Intraoperative Radiotherapy in Lung Cancer: Methodology (Electrons or Brachytherapy), Clinical Experiences, and Long-Term Institutional Results

Intraoperative radiotherapy is a feasible technical modality to improve precision and dose escalation in high-local-risk lung cancer patients. Methodology is described regarding the use of high-energy electron beams or brachytherapy. Results of normal tissue tolerance in experimental animal models and in clinical experiences are analyzed in detail. Characteristics of clinical experiences using IORT electrons or brachytherapy are reported and clinical outcome results are discussed. Ten IORT brachytherapy and six electron-based publications are identified proving the adaptability of IORT to the clinical-therapeutic scenario of lung cancer, its feasibility, and the promotion of high local control rates in the context of dose escalation trials. The context of therapeutic potential of these high-precision irradiation techniques evolves with the advances in imaging, staging techniques, molecular biology, and improved systemic therapy (Calvo, Radiat Oncol 12:36–39, 2017).