[Intraoperative radiotherapy as multimodal therapy approach in epithelial tumors of the gastrointestinal system].
Surgery alone often fails to achieve local control in advanced gastrointestinal tumors. With multimodal therapy approaches, both local tumor control and long-term survival appear to be improved. Intraoperative radiation therapy (IORT) is an attempt to achieve higher doses of irradiation while dose-limiting structures are surgically displaced. It has been shown previously that both local tumor control and long-term survival are improved in patients undergoing surgery combined with IORT for both primary and recurrent rectal carcinoma. In advanced gastric carcinoma, IORT has achieved optimistic survival results in a few studies. In locally advanced pancreatic cancer, an apparent improvement in local control has been noted with IORT, but survival has not been prolonged because of a high incidence of both liver and peritoneal metastases. The data concerning IORT for esophageal carcinoma are not yet sufficient to allow judgement.
Brüwer
M
M
Klinik und Poliklinik für Allgemeine Chirurgie, Westfälische Wilhelms-Universität Münster. bruwer@uni-muenster.de
Hesselmann
S
S
Schäfer
U
U
Willich
N
N
Senninger
N
N
D000818:Animals; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004285:Dogs; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D013997:Time Factors