Intraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors

Despite the continued controversy over defining an optimal delivery mechanism, the critical role of adjuvant radiation in the management of surgically resected primary and metastatic brain tumors remains one of the universally accepted standards in neuro-oncology. Local disease control still ranks a...

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Autores principales:	Christopher P. Cifarelli, Geraldine M. Jacobson
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	IORT brain metastases glioblastoma radiotherapy local control radiobiology Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/071be05c96bd443bace32e02029a851e
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spelling	oai:doaj.org-article:071be05c96bd443bace32e02029a851e2021-11-11T04:48:36ZIntraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors2234-943X10.3389/fonc.2021.768168https://doaj.org/article/071be05c96bd443bace32e02029a851e2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.768168/fullhttps://doaj.org/toc/2234-943XDespite the continued controversy over defining an optimal delivery mechanism, the critical role of adjuvant radiation in the management of surgically resected primary and metastatic brain tumors remains one of the universally accepted standards in neuro-oncology. Local disease control still ranks as a significant predictor of survival in both high-grade glioma and treated intracranial metastases with radiation treatment being essential in maximizing tumor control. As with the emergence and eventual acceptance of cranial stereotactic radiosurgery (SRS) following an era dominated by traditional radiotherapy, evidence to support the use of intraoperative radiotherapy (IORT) in brain tumors requiring surgical intervention continues to accumulate. While the clinical trial strategies in treating glioblastoma with IORT involve delivery of a boost of cavitary radiation prior to the planned standard external beam radiation, the use of IORT in metastatic disease offers the potential for dose escalation to the level needed for definitive adjuvant radiation, eliminating the need for additional episodes of care while providing local control equal or superior to that achieved with SRS in a single fraction. In this review, we explore the contemporary clinical data on IORT in the treatment of brain tumors along with a discussion of the unique dosimetric and radiobiological factors inherent in IORT that could account for favorable outcome data beyond those seen in other techniques.Christopher P. CifarelliChristopher P. CifarelliGeraldine M. JacobsonFrontiers Media S.A.articleIORTbrain metastasesglioblastomaradiotherapylocal controlradiobiologyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	IORT brain metastases glioblastoma radiotherapy local control radiobiology Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	IORT brain metastases glioblastoma radiotherapy local control radiobiology Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Christopher P. Cifarelli Christopher P. Cifarelli Geraldine M. Jacobson Intraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors
description	Despite the continued controversy over defining an optimal delivery mechanism, the critical role of adjuvant radiation in the management of surgically resected primary and metastatic brain tumors remains one of the universally accepted standards in neuro-oncology. Local disease control still ranks as a significant predictor of survival in both high-grade glioma and treated intracranial metastases with radiation treatment being essential in maximizing tumor control. As with the emergence and eventual acceptance of cranial stereotactic radiosurgery (SRS) following an era dominated by traditional radiotherapy, evidence to support the use of intraoperative radiotherapy (IORT) in brain tumors requiring surgical intervention continues to accumulate. While the clinical trial strategies in treating glioblastoma with IORT involve delivery of a boost of cavitary radiation prior to the planned standard external beam radiation, the use of IORT in metastatic disease offers the potential for dose escalation to the level needed for definitive adjuvant radiation, eliminating the need for additional episodes of care while providing local control equal or superior to that achieved with SRS in a single fraction. In this review, we explore the contemporary clinical data on IORT in the treatment of brain tumors along with a discussion of the unique dosimetric and radiobiological factors inherent in IORT that could account for favorable outcome data beyond those seen in other techniques.
format	article
author	Christopher P. Cifarelli Christopher P. Cifarelli Geraldine M. Jacobson
author_facet	Christopher P. Cifarelli Christopher P. Cifarelli Geraldine M. Jacobson
author_sort	Christopher P. Cifarelli
title	Intraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors
title_short	Intraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors
title_full	Intraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors
title_fullStr	Intraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors
title_full_unstemmed	Intraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors
title_sort	intraoperative radiotherapy in brain malignancies: indications and outcomes in primary and metastatic brain tumors
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/071be05c96bd443bace32e02029a851e
work_keys_str_mv	AT christopherpcifarelli intraoperativeradiotherapyinbrainmalignanciesindicationsandoutcomesinprimaryandmetastaticbraintumors AT christopherpcifarelli intraoperativeradiotherapyinbrainmalignanciesindicationsandoutcomesinprimaryandmetastaticbraintumors AT geraldinemjacobson intraoperativeradiotherapyinbrainmalignanciesindicationsandoutcomesinprimaryandmetastaticbraintumors
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Intraoperative Radiotherapy in Brain Malignancies: Indications and Outcomes in Primary and Metastatic Brain Tumors

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