Intraoperative Radiation Therapy (IORT)

Intraoperative radiation therapy (IORT) is a type of radiation therapy that is administered during surgery. It involves the delivery of a high dose of radiation to a tumor or tumor bed while the patient is still under anesthesia in the operating room.

History and Development

IORT has been used for several decades, with the first reported use dating back to the 1950s. Initially, it was used to treat various types of cancer, including breast, lung, and brain tumors. Over the years, IORT has undergone significant advancements in technology, leading to improved treatment outcomes and reduced side effects.

Procedure

The IORT procedure typically involves the following steps:

• The patient is taken to the operating room and anesthesia is administered.
• The surgeon removes the tumor or performs a surgical procedure to expose the tumor bed.
• A radiation oncologist and a physicist work together to position the IORT device, which delivers a high dose of radiation to the tumor site.
• The radiation is delivered for a short period, usually several minutes.
• After the radiation is delivered, the surgeon closes the incision and the patient is taken to the recovery room.

Types of IORT

There are two main types of IORT:

• Electron beam IORT (eIORT): This type uses electrons to deliver radiation to the tumor site. eIORT is commonly used for breast, lung, and colorectal cancers.
• Low-energy X-ray IORT (LIXT): This type uses low-energy X-rays to deliver radiation to the tumor site. LIXT is often used for breast cancer and other superficial tumors.

Benefits

IORT has several benefits, including:

• Precise delivery of radiation: IORT allows for precise delivery of radiation to the tumor site, reducing damage to surrounding healthy tissues.
• Reduced treatment time: IORT can reduce the overall treatment time, as it is often used in conjunction with surgery.
• Improved local control: IORT has been shown to improve local control of tumors, reducing the risk of recurrence.

Risks and Side Effects

IORT can cause side effects, including:

• Wound complications: IORT can increase the risk of wound complications, such as infection or delayed healing.
• Nerve damage: IORT can cause nerve damage, leading to numbness, tingling, or pain.
• Bone fractures: IORT can weaken bones, increasing the risk of fractures.

Indications and Contraindications

IORT is commonly used for various types of cancer, including:

• Breast cancer
• Lung cancer
• Colorectal cancer
• Sarcomas

Contraindications for IORT include:

• Pregnancy or breastfeeding
• Previous radiation therapy to the same area
• Certain medical conditions, such as connective tissue disorders