Intraoperative radiation therapy (IORT) for gynecologic malignancies

•Intraoperative radiaton therapy results in high rates of local control.•Even with IORT, patients with negative margins have better outcomes.•Neuropathy is the most common side effect associated with IORT.

Every year almost 95,000 women are diagnosed with a gynecologic malignancy and over 28,000 women will succumb to their disease. For patients with an isolated locoregional recurrence after primary therapy, surgical resection may sometimes provide a chance of cure. To optimize the chance of local control intraoperative radiation therapy (IORT) has been used. The combination of salvage surgery and IORT has resulted in reasonable control in the IORT field. The addition of external beam radiation to limited volumes seems to result in improved disease control over surgery and IORT alone. Side effects are closely related to radical surgery, although neuropathy is seen more frequently after IORT; especially if doses of > 20 Gy are prescribed. Margin status remains critical, even with IORT.