Intraoperative radiation therapy (IORT) is able to contribute to local tumor control in the context of surgical resections by means of delivery of high single doses of ionizing radiation. In the treatment of gastric cancer IORT is applied either as sole irradiation modality with doses of 15-30 Gy or as component of combined radiation treatment in combination with external beam radiation therapy (EBRT) with doses of 10-20 Gy. The analysis of available randomized and nonrandomized studies indicates that in the treatment of gastric cancer IORT is most likely utilizable for locally advanced stages. Apparently local tumor control may be improved in these situations. Due to reported results from some studies, it can be assumed that this can be also translated into improved survival rates. However, IORT for gastric cancer should currently be considered an experimental modality due to a small data base from published studies, different study designs, different operation modalities, stage classifications, and quality of documentation.
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