Abstract

Intraoperative radiotherapy (IORT) is a new modality for cancer treatment. IORT depends on direct visualisation of the tumour and administration radiotherapy to the involved area. Single high dose radiation is applied to tumour bed, residual tumour tissue or limited regional lymph node. IORT treatment requires a multidisciplinary approach by the surgeon, anesthesiologist, radiotherapist, radiologist, pathologist and surgical support team. Since November 2012, IORT treatment with mobile Mobetron (intraoperatively incorporated Santa Clara) is performed in our hospital. These patients are selected according to the IORT application criteria and previously are evaluated as multidisciplinary in the collected IORT council. The anesthesiologist is the member of this council and takes place from the decision process to all stage of the IORT treatment. The preoperative preparation, isolation, position during irradiation and monitorization of the patient who will receive high doses of radiation therapy in the operating room are crucial for the anesthesia. Anesthesiologists should ensure that IORT patients are operated under optimal conditions. During the operation, precautions is taken to ensure that vessel routes, cables, and respiratory circuits remain constant during patient position changes. When ventilation is stopped during irradiation, patients' respiratory parameters are protected. Since patients are isolated under anesthesia in operating room, it is important to follow the monitor carefully from the control room. The anesthesiologist is responsible for safety of the patient who has to be isolated for IORT applications and to ensure safe anesthesia; from the preparation of the patient until comfortable postoperative period. In this review we aimed our experinces of anesthesia in 111 cancer patients who were given IORT theraphy since november 2012 until today.