Low-kilovolt x-ray intraoperative radiotherapy for pT3 locally advanced colon cancer: A single-institution retrospective analysis

Li Ma, Li Ma, Li Ma, Junhao Qiang, Junhao Qiang, Heliang Yin, Heliang Yin, Heliang Yin, Lin Lin, Lin Lin, Lin Lin, Yan Jiao, Changying Ma, Changying Ma, Xinwei Li, Xinwei Li, Li Dong, Li Dong, Jinglin Cui, Jinglin CuiDongmei Wei, Dongmei Wei, Ankur M. Sharma, David L. Schwartz, Weikuan Gu, Weikuan Gu, Hong Chen, Hong Chen

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Patients with locally advanced colon cancer (LACC) treated with surgery had a high risk of local recurrence. The outcomes can vary significantly among patients with pT3 disease. This study was undertaken to assess whether low-kilovolt (kV) x-ray intraoperative radiotherapy (IORT) can achieve promising results compared with electron beam IORT (IOERT) and whether specific subgroups of patients with pT3 colon cancer may benefit from low-kV x-ray IORT. Methods: We retrospectively reviewed 44 patients with pT3 LACC treated with low-kV x-ray IORT. Clinicopathologic characteristics were analyzed to identify patients that could potentially benefit from low-kV x-ray IORT. The Kaplan-Meier survival analysis was used to assess overall survival (OS) and progression-free survival (PFS). Correlation analysis was used to discover the association of multiple factors to the results of treatment represented by the values of OS and PFS. Results: The median follow-up of patients was 20.5 months (range, 6.1-38.8 months). At the time of analysis, 38 (86%) were alive and 6 (14%) had died of their disease. The 3-year Kaplan-Meier of PFS and OS for the entire cohort was 82.8% and 82.1%, respectively. At median follow-up, no in-field failure within the low-kV x-ray IORT field had occurred. Locoregional and distant failure had occurred in 2 (5%) patients each. The rate of perioperative 30-day mortality was 0%, and the morbidity rate was 11%. Five patients experienced 7 complications, including 4 early complications (30 days) and three late complications (> 30 days) leading early and late morbidity rates of 9% and 7%, respectively. Conclusion: Patients with LACC who had undergone an additional low-kV x-ray IORT can achieve encouraging locoregional control, PFS, OS, and distant control without an increase in short-term or long-term complications. Low-kV x-ray IORT can be considered as part of management in pT3 LACC.

Original languageEnglish (US)
Article number132
JournalWorld Journal of Surgical Oncology
Issue number1
StatePublished - Jun 17 2020
Externally publishedYes


  • Intraoperative radiotherapy
  • Locally advanced colon cancer
  • Low-kV x-ray
  • pT3 colon cancer

ASJC Scopus subject areas

  • Surgery
  • Oncology


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