[Intraoperative radiotherapy for brain metastases: an experience in Argentina]

Postoperative stereotactic radiosurgery or hypofractionated radiotherapy represent the standard local adjuvant treatment modality after surgical resection of single brain metastases. Intraoperative radiotherapy (IORT) offers the advantage of delivering an ablative dose during the same surgical procedure, avoiding delays and allowing early reinitiation of systemic therapies. This work describes our first national experience with IORT, with preliminary results from a case series. The series included three male patients diagnosed with a single supratentorial brain metastasis (two right frontal and one left temporal), with surgical indication due to mass effect or diagnostic need (pathology analysis) and who met criteria for IORT. The primary tumors were colorectal carcinoma in one case and non-small cell lung cancer in two cases. In our experience, we documented no cases of local recurrence at follow-up, nor evidence of radionecrosis or leptomeningeal dissemination, the patients were alive at the close of the analysis and without central nervous system disease progression. IORT resulted feasible and safe, with encouraging preliminary results, which, with future studies, could consolidate it as an alternative to the traditional regimen of surgery plus postoperative radiotherapy.