Clinical Applications

Radiation Therapy administered directly to the anatomical area that contained the neoplasia, a possible location of sub-clinical disease or macroscopic residue, has marked an improvement in the effectiveness and safety of the treatment associated with surgery and, in more serious cases, with chemotherapy.

The possibility to also deliver radiation therapy at the same time as the surgery, due to the production of mobile electron accelerators, has enabled to overcome the limitations of conventional treatment (moving the patient from the operating room to the radiation therapy department, exposure to risks during the transfer, extended anaesthesia, etc.).

 The first scope of application was in breast cancer, at that time the big innovation was the boost radiation or in a single dose and at the same time as the resection in the operating room (ELIOT).

The document issued by the Associazione Italiana di Radioterapia Oncologica (IORT working group) and the literature data which emerged from the International Conference of the International Society of Intra-Operative Radiotherapy (ISIORT) recommend the use of IORT for the treatment the following diseases:

• Breast cancer
• Locally advanced rectal cancer
• Pancreatic cancer
• Stomach cancer
• Soft tissue sarcoma
• Prostate cancer

For other tumours, such as gynaecological, lung and oesophagus, the data are still insufficient and scarce, despite a reported decrease of local recurrences following IORT treatment.