脑转移瘤和原发性脑肿瘤的术中放射治疗（IORT）已成为一种辅助放射治疗方法，它使得治疗可以在单次手术麻醉中完成。然而，关于IORT可能对围手术期和长期癫痫风险的影响的数据很少。本文通过回顾性分析接受肿瘤切除期间接受IORT治疗的患者的数据，包括围手术期抗癫痫药物和麻醉剂的使用。术中采用脑电图（ECoG）进行脑神经监测，记录IORT之前、中间和之后的电活动，并分析是否存在癫痫或基线变化的证据。使用Kaplan-Meier估计对手术后的癫痫发生率与总生存率进行分析。 共有24位连续接受IORT治疗的患者被纳入分析，其中18位（75%）患者诊断为脑转移瘤，而6位（25%）患者为新诊断的胶质母细胞瘤。平均和中位生存时间分别为487天和372天。术后3位患者出现临床癫痫发作，其中2位脑转移瘤患者在9个月内出现，1位胶质母细胞瘤患者在14个月后出现。IORT时间占总麻醉时间的9.5%。对5位患者（4位脑转移瘤，1位胶质母细胞瘤）进行了ECoG记录，平均记录持续时间占总麻醉时间的13％，没有发现高频振荡或癫痫活动的证据。 IORT是在术中切除脑肿瘤的情况下进行明确放射治疗的选择，而不增加围手术期和长期癫痫风险。IORT传递放射治疗期间的ECoG数据未能显示任何电生理学变化作为对电离辐射的反应。 © 2023. 本文作者通过独家许可，授权给Springer Science+Business Media, LLC，属于Springer Nature的一部分。

Intra-operative radiotherapy (IORT) for brain metastases (BMs) and primary brain tumors has emerged as an adjuvant radiation modality that allows for consolidation of care into a single anesthetic episode with surgical resection. Yet, there is a paucity of data regarding the impact that IORT may have on peri-operative and long-term seizure risk.A retrospective analysis of patients receiving IORT during tumor resection was performed via registry including data regarding peri-operative anti-seizure medications and anesthetic agents. Intra-operative neuromonitoring was performed using electrocorticography (ECoG) captured before-, during-, and after-IORT then analyzed for evidence of seizure or significant baseline changes. Kaplan-Meir estimations were used for overall survival analysis relative to documented clinical seizure incidence post-IORT.Of the 24 consecutive patients treated with IORT during tumor resection included, 18 (75%) patients were diagnosed with BMs while 6 (25%) had newly-diagnosed glioblastoma. Mean and median survival times were 487 and 372 days, respectively. Clinical seizures occurred in 3 patients post-IORT, 2 BMs patients within 9 months and 1 glioblastoma patient at 14 months. IORT time represented 9.5% of anesthetic time. ECoG recordings were available for 5 patients (4 BMs; 1 glioblastoma), with mean recording durations of 13% of the total anesthetic time and no evidence of high-frequency oscillations or seizure activity.IORT is an option for delivery of definitive radiation in surgically resected brain tumors without increasing the peri-operative or long-term risk of seizure. ECoG data during the delivery of radiation fail to demonstrate any electrophysiological changes in response to ionizing radiation.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.