Intraoperative radiation therapy for Wilms' tumor in situ or ex vivo

Article Abstract:

Wilms' tumor is a kidney tumor which arises from embryonic kidney cells. When treating disease in organs as important as the kidneys, every attempt is made to preserve kidney function as much as possible; the surgical removal of the kidneys is generally regarded as a last resort. If Wilms' tumors recur in both kidneys after chemotherapy, further chemotherapy is generally ineffective. One method of treating the recurrent cancer while maintaining some residual kidney function is intraoperative radiation therapy. In this procedure, the kidney is exposed to radiation during surgery; radiation doses may be more accurately delivered to the affected area when the kidney is exposed. Intraoperative radiotherapy may be performed in situ, which means while the kidney is in place and the surrounding tissues are shielded from the radiation. Medical researchers now report the first case of intraoperative radiotherapy ex vivo, in which the kidney is actually removed from the patient, exposed to radiation, and then reimplanted into the patient. The patient was a one-year-old girl; her kidney was removed, carried to the radiotherapy suite, treated, and then carried back to the operating theater. In this case and a second case in which intraoperative radiotherapy was delivered in situ, adequate levels of kidney function were achieved as a result of the treatment. The two patients have survived without evidence of disease for 2 and 2.5 years. The technique of ex vivo irradiation may be applied to other forms of kidney cancer as well. Another example of cancer which might be treated successfully by this method is bilateral (that is, involving both kidneys) kidney cancer associated with von Hipple-Lindau syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Case studies, Nephroblastoma, Tumors in children, Pediatric tumors, Intraoperative radiotherapy

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Improvement in Hindbrain Herniation Demonstrated by Serial Fetal Magnetic Resonance Imaging Following Fetal Surgery for Myelomeningocele

Article Abstract:

Intrauterine surgery to correct fetal spinal defects appears to lower the rate of complications after the baby is born. Intrauterine surgery is done before the baby is born and requires small incisions in the mother's abdomen and uterus. Researchers performed intrauterine surgery on 10 fetuses with hindbrain herniation. This complication of a spinal defect occurs when the baby's brain protrudes through the opening in the bottom of the skull. Intrauterine surgery was successful in treating this complication in all the babies.

Fetus, Prognosis, Surgery, Fetal surgery, Myelomeningocele, Encephalocele, Meningomyelocele

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