Intraoperative Irradiation

The rationale for using intraoperative irradiation (IORT) is based on the realization that tolerable doses of eternal beam radiation are often insufficient to achieve control of locally advanced malignancies. In these instances, the IORT component of treatment becomes the optimal conformal technique of irradiation, since dose-limiting organs or structures can either be surgically displaced or protected by placement of lead shielding.

Rationale and Historical Perspective of Intraoperative Irradiation.- Radiobiology of Large Dose per Fraction Irradiation.- Intraoperative Electron-Beam Irradiation (IOERT): Physics and Techniques.- HDR-IORT: Physics and Techniques.- Electronic Brachytherapy/Low KV IORT: Physics and Techniques.- IORT with Electron Beam, High Dose Rate Brachytherapy or Low-KV/Electronic Brachytherapy: Methodological Comparisons.- Normal Tissue Tolerance to IOERT, EBRT or Both: Animal Studies and Clinical.- Central Nervous System Tumors.- Head and Neck Cancer.- Breast Cancer.- Lung Cancer.- Gastric Cancer.- Pancreas Cancer.- Bile Duct and Gallbladder Cancer.- Primary Colorectal Cancer.- Recurrent Colorectal Cancer.- Retroperitoneal Sarcomas.- Extremity and Trunk Soft Tissue Sarcomas.- Bone Sarcomas.- Gynecologic Malignancies.- Genitourinary Cancer.- Pediatric Malignancies.- Conclusions and Future Possibilities - IORT.