Local control, survival, and operative morbidity and mortality after re-resection, and intraoperative radiation therapy for recurrent or persistent primary high-risk XXXX .

@entity1 @entity5 @entity260 @entity521 @entity4180
BACKGROUND/PURPOSE: @entity1 with locally recurrent or persistent high-risk @entity521 are difficult to treat. We describe our experience using intraoperative radiation therapy (IORT) after re-resection in this high-risk population. METHODS: We retrospectively reviewed 44 consecutive @entity1 who received IORT at our institution between April 2000 and September 2009 after gross total resection of recurrent/persistent @entity5 . Specifically, we evaluated local recurrence rates, complications, and overall survival. RESULTS: The median age at diagnosis was 41.5 months. Median follow-up after IORT was 10.5 months. Each @entity1 received prior chemotherapy and surgery, while 94.5% had previous external beam radiation therapy. @entity4180 was amplified in 34% of @entity1 . There were no operative or postoperative deaths, and 18 @entity1 (40.9%) had @entity260 . There was a 50.4% probability of local control. @entity4180 amplification did not affect local control (local recurrence rate of 53.9% vs 52.4%, P = .89). Median overall survival was 18.7 months (95% confidence interval, 11.7-25.6 months). Mean survival for @entity4180 -amplified @entity1 was 13.0 vs 39.2 months for those without @entity4180 amplification (P = .035). CONCLUSIONS: Intraoperative radiation therapy after re-resection of locally recurrent/persistent @entity521 results in a reasonable rate of local control with acceptable morbidity and survival. This approach should be considered in this high-risk population.
