[Intraoperative radiotherapy in abdominal-pelvic cancer surgery].

Intraoperative radiotherapy consists in the irradiation of the affected area, exposed using anesthesiological and laparotomic procedures, following the removal of a neoplasia using palliative or macroscopically radical surgical. This increases local tumour control and augments the selectivity of treatment between healthy and neoplastic tissues, thus obtaining a marked improvement in survival or palliation. The authors analyse the data reported in international literature regarding the possible use of intraoperative radiotherapy in patients undergoing abdomino-pelvic oncological surgery. The aim of the study was to evaluate this method for use in selected and combined treatment in which surgery represents an obligatory step. Studies were carried out in a few highly specialised centres given that special technical, logistic and professional skills were required. The populations studied were often very small with a marked prevalence of feasibility studies compared to random studies. In spite of this intraoperative radiotherapy is undoubtedly indicated in locally advanced gastric, rectal and vesical neoplasia, it represents a valid palliative solution in pancreatic neoplasia and in pelvic recidivation, and an effective alternative solution to mutilating surgery in the initial stages of vesical cancer. Positive results are obtained in prostate and uterine cancer, but they are reported by non-conclusive studies. Toxicity is acceptable and non-limiting within a given range of doses and irradiated volume. The "repercussion" in terms of knowledge, experience, scientific integration between oncological surgeons and radiotherapists is basic, with a marked improved in the management of cancer treatment.