Introduction: We studied the role of intraoperative radiotherapy (IORT) in preventing local recurrence, in cases of malignant soft-tissue tumors and desmoids.

Methods: Ten patients (age 5814yrs) with recurrent soft-tissue tumors, grade IIA/IIB, 3 – 7cm long, involving thigh, calf, forearm and thenar were widely excised and irradiated into the operating room by a specially designed electron linear accelerator. The field was irradiated with electons (10 – 15Gy, 3 – 7MeV) with a circular-cut applicator (Φ40 – Φ80).

Results: Common local post-irradiation complications such as neuropathy, vascular damage, fibrosis, wound problems or bone necrosis, were not noticed. At follow-up (24 – 38months) four patients (40%) remain disease free. Six (60%) had recurrence shortly after operation, two developed lung metastases.

Discussion and Conclusion: IORT permits the application of high dose radiation during surgery. Manual displacement of healthy tissues situated between the radiation beam and the target reduces its toxicity. Direct vision assures maximum precision in the administration of radiation. It eliminates any remaining tumor, intensifies radiotherapy‘s antitumoral effect as it permits the administration of high doses of radiation otherwise not approachable. External irradiation is applied after wound closure. IORT reduces the lapse time between surgical exploration and irradiation during which residual satellite cellular clones can grow. We did wide resection and IORT in aggressive, recurrent tumors, as an alternative to amputation. Considering the advantages of IORT, we conclude that modification of the dose and irradiated area may further improve the results and reduce unpleasant therapies.