The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
J S Vaidya - One of the best experts on this subject based on the ideXlab platform.
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targeted Intraoperative Radiotherapy tumour bed boost during breast conserving surgery after neoadjuvant chemotherapy
Strahlentherapie Und Onkologie, 2016Co-Authors: Hans Christian Kolberg, Max Bulsara, Gyoergy Loevey, L Akpolatbasci, M Stephanou, Peter A Fasching, M Untch, Cornelia Liedtke, J S VaidyaAbstract:Introduction The use of targeted Intraoperative Radiotherapy (TARGIT-IORT) as a tumour bed boost during breast-conserving surgery (BCS) for breast cancer has been reported since 1998. We present its use in patients undergoing breast conservation following neoadjuvant therapy (NACT).
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targeted Intraoperative Radiotherapy versus whole breast Radiotherapy for breast cancer targit a trial an international prospective randomised non inferiority phase 3 trial
The Lancet, 2010Co-Authors: J S Vaidya, J S Tobias, Christobel Saunders, Michael Alvarado, Henrik Flyger, David Joseph, Max Bulsara, Frederik Wenz, Samuele MassarutAbstract:Findings 1113 patients were randomly allocated to targeted Intraoperative Radiotherapy and 1119 were allocated to external beam Radiotherapy. Of 996 patients who received the allocated treatment in the targeted Intraoperative Radiotherapy group, 854 (86%) received targeted Intraoperative Radiotherapy only and 142 (14%) received targeted Intraoperative Radiotherapy plus external beam Radiotherapy. 1025 (92%) patients in the external beam Radiotherapy group received the allocated treatment. At 4 years, there were six local recurrences in the Intraoperative Radiotherapy group and five in the external beam Radiotherapy group. The Kaplan-Meier estimate of local recurrence in the conserved breast at 4 years was 1·20% (95% CI 0·53–2·71) in the targeted Intraoperative Radiotherapy and 0·95% (0·39–2·31) in the external beam Radiotherapy group (difference between groups 0·25%, –1·04 to 1·54; p=0·41). The frequency of any complications and major toxicity was similar in the two groups (for major toxicity, targeted Intraoperative Radiotherapy, 37 [3·3%] of 1113 vs external beam Radiotherapy, 44 [3·9%] of 1119; p=0·44). Radiotherapy toxicity (Radiation Therapy Oncology Group grade 3) was lower in the targeted Intraoperative Radiotherapy group (six patients [0·5%]) than in the external beam Radiotherapy group (23 patients [2·1%]; p=0·002).
Max Bulsara - One of the best experts on this subject based on the ideXlab platform.
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targeted Intraoperative Radiotherapy tumour bed boost during breast conserving surgery after neoadjuvant chemotherapy
Strahlentherapie Und Onkologie, 2016Co-Authors: Hans Christian Kolberg, Max Bulsara, Gyoergy Loevey, L Akpolatbasci, M Stephanou, Peter A Fasching, M Untch, Cornelia Liedtke, J S VaidyaAbstract:Introduction The use of targeted Intraoperative Radiotherapy (TARGIT-IORT) as a tumour bed boost during breast-conserving surgery (BCS) for breast cancer has been reported since 1998. We present its use in patients undergoing breast conservation following neoadjuvant therapy (NACT).
