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To establish the primary determinants of operative radiation use during fixation of proximal femur fractures.
Intra Operative Radiation Therapy (IORT) is a technique based on delivery of a high dose of ionising radiation to the cancer tissue, after tumour ablation, during surgery, while reducing the exposure of normal surrounding tissue.
Three large RCTs remained: the Post Operative Radiation Therapy in Endometrial Carcinoma-1 study from Creutzberg (PORTEC-1), the Gynecologic Oncology Group 99 study from Keys (GOG 99) and A Study in the Treatment of Endometrial Cancer/EN.5 study from the ASTEC/EN.5 writing committee 2008 (ASTEC/EN.5) (Creutzberg et al, 2000; Keys et al, 2004; the ASTEC/EN.5 writing committee 2008, 2009).
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Intra-operative radiation is performed during surgery.
The standard adjuvant therapies are post-operative radiation therapy or post-operative chemoradiotherapy.
Patients received post-operative radiation therapy depending on the surgical pathological risk factors.
The technique, called intra-operative radiation, is suitable only for patients who have caught their cancer early.
Fluoroscopy is used extensively during locked intramedullary nailing, which increases the intra-operative radiation exposure [5, 24].
Previous estimates have suggested a shift to intra-operative radiation could free up resources and save the NHS £15m a year.
In one study, complication occurrence because of delayed bone healing on the fracture line after bone graft in pre-operative radiation therapy patients was reported.
Another study reported an increased bone resorption rate (27.9 %) on pre-operative radiation therapy patients after non-vascularized iliac bone graft [15, 16].
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