Felipe A. Calvo – författare

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.

International radiation oncologists, surgeons, and scientists comprehensively review the techniques, indications, and results of using intraoperative electrons (IOERT) and high-dose rate brachytherapy (HDR-IORT). State-of-the-art topics range from methods and techniques of treatment and issues of normal tissue/organ tolerance to IORT, to techniques and results by disease-site, as well as future possibilities. The disease-site chapters cover every body part for which the potential merit of IORT has been demonstrated, with disease-specific treatment factors presented by a radiation oncologist and a surgeon. The diseases range from GI cancers to CNS and breast malignancies. International in authorship and comprehensive in scope, Intraoperative Irradiation: Techniques and Results offers a cutting-edge resource and reference for surgeons, radiation oncologists, physicists, anesthesiologists, medical oncologists, and all others involved in providing IORT and HDR-IORT procedures and cancer care today.

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.This fully revised and expanded second edition is of interest to those with intraoperative electron (IOERT) capabilities, high-dose-rate brachytherapy (HDR-IORT) capabilities, or both. Techniques, indications, and results are discussed by disease site. Each chapter is dual authored by a radiation oncologist and a surgeon, giving a balanced presentation of clinical scenarios. Issues of basic science and physics are also covered, and a notable chapter on normal tissue tolerance is included.Intraoperative Irradiation: Techniques and Results, Second Edition is a superb compilation, providing essential cutting-edge knowledge. It is a foundation for physicians as IORT develops and becomes more widely available.

The development of the capacity to use electron beams at various energies stimulated the development of the new technology of intraoperative radiation therapy. The visual­ ization of the primary tumor, definition of the site to be irradiated, and knowledge of the size of tumor to be irradiated, including adequate margins for microscopic extent along with debulking of the tumor, have allowed intraoperative radiation therapy to be pur­ sued in a wide variety of disease processes. Not only is it possible to treat tumors that were highly resistant, but it is also possible to specifically localize the tumor with a mar­ gin adequate to encompass potential microscopic extensions and to choose the appro­ priate electron beam energy to treat the potential residual tumor and spare the adjacent normal structures. It is, furthermore, possible to treat patients with unresectable tumors. Central to this entire development is the fact that normal structures can be removed from the field of treatment. In the beginning, the emphasis was on single fractions of electron beam radiation without subsequent supplementation by external photon beam radiation therapy. How­ ever, more recently it has become necessary to use not only a single electron beam frac­ tion during the course of the operation, but to supplement it with external beam treat­ ment. The encouraging results obtained with intraoperative radiation therapy have led to clinical trials at a large number of institutions throughout the world.