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targeted Intraoperative Radiotherapy versus whole breast Radiotherapy for breast cancer targit a trial an international prospective randomised non inferiority phase 3 trial
The Lancet, 2010Co-Authors: J S Vaidya, J S Tobias, Christobel Saunders, Michael Alvarado, Henrik Flyger, David Joseph, Max Bulsara, Frederik Wenz, Samuele MassarutAbstract:Findings 1113 patients were randomly allocated to targeted Intraoperative Radiotherapy and 1119 were allocated to external beam Radiotherapy. Of 996 patients who received the allocated treatment in the targeted Intraoperative Radiotherapy group, 854 (86%) received targeted Intraoperative Radiotherapy only and 142 (14%) received targeted Intraoperative Radiotherapy plus external beam Radiotherapy. 1025 (92%) patients in the external beam Radiotherapy group received the allocated treatment. At 4 years, there were six local recurrences in the Intraoperative Radiotherapy group and five in the external beam Radiotherapy group. The Kaplan-Meier estimate of local recurrence in the conserved breast at 4 years was 1·20% (95% CI 0·53–2·71) in the targeted Intraoperative Radiotherapy and 0·95% (0·39–2·31) in the external beam Radiotherapy group (difference between groups 0·25%, –1·04 to 1·54; p=0·41). The frequency of any complications and major toxicity was similar in the two groups (for major toxicity, targeted Intraoperative Radiotherapy, 37 [3·3%] of 1113 vs external beam Radiotherapy, 44 [3·9%] of 1119; p=0·44). Radiotherapy toxicity (Radiation Therapy Oncology Group grade 3) was lower in the targeted Intraoperative Radiotherapy group (six patients [0·5%]) than in the external beam Radiotherapy group (23 patients [2·1%]; p=0·002).
William F Sindelar - One of the best experts on this subject based on the ideXlab platform.
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Intraoperative Radiotherapy for pancreatic carcinoma: Experimental and clinical studies
Cancer, 1996Co-Authors: Timothy J Kinsella, William F SindelarAbstract:Intraoperative Radiotherapy (IORT) is an innovative treatment approach that has been tested in several Phase I-II studies and small Phase III trials in patients with resectable and unresectable pancreatic cancer. The technical approach and dose guidelines for adjacent normal tissues have been established in a series of experiments using a large animal (canine) model. This article reviews the experimental and clinical studies of IORT in cancer of the pancreas.
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Tumors in dogs exposed to experimental Intraoperative Radiotherapy
International Journal of Radiation Oncology Biology Physics, 1996Co-Authors: Peter A.s. Johnstone, Timothy J Kinsella, Anne Marie Deluca, Margaret Barnes, William B. Laskin, William F SindelarAbstract:Purpose : The frequency of radiation-induced neoplasms was determined in dogs enrolled in the National Cancer Institute canine trials of Intraoperative Radiotherapy (IORT). Methods and Materials : Twelve protocols assessing normal tissue response to IORT involved 238 dogs in a 15-year trial. Eighty-one dogs were followed for > 24 months postoperatively and were assessed for tumor development ; 59 of these animals received IORT. Results : Twelve tumors occurred in the 59 dogs receiving IORT. Nine were in the IORT portals and were considered to be radiation induced. No tumors occurred in 13 sham animals or in 9 animals treated with external beam Radiotherapy alone. The frequency of radiation-induced malignancies in dogs receiving IORT was 15%, and was 25% in animals receiving ≥ 25 Gy IORT. Frequency of all tumors, including spontaneous lesions, was 20%. Conclusions : Intraoperative Radiotherapy contributed to a high frequency of sarcoma induction in these dogs. Unknown to date in humans involved in clinical trials of IORT, this potential complication should be looked for as long-term survivors are followed.
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Clinical toxicity of peripheral nerve to Intraoperative Radiotherapy in a canine model
International Journal of Radiation Oncology Biology Physics, 1995Co-Authors: Peter A.s. Johnstone, Timothy J Kinsella, Anne Marie Deluca, William J. Anderson, Richard Terrill, John Bacher, Victoria A. Hampshire, William F SindelarAbstract:The clinical late effects of Intraoperative Radiotherapy (IORT) on peripheral nerve were investigated in a foxhound model. Between 1982 and 1987, 40 animals underwent laparotomy with Intraoperative Radiotherapy of doses from 0-75 Gy administered to the right lumbosacral plexus. Subsequently, all animals were monitored closely and sacrificed to assess clinical effects to peripheral nerve. This analysis reports final clinical results of all animals, with follow-up to 5 years. All animals treated with {>=} 25 Gy developed ipsilateral neuropathy. An inverse relationship was noted between Intraoperative Radiotherapy dose and time to neuropathy, with an effective dose for 50% paralysis (ED{sub 50}) of 17.2 Gy. One of the animals treated with 15 Gy IORT developed paralysis, after a much longer latency than the other animals. Doses of 15 Gy delivered Intraoperatively may be accompanied by peripheral neuropathy with long-term follow-up. This threshold is less than that reported with shorter follow-up. The value of ED{sub 50} determined here is in keeping with data from other animal trials, and from clinical trials in humans. 11 refs., 2 figs.
