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Related Concept Videos

Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Related Experiment Video

Updated: Jun 14, 2025

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Local Control, Survival, and Toxicity Outcomes with High-Dose-Rate Peri-Operative Interventional Radiotherapy

Warren Bacorro1,2, Bruno Fionda3, Tamer Soror4

  • 1Department of Clinical Epidemiology, Faculty of Medicine and Surgery, University of Santo Tomas, 1008 Manila, Philippines.

Journal of Personalized Medicine
|August 29, 2024
PubMed
Summary

Peri-operative interventional radiotherapy (POIRT) shows promise for early tongue cancers, offering high survival rates. For advanced head and neck cancers (HNCs), POIRT requires careful consideration, especially in re-irradiation cases where gross total resection improves outcomes.

Keywords:
head and neck cancershigh dose rateinterventional radiotherapyperi-operative brachytherapy

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Head and Neck Surgery

Background:

  • Peri-operative interventional radiotherapy (POIRT) integrates tumor resection, catheter implantation, and peri-operative irradiation.
  • POIRT offers benefits including maximal tumor reduction, improved tumor bed identification, flexible implant geometry, conformal irradiation, and minimized treatment delays.
  • This review examines POIRT outcomes for head and neck cancers (HNCs) in both primary and re-irradiation settings.

Purpose of the Study:

  • To systematically review and synthesize published data on local control, survival, toxicity, and quality of life (QOL) associated with POIRT in HNCs.
  • To evaluate the efficacy and safety of POIRT in primary treatment and re-irradiation for HNCs.

Main Methods:

  • Systematic literature search of major databases (PubMed, Scopus, Science Direct) supplemented by bibliography scanning and hand-searching.
  • Inclusion of 15 unique articles, with 5 merged into more updated studies, resulting in 10 studies for analysis (4 primary POIRT, 7 re-irradiation POIRT).
  • Qualitative synthesis due to data heterogeneity.

Main Results:

  • Primary POIRT for early tongue cancer yields 6-year recurrence-free survival (RFS) and overall survival (OS) of 92%.
  • For advanced HNCs, primary POIRT shows 9-year RFS and OS rates of 52% and 55%, respectively, with common Grade 1-2 toxicity and rare Grade 3-5 toxicity.
  • Re-irradiation POIRT for recurrent HNCs demonstrates 5-year RFS of 37-55% and OS of 17-50%, with improved outcomes linked to gross total resection (GTR). Quality of life data is limited.

Conclusions:

  • Primary POIRT is a safe and effective treatment for early tongue cancers.
  • The application of POIRT in other HNC sites, particularly for advanced disease, warrants careful consideration.
  • Re-irradiation POIRT is most effective and safe when combined with GTR; managing significant toxicity requires meticulous case selection, implant planning, and adherence to dose constraints.