[Late effects of intraoperative radiotherapy]

Several experimental studies on animals have yielded to the tolerance single doses for different critical organs. Anatomical alterations are located essentially in the intima of the arteries with oedema, histio-lymphoplasmocytoïd infiltration in a first time leading to arterial obstructions and necrosis after the 6th week. These radiation injuries are related to the IORT dose, the target volume and the time interval between the IORT treatment and the apparition of the side-effects. Moreover, some radiation induced sarcomas have been observed in animals after the 5th year which suggest that the follow-up period after IORT must be prolonged enough to appreciate the exact complications rate of IORT. If we exclude the usual post-operative complications, the complications observed in human IORT treatments may be either early side effects on small bowel, esophagus or late effects: peripheral neuropathies, osseous complications, and microvascular obstructions. A more precise clinical description and an improved knowledge of the relationships with different treatment characteristics should allow us to prevent more efficiently the IORT complications.