Cifarelli CP, Vargo JA, Hack J, et al. - Researchers assessed local disease control and dosimetric parameters associated with intracranial intraoperative radiotherapy (IORT) administered immediately after surgical resection of brain metastases (BMs). This study included 54 patients with a median age of 64 years who received IORT, with non-small cell lung cancer (40%) being the most common primary diagnosis and frontal lobe (38%) being the most common location. Participants were observed over a median duration of 7.2 months. One-year local control (LC) rate was estimated to be 88% with radiation necrosis (RN) present in 4 patients (7%). The non-target V10 and V12 volumes were 24.75cm³ and 14.76cm³, respectively, as revealed by the dosimetric comparison of a single IORT case, for the stereotactic radiosurgery (SRS) treatment plan of 16Gy to the margin. Findings revealed the safety as well as the efficacy of IORT as a means of delivering adjuvant radiation to the BM resection cavities. It offered a high rate of LC, low incidence of RN, increased homogeneity of target dose and ability to escalate dose beyond traditional SRS plans.