[Intraoperative electron irradiation (IORT) of urologic tumors. Initial results of a pilot study of local recurrences of renal cell cancers].

The efficacy of radiotherapy of renal cell carcinomas is limited by its side effects. To avoid gastrointestinal problems the dose must not exceed 45 Gy, but with corresponding protocols no effect has been seen in curative and adjuvant trials. A new three-step protocol combining surgery with intraoperative radiotherapy focussed on the tumor bed fading out the intestine (IORT) and external boost radiotherapy (40 Gy) was used in six patients with local recurrences after tumor nephrectomy. No increase in morbidity was induced by IORT. One year after radiotherapy no recurrences have been seen in the radiation field. We recommend this protocol for patients with solitary local recurrences and for tumors of clinical stage T3 and T4.