IOERT has a long history of clinical applications, with promising results, in the management of solid tumors (e.g., pancreatic cancer, locally advanced and recurrent rectal cancer, breast tumors, sarcomas, and selected gynaecologic and genitourinary malignancies, neuroblastomas and brain tumors. In virtually every tumor site,<unk>  IORT improves local control, reducing the need for additional surgeries or interventions. The following is a list of disease sites currently treated by IOERT: Breast cancer Since 1975, breast cancer rates have declined in the U.S., largely due to mammograms and the use of adjuvant treatments such as radiotherapy. Local recurrence rates are greatly reduced by postoperative radiotherapy, which translates into improved survival: Preventing four local recurrences can prevent one breast cancer death. In one of the largest published studies so far called (ELIOT), researchers found that after treating 574 patients with full-dose IOERT with 21 Gy, at a median follow-up of 20 months, there was an in-breast tumor recurrence rate of only 1.05%. Other studies show that IOERT provides acceptable results when treating breast cancer in low-risk patients. More research is needed for defining the optimal dose of IOERT, alone or in combination with EBRT, and for determining when it may be appropriate to use it as part of the treatment for higher risk patients. Colorectal cancer Over the past 30 years, treatment of locally advanced colorectal cancer has evolved, particularly in the area of local control – stopping the spread of cancer from the tumor site. IOERT shows promising results. When combined with preoperative external beam irradiation plus chemotherapy and maximal surgical resection, it may be a successful component in the treatment of high-risk patients with locally advanced primary or locally recurrent cancers. Gynecological cancer Studies suggest that<unk>  IORT may play an important and useful role in the treatment of patients with locally advanced and recurrent gynecologic cancers, especially for patients with locally recurrent cancer after treatment for their primary lesion. Further research into<unk>  doses and how to best combine IOERT with other interventions will help to define the sequencing of treatment and the patients who would most benefit from receiving<unk>  IORT, as part of the multimodality treatment of this disease. Head and neck cancer Head and neck cancers are often difficult to treat and have a high rate of recurrence or metastasis. IOERT is an effective means of treating locally advanced or recurrent head and neck cancers. Furthermore, research shows that a boost given by IOERT reduces the ability for surviving tumor cells to replicate, creating extra time for healing of the surgical wound before EBRT is administered. Pancreatic cancer In the U.S., pancreatic cancer is the fourth leading cause of cancer death, even though there has been a slight improvement in mortality rates in recent years. Although the optimal treatment plan remains debated, a combination of radiotherapy and chemotherapy is favored in the U.S. As part of a multimodality treatment, IOERT appears to reduce local recurrence when combined with EBRT, chemoradiation, and surgical resection. Soft tissue sarcomas Soft tissue sarcomas can be effectively treated by<unk>  IORT, which appears to be gaining acceptance as the current practice for sarcomas in combination with EBRT (preferably preoperative) and maximal resection. Used together, IOERT and EBRT appear to be improving local control, and this method is being refined so that it can effectively be used in combination with other interventions if indicated. In studies regarding the delivery of therapeutic<unk>  in the limb-sparing approach to extremity soft tissue sarcomas,<unk>  IORT has been called ‘precision radiotherapy’ by some, because the treating physician has direct visualization of the tumor or surgical cavity and can manually exclude normal tissue from the field.
Intraoperative electron radiation therapy
Intraoperative radiation therapy
Targeted intra-operative radiotherapy
Adjuvant therapy
Neoadjuvant therapy
Prostate brachytherapy
Selective internal radiation therapy
Prostate steam treatment