., Travis, E. L., Rosenberg, S. A., & Glatstein, E. (1983). Experimental and clinical studies with intraoperative radiotherapy. Surgery Gynecology and Obstetrics, 157(3), 205-219.

Experimental and clinical studies with intraoperative radiotherapy. / Sindelar, W. F.; Kinsella, T.; Tepper, J.; Travis, E. L.; Rosenberg, S. A.; Glatstein, E.

In: Surgery Gynecology and Obstetrics, Vol. 157, No. 3, 1983, p. 205-219.

Research output: Contribution to journalArticle

Sindelar, WF, Kinsella, T, Tepper, J, Travis, EL, Rosenberg, SA & Glatstein, E 1983, 'Experimental and clinical studies with intraoperative radiotherapy', Surgery Gynecology and Obstetrics, vol. 157, no. 3, pp. 205-219.
Sindelar WF, Kinsella T, Tepper J, Travis EL, Rosenberg SA, Glatstein E. Experimental and clinical studies with intraoperative radiotherapy. Surgery Gynecology and Obstetrics. 1983;157(3):205-219.
Sindelar, W. F. ; Kinsella, T. ; Tepper, J. ; Travis, E. L. ; Rosenberg, S. A. ; Glatstein, E. / Experimental and clinical studies with intraoperative radiotherapy. In: Surgery Gynecology and Obstetrics. 1983 ; Vol. 157, No. 3. pp. 205-219.
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