title: Intraoperative radiotherapy with electrons: fundamentals, results, and innovation.
abstract: OBJECTIVE
  To analyse the programme activity and clinical innovation and/or technology developed over a period of 17 years with regard to the introduction and the use of intraoperative radiotherapy (IORT) as a therapeutic component in a medical-surgical multidisciplinary cancer hospital.
  
  
  METHODS
  To standardise and record this procedure, the Radiation Oncology service has an institutional programme and protocols that must be completed by the different specialists involved. For 17 years, IORT procedures were recorded on a specific database that includes 23 variables with information recorded on institutional protocols. As part of the development and innovation activity, two technological tools were implemented (RADIANCE and MEDTING) in line with the standardisation of this modality in clinical practice.
  
  
  RESULTS
  During the 17 years studied, 1,004 patients were treated through 1,036 IORT procedures. The state of the disease at the time of IORT was 77% primary and 23% recurrent. The origin and distribution of cancers were 62% gastrointestinal, 18% sarcomas, 5% pancreatic, 2% paediatric, 3% breast, 7% less common locations, and 2% others. The research and development projects have generated a patent on virtual planning (RADIANCE) and proof of concept to explore as a professional social network (MEDTING). During 2012, there were 69 IORT procedures. There was defined treatment volume (target or target region) in all of them, and 43 were conducted by the virtual planning RADIANCE system. Eighteen have been registered on the platform MEDTING as clinical cases.
  
  
  CONCLUSIONS
  The IORT programme, developed in a university hospital with an academic tradition, and interdisciplinary surgical oncology, is a feasible care initiative, able to generate the necessary intense clinical activity for tending to the cancer patient. Moreover, it is a competitive source for research, development, and scientific innovation.
authors.affiliation: Department of Oncology, Gregorio Marañón General University Hospital, Madrid 28007, Spain ; School of Medicine, Complutense University, Madrid, Spain ; Institute of Research Investigation, Gregorio Marañón General University Hospital, Madrid 28007, Spain.
authors.forename: Fa
authors.initials: F
authors.lastname: Calvo
authors.forename: Cv
authors.initials: C
authors.lastname: Sole
authors.forename: R
authors.initials: R
authors.lastname: Herranz
authors.forename: M
authors.initials: M
authors.lastname: Lopez-Bote
authors.forename: J
authors.initials: J
authors.lastname: Pascau
authors.forename: A
authors.initials: A
authors.lastname: Santos
authors.forename: A
authors.initials: A
authors.lastname: Muñoz-Calero
authors.forename: C
authors.initials: C
authors.lastname: Ferrer
authors.forename: Jl
authors.initials: J
authors.lastname: Garcia-Sabrido
keywords: MEDTING; RADIANCE; disease-free survival; global survival; innovative activity; intraoperative radiotherapy; multidisciplinary; standardisation