Table 8. Studies of IORT in recurrent gynaecological malignancies after gross total resection.
| Author/Year | Sample size | Site | Primary/Recurrent | IORT type | IORT dose (Gy) | Prior EBRT % | Present EBRT % | Median follow-up | LC 5yr (%) | OS 5yr (%) | Toxicity grade 3 or > |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Haddock et al. [113, 115] 1996 | 63 | Cervix-40 Endometrium-16 Others-8 |
Primary-16% Recurrent-84% |
IOERT | 8–25 | 0 70 |
100 63 |
NR | 61 | 27 | Total-17% GI-5* Neuropathy-2* |
| Mahe et al. [124, 125] 1996 | 70 | Cervix | Recurrent-100% | IOERT X ray IORT |
10–30 | 97 | 42 | 15 | 21 (3yr) | 8 (3yr) | Total-14%Neuropathy-5* Ureteral obstruction-4* |
| Del carmen et al. [126] 2000 | 15 | Cervix-5Endometrium-3 Vagina-7 |
Recurrent-93% | IOERT | 10–22.5 | 60 | 6 | NR | NR | 74 | Neuropathy-4* GU-3* Lymphedema-2* |
| Martinez-monge et al.[116] 2001 | 67 | Cervix | Primary-46% Recurrent-54% |
IOERT | 10–25 10–20 |
86 |
97 14 |
58 19 |
80.5 49 |
58 (10yr) 14 (10yr) |
Total-14.9% Neuropathy-1* Chronic pain-8* |
| Gemignani et al. [114] 2001 | 17 | Cervix-9 Endometrium-7 Vagina-1 |
Recurrent- 100% |
HDR-IORT | 12–15 | 82 | 12 | 20 | 67 (3yr) | 54 (3yr) | GI-4* Neuropathy-3* Wound-4* |
| Dowdy et al. [126] 2006 | 25 | Endometrium | Recurrent- 100% |
IOERT | 10–25 | 56 | 84 | 34 | 84 |
R0-71 R1-47 R2-0 |
Neuropathy-8* GU-5* Fitula-5* |
| Tran et al. [118] 2007 |
36 | Cervix-17 Endometrium-11 Others-8 |
Recurrent-89% | X-ray IORT | 6–17.5 | 72 | 53 | 50 | 44 | 47 | Total-27% Wound-4* GI-1* |
| Barney et al [119].2013 | 86 | Cervix-100 | Recurrent-85% | IOERT | 6–25 | 81 | 71 | 32 | Primary-70 Recurrent-61% (3yr) |
25 (3yr) |
GI-4* GU-4* Neuropathy-1* |
| Calvo et al.[120] 2013 | 35 | Cervix-20 Endometrium-7 Others-8 | Recurrent- 100% |
IOERT | 10–15 | 71 | 46 | 46 | 58 | 42 | Fistula-5* Ureter stenosi-2* Neuropathy-1* |
| Backes et al.[127] 2014 | 32 | Cervix-21 Others-11 IORT in 66% only |
Recurrent- 100% |
IOERT/HDR-IORT | 10–20 | 100 | 0 | NR | PE+IORT-10Mon LEER+IORT-9Mon PE-33Mon |
PE+IORT-10Mon LEER+IORT-10Mon PE-41Mon |
NR |
| Foley et al.[121] 2014 | 32 | Cervix-21 Endometrium-6 Others-5 |
Rccurent-81% | IOERT | 10–22.5 | 88 | 20 | 26 |
R1-73 R2-71 |
R1-77 R2-55 p = 0.001 |
Total-47% GU-2 Lymphedema-2 |
| Sole et al. [117] 2014 | 61 | Cervix-18 Endometrium-32 Ovarian-9 Vagina-2 |
Recurrent Pelvic-57% Para-aortic- 43% |
IOERT | 10–15 | 66 | 48 | 42 | 65 | 45 | Total-20% Fistula-5* Neuropathy-1* Wound-3* |
| Arians et al.[122] 2016 | 36 | Cervix-18 Endometrium-12 Vulva-6 |
Recurrent- 100% |
IOERT | 10–18 | 76 25 100 |
11 17 17 |
14 | Cervix-0 Endometrium-40 Vulva-20 p = 0.017 |
Cervix-6 Endometrium-50 Vulva-17 P = 0.038 |
Wound complications-5* Neuropathy-4* Lymphedema-3* |
Sx: surgery, LC: local control, OS: overall survival, NR: not reported,
*
Number of patients
PE: pelvic exenteration, LEER: laterally extended endopelvic resection, Mon: median survival in months.