Radiotherapy can be delivered to a tumour volume under direct visual localization during an open operation within a designated radiotherapy suite. A large single dose is delivered at the one procedure. The potential advantage of a targeted boost (given in addition to external-beam fractionated therapy) is balanced by the theoretical limitations of the biological effects of the single large dose.
A few centers in the world currently use this technique and some results suggest a survival benefit. There remains controversy over the difficult logistics of delivery and further larger clinical studies are needed to define and quantify any benefit.
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