The use of radiotherapy during surgery in the treatment of brain tumors (systematic review)

Brain tumors are less common than other cancers; however, they are associated with serious symptoms and poor prognosis.Most brain tumors are treated through surgery combined with radiotherapy and chemotherapy. These therapeutic methods are associated with neurotoxic complications and decrease the quality of life of patients. Intraoperative Radiation Therapy (IORT) is an innovative combination of surgery and radiotherapy, in which the direct radiation to the tumor bed during tumor resection is done. IORT is a new therapeutic method; therefore, the present 5-year systematic review was conducted to introduce IORT and its advantages and disadvantages in the treatment of brain tumors.

In this systematic review study, PubMed, Google Scholar, Cochrane Database, and Trip Medical Database, and CINAHL Database were searched for the published articles over a five year (2014 to 2019) using the keywords, including IORT and Brain Tumor and Intraoperative Radiation Therapy AND Brain Tumor. Articles were checked with the PRISMA checklist. Finally, 50 articles were included in the study.

IORT method has been used in the treatment of brain tumors, especially glioblastoma. The effective radiation dose to treat brain tumors is 15-40 Gy. However, the appropriate technique and patient selection is the key to success with IORT. It is also used to treat recurrent pelvic, head and neck, and colorectal cancers, but it has shown more effective to treat brain tumors.

IORT is an effective treatment for brain tumors, especially glioblastoma. It is more effective than external radiation therapy, due to the reduced tumor recurrence, maximal protection of healthy tissue, shorter duration of treatment, and cost-effectiveness.