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Updated: Aug 5, 2026
Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition
Published on: March 11, 2021
A Comprehensive Meta-Analysis and Review of Intraoperative Radiotherapy in Colorectal Cancer: Examining Radiation
Chuhan Guo1, Shuyang Liu1, Liangliang Li1
1Department of Gastrointestinal, Colorectal and Anal Surgery, China-Japan Friendship Hospital, Jilin University, Changchun, China.
Background:
The effect of device type and radiation dose in intraoperative radiotherapy (IORT) for colorectal cancer is not well established. To explore this, we reviewed studies reporting postoperative complications, disease-free survival, local control, and long-term survival in patients treated with non-implantable IORT techniques-IOERT, KV-IORT, and HDR-IORT. Most of the available evidence relates to IOERT or HDR-IORT, which is usually delivered at 15 Gy (range 10-20 Gy). The median dose for KV-IORT is typically 12.5 Gy.
Methods:
We conducted a systematic search of literature through November 2023 to identify studies that compared non-implantable IORT with surgery alone or other treatment approaches (PROSPERO registration: CRD42024508349). Twenty-five studies involving 2664 patients met the inclusion criteria.
Results:
Patients treated with non-implantable IORT tended to achieve better 5-year overall survival than those managed without it, with IOERT contributing most clearly to this difference. A similar pattern emerged for long-term local control, where IORT showed an advantage [OR 2.08, 95% CI 1.19-3.64]; studies of IOERT reported an even stronger effect [OR 2.23, 95% CI 1.07-4.65]. Importantly, the use of IORT did not correspond with higher rates of key postoperative complications, including anastomotic leakage, pelvic collections, wound problems, or bowel obstruction.
Conclusions:
Our results suggest that IORT may improve survival and local control for patients with advanced or recurrent colorectal cancer, despite the heterogeneity among studies. Device-related and dose-related factors may also play a role and merit closer study, thus warranting closer examination in future work.
