Intraoperative radiotherapy: back to the future?

Since the first Japanese publications, intraoperative radiotherapy (I.O.R.T.) has been used with electrons delivered with homogeneous techniques in miscellaneous indications. The main goal was to increase the total dose in a limited volume leading to an optimized therapeutic ratio between the tumor and the healthy tissue. The main indications are not only recurrences of digestive and gynecological tumors but also retroperitoneal sarcomas. Recently, the development of the concept of partial breast irradiation reinforces the use of such a technique in the strategy of breast-conserving surgery for small tumors in the elderly. I.O.R.T. was evaluated either as boost or as an exclusive treatment delivering one fraction during the surgical procedure. (author)