 RIUNIONE GRUPPO DI STUDIO RADIOTERAPIA INTRAOPERATORIA  Milano, Congresso AIRO, 18 novembre 2008

Programma  Survey dei Centri 2007  ISIORT Madrid  Rinnovo organigramma  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: y confronto di esperienze y procedure di trattamento y programmi di QA y studi cooperativi y 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 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 AreaIORT centresBefore 1999After 1999 Piemonte/ Valle d’Aosta 303 Lombardia312 Trentino AA11 Friuli VG211 Veneto303 Emilia Romagna0 Liguria0 Toscana303 Umbria101 Marche101 Lazio523 Abruzzo0 Molise0 Campania0 Puglia101 Basilicata0 Calabria101 Sicilia202 Sardegna101 Italia27522 In early 2008: + 7

Results 59% of the centres responded 16 centres 9 centres

Treatment modalities used by 16 responding centres centre used two Dm in parallel and 1 centre used two different treatment modalities

Total number of patients treated from 1988 to 2007  N = 6990;  Median number/centre = 130 (range 4181 – 2)

Treatment sites (%) in 2007 Total number of patients 1571

IORT: Patologie (2005)  Mammella: 93% Centri; 48% (0-100%)  Prostata: 30% Centri; 11% (6-41%)  Retto: 70% Centri; 15% (10-96%)  Sarcomi: 60% Centri; 11% (2-28%)  Pancreas: 60% Centri; 3% (2-12%)  Cervice: 20% Centri; 3% (4-10%)  H-N: 10% Centri; 10% (36%)  Stomaco: 10% Centri; <1% (4%)

Indicazione IORT  EBM 50%  Studi Clinici 45%  Individualizzata 5%

Patients treated with IORT in 2007  Total number of patients = 1561  Median number/centre = 34 (range 2 – 970) No. Of centres

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 ° INTERNATIONAL CONFERENCE OF THE INTERNATIONAL SOCIETY OF INTRAOPERATIVE RADIATION THERAPY Madrid, June ABSTRACTS

CONTRIBUTI  3 giornate di lavoro  13 Paesi presenti  40 Centri partecipanti  96 Lavori presentati

Oral presentation ItaliaPosterItalia Mammella118*81 Bio- tecnologia 8281 Fisica3151 Sarcomi52*8 Retto52*1 Rec.pelviche36 Pancreas51*2 Miscellanea14 Stomaco31 ORL31 Prostata1122 Polmone2 Pediatria11 TOTALE

ISIORT  dic.2008: rinnovo presidente. Candidato: Prof.Orecchia ISCRIZIONE alla società sul sito online  Board consiglieri: sono stati presentati per il rinnovo gli attuali di ISIORT Mondo ed Europa  1 giornata al GEC-ESTRO ad Oporto (Portogallo) 13 maggio 2009 (vedere sito ESTRO)  Congresso ISIORT a Phoenix (Arizona) nel 2010