Intraoperative radiation therapy as an "early boost" in locally advanced head and neck cancer: preliminary results of a feasibility study

BACKGROUND: The acute toxicity of intraoperative radiation therapy (IORT) delivered as an "early boost" after tumor resection in patients with locally advanced head and neck cancer was evaluated. METHODS: Twenty-five patients were enrolled in the study. All patients underwent surgery with radical intent, and 17 had microvascular flap reconstruction. The IORT was delivered in the operating room. Twenty patients received adjuvant external beam radiation therapy (EBRT). RESULTS: Five patients experienced various degrees of complications in the postoperative period, all of which were treated conservatively. One patient had a partial flap necrosis after EBRT that was treated with flap removal. Six deaths were recorded during the mean follow-up period of 8 months; none of the deaths were related to radiation treatment. CONCLUSION: This feasibility study shows that the use of IORT as an early boost is feasible with no increase in acute toxicity directly attributable to radiation