Intraoperative Radiotherapy in Carcinoma of the Stomach and Pancreas

Abstract

Intraoperative radiotherapy (IORT) involves delivering large single doses of radiation during surgery directly to operatively exposed tumors or to resected tumor beds at risk for residual malignancy. The rationale for the use of IORT is to maximize the dose of radiation delivered to neoplastic tissues and to minimize the radiation dose to normal tissues which may surround the neoplastic area. Normal tissues may be excluded from the irradiated area by operative displacement from the beam path or by protection with shielding materials positioned at surgery. Manipulations to protect normal tissues at the time of IORT may permit high tumoricidal doses of radiation to abdominal malignancies which otherwise might not be possible by conventional radiotherapy techniques. External-beam radiotherapy (EBRT) delivered in standard fashion may result in radiation enteritis or other toxicity when given in high doses to large abdominal fields.