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Special therapeutic procedures

Modern surgical techniques in oncology must be accompanied sometimes by complementary radiotherapy, which may be performed using different methods. One of these methods is Intraoperative radiotherapy, which consists of a single dose of radiation on the surgical site during the intervention..

In this type of treatments, a multidisciplinary professional team is needed, including general surgeons, radiotherapeutic oncologist, anesthetists and radiation physicist. In Centro Integral Oncológico Clara Campal (CIOCC) we have such a team as well as a Radiology operating room, near the linear particle accelerators (radiotherapy treatment units). Thanks to all this, we can use these procedures with effectiveness and all the safety requirements. When performing intraoperative radiotherapy, CIOCC uses a periscope-type cone system called “Electron Cone System” with different diameters and bevel angulation, as well as an adjustable height and mobile operating table.

Thanks to intraoperative radiotherapy, the patient receives this treatment at the same time of the surgical intervention. Thus, a high dose of radiation can be applied and the local control of the illness is increased, but the specialists can also see the field better and they identify those structures that must not be altered by the treatment. These structures will be removed or protected from the radiation field.

Intraoperative radiotherapy is a useful technique for tumors that require high doses of radiation in the tumoral site. It is frequently used in digestive tumors (pancreatic tumors, gastric cancer, rectal cancer) and sarcomas. It is also effective in other locations (breast, nervous system, lung, gynecologic tumors, etc).

Description

This procedure involves the following stages:

  • Preoperative evaluation:he case is discussed in the digestive tumor clinical session at CIOCC by general surgeons, radiotherapeutic oncologists, oncologists, radiologists, anatomical pathologists, gastroenterologists and nuclear doctors. After discussing it, the most appropriate surgical approach is planned based on image evidences.
  • Treatment: once the general surgery team has removed the areas that contained the tumor or that may contain it, the surgical field is examined by both the radiotherapeutic and radiophysic oncology teams. They determine the most suitable applicator (depending on the diameter and bevel) and the tissue depth that must be treated, as well as selecting the electron energy.
    The patient is taken in the same operating system and under strict aseptic conditions to the treatment unit where they will receive the radiotherapy treatment. The whole process is performed under general anesthesia and mechanical ventilation. Patient and anesthesia monitoring is constant thanks to closed circuit television.
  • Once the radiation finishes, the patient is taken again to the radiology operating room, where the intervention ends.

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