{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:19:03Z","timestamp":1787663943713,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The effect of device type and radiation dose in intraoperative radiotherapy (IORT) for colorectal cancer is not well established. To explore this, we reviewed studies reporting postoperative complications, disease\u2010free survival, local control, and long\u2010term survival in patients treated with non\u2010implantable IORT techniques\u2014IOERT, KV\u2010IORT, and HDR\u2010IORT. Most of the available evidence relates to IOERT or HDR\u2010IORT, which is usually delivered at 15\u2009Gy (range 10\u201320\u2009Gy). The median dose for KV\u2010IORT is typically 12.5\u2009Gy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic search of literature through November 2023 to identify studies that compared non\u2010implantable IORT with surgery alone or other treatment approaches (PROSPERO registration: CRD42024508349). Twenty\u2010five studies involving 2664 patients met the inclusion criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients treated with non\u2010implantable IORT tended to achieve better 5\u2010year overall survival than those managed without it, with IOERT contributing most clearly to this difference. A similar pattern emerged for long\u2010term local control, where IORT showed an advantage [OR 2.08, 95% CI 1.19\u20133.64]; studies of IOERT reported an even stronger effect [OR 2.23, 95% CI 1.07\u20134.65]. Importantly, the use of IORT did not correspond with higher rates of key postoperative complications, including anastomotic leakage, pelvic collections, wound problems, or bowel obstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results suggest that IORT may improve survival and local control for patients with advanced or recurrent colorectal cancer, despite the heterogeneity among studies. Device\u2010related and dose\u2010related factors may also play a role and merit closer study, thus warranting closer examination in future work.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72137","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:15:31Z","timestamp":1785302131000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Comprehensive Meta\u2010Analysis and Review of Intraoperative Radiotherapy in Colorectal Cancer: Examining Radiation Dosage, Long\u2010Term Prognosis, and Treatment\u2010Related Complications"],"prefix":"10.1002","volume":"15","author":[{"given":"Chuhan","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal, Colorectal and Anal Surgery China\u2010Japan Friendship Hospital, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Colorectal and Anal Surgery China\u2010Japan Friendship Hospital, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangliang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Colorectal and Anal Surgery China\u2010Japan Friendship Hospital, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Colorectal and Anal Surgery China\u2010Japan Friendship Hospital, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongji","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Colorectal and Anal Surgery China\u2010Japan Friendship Hospital, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongqiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Colorectal and Anal Surgery China\u2010Japan Friendship Hospital, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2847-614X","authenticated-orcid":false,"given":"Tong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Colorectal and Anal Surgery China\u2010Japan Friendship Hospital, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5299-1588","authenticated-orcid":false,"given":"Fujian","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Colorectal and Anal Surgery China\u2010Japan Friendship Hospital, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61649-9"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.7027"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66545-2"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30024-3"},{"key":"e_1_2_11_6_1","first-page":"98","article-title":"ESTRO\/ACROP IORT Recommendations for Intraoperative Radiation Therapy in Locally Recurrent Rectal Cancer (Vol 24C, Pg 41, 2020)","volume":"27","author":"Calvo F. 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