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Effects of Intraoperative Radiotherapy on vascular grafts in a canine model.
International Journal of Radiation Oncology Biology Physics, 1994Co-Authors: P.a.s. Johnstone, Timothy J Kinsella, Anne Marie Deluca, Richard Terrill, M. Sprague, J.d. Bacher, V.a. Hampshire, William F SindelarAbstract:PURPOSE: The effects of Intraoperative Radiotherapy +/- external beam Radiotherapy on prosthetic vascular grafts were investigated in a canine model. METHODS AND MATERIALS: In 1986 and 1987, 30 adult beagles underwent laparotomy with transection and segmental resection of the infrarenal aorta followed by immediate reconstruction with a prosthetic graft. Intraoperative Radiotherapy at varying doses from 0-30 Gy was then administered to all animals. Half of the dogs received 36 Gy external beam Radiotherapy in 10 fractions postoperatively. Animals were sacrificed and necropsied at predetermined intervals and as clinically indicated to assess early ( 6 months) effects to the vascular graft and surrounding normal tissue. RESULTS: Histopathologic analyses of irradiated vascular structures were performed and correlations were made with the clinical outcome. The most frequent early clinical toxicity was graft thrombosis, occurring in 7 of 10 animals followed for 6 months. Late (> 6 months) graft stenosis was correlated with Intraoperative Radiotherapy dose. At 25 Gy, five of six animals developed late occlusion. On histopathologic review, increasing Intraoperative dose and increasing total Radiotherapy dose (Intraoperative+external beam) appeared to correspond with increasing severity of graft changes seen after 6 months of follow-up. CONCLUSIONS: Thrombus formation is a frequent early complication of vascular graft placement of the infrarenal aorta in our beagle dog model. Intraoperative doses up to 20 Gy appear to contribute minimally to late graft occlusion, while doses > or = 25 Gy contribute to late occlusion with high likelihood. Both Intraoperative dose and total Radiotherapy dose correlated with late graft occlusion, and with histopathologic changes in the graft and anastomoses.
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Intraoperative Radiotherapy in retroperitoneal sarcomas final results of a prospective randomized clinical trial
Archives of Surgery, 1993Co-Authors: William F Sindelar, Timothy J Kinsella, Pauline W Chen, Thomas F Delaney, Joel E Tepper, Steven A Rosenberg, Eli GlatsteinAbstract:• Thirty-five patients with surgically resected sarcomas of the retroperitoneum were enrolled in a prospective, randomized, clinical trial comparing 20-Gy Intraoperative Radiotherapy in combination with postoperative low-dose (35- to 40-Gy) external-beam Radiotherapy with postoperative high-dose (50- to 55-Gy) external-beam Radiotherapy alone. Chemotherapy with doxorubicin hydrochloride, cyclophosphamide (anhydrous), and methotrexate sodium was used for a portion of the trial. Fifteen patients who received Intraoperative Radiotherapy and 20 control patients were followed up for a minimum of 5 years (median follow-up, 8 years). Median survival times were similar for the group that received Intraoperative Radiotherapy (45 months) and the control group (52 months). There were no indications of benefit from adjunctive chemotherapy. The number of locoregional recurrences was significantly lower among those who received Intraoperative Radiotherapy (six of 15) than control patients (16 of 20). Patients who received Intraoperative Radiotherapy had fewer complications of disabling radiation-related enteritis (two of 15) than control patients (10 of 20), but radiation-related peripheral neuropathy was more frequent among those who received Intraoperative Radiotherapy (nine of 15) than among control patients (one of 20). ( Arch Surg. 1993;128:402-410)
Samuele Massarut - One of the best experts on this subject based on the ideXlab platform.
