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Open Access Research

Intraoperative radiation therapy for advanced cervical metastasis: a single institution experience

Youssef H Zeidan1*, Alex Yeh2, Daniel Weed2, Colin Terry4, Stephen Freeman3, Edward Krowiak3, Robert Borrowdale3 and Tod Huntley3

Author Affiliations

1 Department of Radiation Oncology, Stanford University, Stanford, CA, USA

2 Department of Radiation Oncology, Methodist Hospital, Indianapolis, IN, USA

3 Center for Ear Nose Throat & Allergy, Indianapolis, IN, USA

4 Methodist Research Institute, Methodist Hospital, Indianapolis, IN, USA

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Radiation Oncology 2011, 6:72  doi:10.1186/1748-717X-6-72

Published: 15 June 2011

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.

Keywords:
intraoperative radiotherapy; IORT; cervical metastasis