立体定向放射治疗（SRT）是脑转移瘤（BM）切除后切除腔照射的主要方法。使用 50 kV X 射线的术中放疗 (IORT) 是局部照射切除腔的另一种方法。我们已经报告了 2020 年之前接受治疗的首批 40 名 IORT 患者的结果。从那时起，由于患者的选择，IORT 已成为我们中心的主要腔道治疗方法。我们回顾性分析了所有接受 BM 切除和 IORT 的患者的结果2013 年至 2023 年 8 月在奥格斯堡大学医学中心 (UKA) 进行的研究。我们确定了 105 名患者，其中 117 处已切除的 BM 接受了 50 kV X 射线 IORT 治疗。切除的转移瘤的中位直径为 3.1 厘米（范围 1.3 - 7.0 厘米）。中位应用剂量为 20 Gy。所有患者均接受标准化随访 (FU)，包括三个月一次的脑部 MRI 检查。平均 FU 为 14 个月，患者的 MRI FU 中位生存期为 9 个月。所有接受治疗的患者的中位总生存期 (OS) 为 18.2 个月（估计 1 年 OS 为 57.7%）。观察到的切除腔局部控制（LC）率为90.5%（估计1年LC为84.2%）。远程大脑控制 (DC) 为 61.9%（估计 1 年 DC 为 47.9%）。只有 16.2% 的患者在进一步的病程中需要 WBI。观察到的放射性坏死率为 2.6%。经过 117 次手术后，IORT 似乎仍然是一种安全且有吸引力的神经外科切除 BM 后进行腔内 RT 的方法，具有低毒性和出色的 LC。© 2024。作者。

Stereotactic radiotherapy (SRT) is the predominant method for the irradiation of resection cavities after resection of brain metastases (BM). Intraoperative radiotherapy (IORT) with 50 kV x-rays is an alternative way to irradiate the resection cavity focally. We have already reported the outcome of our first 40 IORT patients treated until 2020. Since then, IORT has become the predominant cavity treatment in our center due to patients´ choice.We retrospectively analyzed the outcomes of all patients who underwent resection of BM and IORT between 2013 and August 2023 at Augsburg University Medical Center (UKA).We identified 105 patients with 117 resected BM treated with 50 kV x-ray IORT. Median diameter of the resected metastases was 3.1 cm (range 1.3 - 7.0 cm). Median applied dose was 20 Gy. All patients received standardized follow-up (FU) including three-monthly MRI of the brain. Mean FU was 14 months, with a median MRI FU for patients alive of nine months. Median overall survival (OS) of all treated patients was 18.2 months (estimated 1-year OS 57.7%). The observed local control (LC) rate of the resection cavity was 90.5% (estimated 1-year LC 84.2%). Distant brain control (DC) was 61.9% (estimated 1-year DC 47.9%). Only 16.2% of all patients needed WBI in the further course of disease. The observed radio necrosis rate was 2.6%.After 117 procedures IORT still appears to be a safe and appealing way to perform cavity RT after neurosurgical resection of BM with low toxicity and excellent LC.© 2024. The Author(s).