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targeted Intraoperative Radiotherapy versus whole breast Radiotherapy for breast cancer targit a trial an international prospective randomised non inferiority phase 3 trial
The Lancet, 2010Co-Authors: J S Vaidya, J S Tobias, Christobel Saunders, Michael Alvarado, Henrik Flyger, David Joseph, Max Bulsara, Frederik Wenz, Samuele MassarutAbstract:Findings 1113 patients were randomly allocated to targeted Intraoperative Radiotherapy and 1119 were allocated to external beam Radiotherapy. Of 996 patients who received the allocated treatment in the targeted Intraoperative Radiotherapy group, 854 (86%) received targeted Intraoperative Radiotherapy only and 142 (14%) received targeted Intraoperative Radiotherapy plus external beam Radiotherapy. 1025 (92%) patients in the external beam Radiotherapy group received the allocated treatment. At 4 years, there were six local recurrences in the Intraoperative Radiotherapy group and five in the external beam Radiotherapy group. The Kaplan-Meier estimate of local recurrence in the conserved breast at 4 years was 1·20% (95% CI 0·53–2·71) in the targeted Intraoperative Radiotherapy and 0·95% (0·39–2·31) in the external beam Radiotherapy group (difference between groups 0·25%, –1·04 to 1·54; p=0·41). The frequency of any complications and major toxicity was similar in the two groups (for major toxicity, targeted Intraoperative Radiotherapy, 37 [3·3%] of 1113 vs external beam Radiotherapy, 44 [3·9%] of 1119; p=0·44). Radiotherapy toxicity (Radiation Therapy Oncology Group grade 3) was lower in the targeted Intraoperative Radiotherapy group (six patients [0·5%]) than in the external beam Radiotherapy group (23 patients [2·1%]; p=0·002).
Christobel Saunders - One of the best experts on this subject based on the ideXlab platform.
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targeted Intraoperative Radiotherapy versus whole breast Radiotherapy for breast cancer targit a trial an international prospective randomised non inferiority phase 3 trial
The Lancet, 2010Co-Authors: J S Vaidya, J S Tobias, Christobel Saunders, Michael Alvarado, Henrik Flyger, David Joseph, Max Bulsara, Frederik Wenz, Samuele MassarutAbstract:Findings 1113 patients were randomly allocated to targeted Intraoperative Radiotherapy and 1119 were allocated to external beam Radiotherapy. Of 996 patients who received the allocated treatment in the targeted Intraoperative Radiotherapy group, 854 (86%) received targeted Intraoperative Radiotherapy only and 142 (14%) received targeted Intraoperative Radiotherapy plus external beam Radiotherapy. 1025 (92%) patients in the external beam Radiotherapy group received the allocated treatment. At 4 years, there were six local recurrences in the Intraoperative Radiotherapy group and five in the external beam Radiotherapy group. The Kaplan-Meier estimate of local recurrence in the conserved breast at 4 years was 1·20% (95% CI 0·53–2·71) in the targeted Intraoperative Radiotherapy and 0·95% (0·39–2·31) in the external beam Radiotherapy group (difference between groups 0·25%, –1·04 to 1·54; p=0·41). The frequency of any complications and major toxicity was similar in the two groups (for major toxicity, targeted Intraoperative Radiotherapy, 37 [3·3%] of 1113 vs external beam Radiotherapy, 44 [3·9%] of 1119; p=0·44). Radiotherapy toxicity (Radiation Therapy Oncology Group grade 3) was lower in the targeted Intraoperative Radiotherapy group (six patients [0·5%]) than in the external beam Radiotherapy group (23 patients [2·1%]; p=0·002).