Radiobiological Aspects of Pre-operative Irradiation

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Abstract
The various combinations of radiotherapy and surgery are discussed. Postoperative irradiation cannot influence distant metastases occurring at the time of operation. High dose pre -operative irradiation may delay operation and allow regrowth of surviving cells. Low-dose pre-operative irradiation permits immediate operation. Pre-operative irradiation will only be useful in clinical situations where there is a significant incidence of local recurrence and/or where a significant proportion of distant metastases occur at the time of operation. Cancer cells disseminated at operation, either locally or distantly, will be oxygenated and radiosensitive. Radiobiological evidence is presented on wound healing, distant metastases and local recurrence. A single dose of 500-1,000 rads should be delivered immediately before surgery.