title: Intraoperative radiation therapy and Mohs micrographic surgery on an outpatient basis.
abstract: BACKGROUND
  Intraoperative radiation therapy (IORT) is used to deliver therapeutic doses of radiation to a surgically exposed tumor or tumor bed while minimizing the radiation dose to adjacent normal tissue. It is traditionally given with the patient under general anesthesia.
  
  
  OBJECTIVE
  To report a case of a recurrent squamous cell carcinoma treated with Mohs micrographic surgery and IORT on an outpatient basis.
  
  
  METHODS
  Mohs surgery was used to clear the tumor in all fields except for the area of the spinal accessory nerve, which was preserved. IORT was then delivered to the area of nerve with possible residual tumor.
  
  
  RESULTS
  The patient remains clinically tumor free 42 months posttreatment. There were no complications.
  
  
  CONCLUSIONS
  Intraoperative radiation therapy can be effectively used in the outpatient setting as an adjunctive therapy after Mohs micrographic surgery.
authors.affiliation: Department of Otolaryngology, Arthur G. James Cancer Hospital and Research Institute, Ohio State University, Columbus 43210, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Siegle
authors.forename: S
authors.initials: S
authors.lastname: Houser
authors.forename: S
authors.initials: S
authors.lastname: Nag
authors.forename: B K
authors.initials: BK
authors.lastname: Summers
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods; D013524:Surgical Flaps