2% in 2005 - AIRO associazione italiana radioterapia oncologica

 RIUNIONE GRUPPO DI STUDIO
RADIOTERAPIA INTRAOPERATORIA
 Milano, Congresso AIRO, 18
novembre 2008
Programma




Survey dei Centri 2007
ISIORT Madrid
Rinnovo organigramma 2009-10
Varie
IntraOperativeRadioTherapy
(IORT) in Italy. A survey by
the study group of the Italian
Association for Radiation
Oncology (AIRO)
Luigi Tomio, Giovanni Battista Ivaldi, Antonino De
Paoli,
Marco Krengli, Stefania Manfrida, Stefano
Spagnesi, Sergio Maluta, Giorgio Arcangeli, Umberto
Ricardi, Tino Ceschia, Francesca Coghetto, Alberto
Personeni, Franco Checcaglini, Stefano Pergolizzi,
Riccardo Vigna, Antonella Ciabattoni
Trento, Milano (EIO), Aviano, Novara, Roma (UCSC),
Pisa, Verona, Roma (IRE), Torino, Udine, Treviso,
Bergamo, Città di Castello, Taormina, Cuneo, Roma
(SFN)
Gruppo di Studio Nazionale
Radioterapia Intraoperatoria
Coordinatore:Prof. Vincenzo Valentini
Scopi generali:
 confronto di esperienze
 procedure di trattamento
 programmi di QA
 studi cooperativi
 monitoraggio e sviluppo di attività IORT
AIRO-IORT
Corso di Formazione AIRO
IORT: Attuali indicazioni, aspetti applicativi e
tecnologie. Roma-Aviano,Genn/Febb2004
Tumori Suppl. Nov-Dic 2005
IORT in EBM
 L’analisi dei dati pervenuti ha fornito il
consenso dei Centri su quattro patologie
nelle quali la IORT è stata ritenuta un
trattamento basato sull’evidenza:




•
•
•
•
neoplasie del retto localmente avanzato
recidive delle neoplasie del retto
sarcomi delle parti molli
neoplasie del pancreas
Purposes
 In Italy IORT has been traditionally restricted to a
small number of institutions that used mostly not
dedicated multi-purpose accelerators. In 2002 was
established the IORT Study Group in order to
coordinate the development of new areas of research.
The use of dedicated mobile accelerators developed
by Italian companies (Novac 7, Liac) helped in the
progress of research trials on breast cancer that
started in 1999 at European Institute of Oncology
(EIO) in Milan. We conducted a national survey to
better describe current pattern of exploitment of IORT
in Italy, to assess adherence to national guidelines,
compare results with international reports, and
stimulate collaborative multicentric studies.
Materials and Methods
 In 2005 a structured questionnaire was mailed
to all the Italian Radiation Oncology centres
known to perform (or being in the process of
implementing) IORT and it was updated at the
end of 2007. Indication of treatment modality,
use of dedicated or multi-purpose facilities,
treatment sites, participation in clinical studies,
as well as adherence to EBM as defined in the
national guidelines were acquired
IORT centres in Italy - 2007
In early 2008: + 7
Area
IORT centres
Before 1999
After 1999
Piemonte/
Valle d’Aosta
3
0
3
Lombardia
3
1
2
Trentino AA
1
1
Friuli VG
2
1
1
Veneto
3
0
3
Emilia Romagna
0
Liguria
0
Toscana
3
0
3
Umbria
1
0
1
Marche
1
0
1
Lazio
5
2
3
Abruzzo
0
Molise
0
Campania
0
Puglia
1
0
1
Basilicata
0
Calabria
1
0
1
Sicilia
2
0
2
Sardegna
1
0
1
Italia
27
5
22
Results
59% of the centres
responded
Not responding
41%
9 centres
16 centres
Responding
59%
Treatment modalities used by
16 responding centres
1
Intrabeam
Standard
Linac
1 centre used two Dm in
parallel and 1 centre used
two different treatment
modalities
3
Dedicated
mobile
12
0
5
10
15
Total number of patients
treated from 1988 to 2007
 N = 6990;
 Median
number/centre =
130 (range
4181 – 2)
before
1999
20%
after
1999
80%
Treatment sites (%) in 2007
Pancreas
Sarcomas
1,4%
2,5%
Prostate
Other
2,8%
1,7%
Rectum
3,6%
Total number of
patients 1571
Breast
88%
IORT: Patologie (2005)
 Mammella:
 Prostata:
93% Centri; 48% (0-100%)
30% Centri; 11% (6-41%)
 Retto:
 Sarcomi:
 Pancreas:
70% Centri; 15% (10-96%)
60% Centri; 11% (2-28%)
60% Centri;
3% (2-12%)
 Cervice:
 H-N:
 Stomaco:
20% Centri; 3% (4-10%)
10% Centri; 10% (36%)
10% Centri; <1% (4%)
Indicazione IORT
 EBM
50%
 Studi Clinici
45%
 Individualizzata
5%
Patients treated with IORT in
2007
<10
< 30
30-50
50 - 100
7
6
5
4
3
2
1
0
> 100
No. Of centres
 Total number of patients = 1561
 Median number/centre = 34 (range
2 – 970)
IORT workload in 2007
IORT 6,3%
(2% in 2005)
All other
techniques
93,7%
CONCLUSIONS
 The number of IORT centres in Italy
increased significantly after 1999 and
is growing fast. The majority of them
use mobile dedicated linac, treat
breast cancer and participate in
clinical trials. We encourage
collaboration between centres in
designing prospective studies to help
standardize treatment techniques and
define guidelines.
revisiones en CANCER vol.22 extra
ISIORT 2008
5° INTERNATIONAL CONFERENCE OF
THE INTERNATIONAL SOCIETY OF
INTRAOPERATIVE RADIATION
THERAPY
Madrid, June 10-13
ABSTRACTS
CONTRIBUTI
 3 giornate di lavoro
 13 Paesi presenti
 40 Centri partecipanti
 96 Lavori presentati
Oral
presentation
Italia
Poster Italia
Mammella
11
8*
8
1
Biotecnologia
8
2
8
1
Fisica
3
1
5
1
Sarcomi
5
2*
8
Retto
5
2*
1
Rec.pelviche
3
Pancreas
5
Miscellanea
1
Stomaco
3
1
ORL
3
1
Prostata
1
1
6
1*
2
4
Polmone
2
2
2
Pediatria
1
TOTALE
49
1
19
47
5
ISIORT
 dic.2008: rinnovo presidente. Candidato:
Prof.Orecchia
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