Abstract
Low-energy x-rays are increasingly being used for intraoperative radiotherapy within and outside controlled trials. The Photon Radiosurgery System (PRS) is a miniaturized x-ray machine producing an essentially isotropic field of 30–50 kV x-rays. This device delivers a highly localized dose distribution and has been used for interstitial tumour irradiation and tumour-bed irradiation in different sites, including brain, abdomen and breast. However, prediction of the biological effect of such treatments is not straightforward because the increased relative biological effectiveness (RBE) of low-energy photons is influenced by the strong variation of dose associated with the non-uniform field and by repair during irradiation which may take up to 0.5–1 hour.
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