Intraoperative radiotherapy for intracranial malignancies. A pilot study

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• Intraoperative radiotherapy (IOR) delivers a single high-energy electron dose to surgically exposed tumors.
• It allows precise target volume assessment and retraction of surrounding healthy tissues.
• IOR serves as a supplemental or boost dose to conventional external beam radiotherapy.

Purpose of the Study:

• To present the clinical experience of using IOR for brain tumors in the US.
• To evaluate the feasibility, tolerance, and preliminary outcomes of this treatment approach.

Main Methods:

• A pilot study involving 12 patients at Howard University Hospital.
• Patients underwent surgical resection or decompression followed by 1500 cGy IOR to the tumor bed.
• Postoperative treatment included 5000 cGy whole-brain irradiation and a 500 cGy tumor bed boost.

Main Results:

• The protocol was best tolerated when the cranial vault was decompressed.
• Two meningioma patients were without evidence of disease at 8, 11, 12, and 15 months.
• Three glioma patients died with disease at 3, 13, and 15 months; two patients died within 30 days post-surgery.

Conclusions:

• Intraoperative radiotherapy is a viable option for brain tumors, particularly when combined with surgical decompression.
• Further investigation is warranted to establish its role in brain tumor treatment protocols.