SUMMARY

Introduction: Radiotherapy is one of the pillars of cancer treatment, with growing interest in techniques that irradiate only the area at greatest risk of local recidivation. In recent decades, there have been important advances in intraoperative radiation techniques, both as part of combined treatment of different types of tumours, locally advanced and recurrent stages of colorectal tumours in particular, and in association with conventional radiotherapy. Such techniques include intraoperative radiotherapy (IORT), which seeks to enhance local control of the disease by administering a single dose of ionising radiation directly to the tumour in the surgical cavity, thereby enabling dosages to be raised without increasing related toxicity, and thus constituting a complement to current treatment.

Objectives: To assess the effectiveness of IORT as adjuvant treatment for the current standard treatment of colorectal cancer, in terms of recurrence, survival, cosmetic results and impact on quality of life; and to ascertain the safety of this procedure, in terms of acute and late toxicity.

Methods: A search of the scientific literature was made from January 2000 to August 2013 in the main biomedical databases, i.e., Centre for Reviews and Dissemination (Health Technology Assessment, Database of Abstracts of Reviews of Effectiveness, NHS Economic Evaluation Database), Cochrane Plus Library, Medline, Embase, ISI Web of Knowledge, CSIC-Índice Médico Español, Clinical Trials Registry, WHO International Clinical Trials Registry Platform and Current Controlled Trials. This process was completed by a general search of quality Internet web pages to locate grey literature. Two independent reviewers selected the papers in accordance with pre-established inclusion and exclusion criteria, excluding, among others, studies that assessed internal sources of radiation or brachytherapy (HDR-IORT) and studies with fewer than 100 patients, with any disagreements being resolved by consensus. A manual review was also performed of the bibliographic references cited in the papers selected. The data were then extracted and summarised in evidence tables. Study quality was assessed using the SIGN scale.

Result, discussion and conclusion: See pdf below.