Table 1.
Studies reporting oncological outcomes following IORT for locally advanced colorectal cancer
| Author, Year, Location | Time frame | N | Cancer type (%) | Clinical T stage (%) | Type of IORT | IORT Dose (Gy) | PR-RT (%) | CT (%) | PO-RT (%) | Follow up (months) | Resection margin | 5-year LC (%) | In-field LC (%) | 5-year OS (%) | 5-year DFS (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Willett et al, 1991, USA [23] ς | 1978-1989 | 42 | R | - | IOERT | 10-20 ϕ | 100 | - | 0 | 26 (6-120) § | R0 R1 R2 |
88 69 50 |
- | - | 53 47 17 |
| Huber et al, 1996, Germany [24] | 1989-1993 | 38 | R | T3 (50) T4 (50) |
HDR-IORT | 15 | 50 | NA (50) A (50) |
50 | 25.5 ‡ | R0/R1/R2 | T3 (84) T4 (90) |
100 | 28 F̵ | - |
| Nakfoor et al, 1998, USA [37] ς | 1978-1996 | 73 | R | - | IOERT | 10-20 ϕ | 100 | - | 0 | 53 ‡ | R0 R1/R2 |
89 65 |
- | - | 63 32 |
| Mannaerts et al, 2000, Netherlands [25] Φ | 1994-1998 | 38 | R | - | IOERT | 10-17.5 ϕ | 100 | - | - | 21 (1-57) § |
R0/R1/R2 | 82* | 92* | 72* | 65* |
| Ratto et al, 2003, Italy [28] ϖ | 1990-1997 | 19 | R | T1-T3 N3 (7) T4Nx (93) |
IOERT | 10-15 ϕ | - | - | - | 74 (27 -120) § |
- | 91 | 95 | 61 | 47 |
| Sadahiro et al, 2004, Japan [26] | 1991-2001 | 99 | R | T1/T2 (29) T3 (59) T4 (12) |
IOERT | 17.3 ‡ | 100 | NA (53) | 0 | 67 Ω | - | 98 | - | 79 | 71 |
| Nuyttens et al, 2004, Netherlands [27] ¡ | 1997-2000 | 18 | R | T1-T4 LN +ve (16) T3N0 (66) T4N0 (16) |
HDR-IORT | 10 | 100 | 0 | 0 | 34 Ω | - | 81* | 94* | 61* | - |
| Diaz-Gonzalez et al, 2006, Spain [38] | 1995-2001 | 115 | R | T1/T2 (8) T3 (95) T4 (12) |
IOERT | 12.5 Ω | 100 | NA (100) A (57) |
0 | 37 (6-83) § |
- | 94* | 98* | 74* | 74* |
| Krempien et al 2006, Germany [39] Φ | 1991-2003 | 210 | R | T1/T2 (6) T3 (72) T4 (22) |
IOERT | 10 (8-18) § |
93 | 93 | 42 | 61 (4-177) § |
R0 R1/R2 |
93 77 |
98 | 74 55 |
68 0 |
| Ferenschild et al, 2006, Netherlands [40] ¡ | 1987-2002 | 30 | R | T3 | HDR-IORT | 10 | 100 | - | 0 | 25 (1-136) § |
R0 R1/R2 |
72 58 |
- | 66 38 |
- |
| Roeder et al, 2007, Germany [41] Φ | 1991-2004 | 243 | R | T1/T2 (14) T3 (66) T4 (20) |
IOERT | 10.4 ‡ | 50 | 36 | 0 | 59 Ω | R0 R1/R2 |
94 72 |
97 | - | - |
| Masaki et al, 2008, Japan [29] | 2000-2007 | 19 | R | T1/T2 (11) T3 (89) |
IOERT | 18-20 ϕ | - | A (37) | - | 34 § | - | 95 | - | 64 | 60 |
| Mathis et al, 2008, USA [30] Φ | 1981-2007 | 146 | C (27) R (73) |
T4 (100) | IOERT | 12.5 (7.5- 25) § |
100 | NA (5) A (40) |
0 | 44 Ω | R0/R1/R2 | 86 | 98 | 52 | 43 |
| Valentini et al, 2009, Italy [31] Φ ϖ | 1991-2006 | 29 | R | T4 (100) | IOERT | 10-15 ϕ | 100 | 100 | 0 | 31 (4-136) § |
R0 | 100 | 100 | - | - |
| Kusters et al, 2010, Netherlands [42] | - | 605 | R | T3 (71) T4 (29) |
IOERT | - | R (36) | A (42) | 0 | - | R0/R1/R2 | 88 | - | 67 | - |
| Dubois et al, 2011, France [32] ¢ | 1993-2001 | 68 | R | T3/T4 (100) | IOERT | 18 Œ | 100 | A (25) | - | 60 (10- 112) § |
- | 92 | 96 | 77 | 62 |
PR-RT pre-operative radiotherapy; CT chemotherapy; PO-RT post-operative radiotherapy; LC local control; OS overall survival; DFS disease-free survival; R rectal; ς all patients having IORT had obvious residual cancer or positive/<5mm margins on frozen section ϕ range reported with no mean/median; § median; ‡ mean; F̵ overall survival reported for T3 and T4 cancers combined; Φ all patients received IORT irrespective of frozen section outcome but dose was increased where margins were positive or close; ϖ overlapping patient populations; * 3-year local control/survival reported; LN lymph node; ¡ IORT used in cases where resection margin was found to be positive or <2mm on intraoperative frozen section.
Ω median reported without range; NA neo-adjuvant chemotherapy; A adjuvant chemotherapy; ¢ randomised controlled trial; Œ one patient received dose of 15Gy.