Intraoperative radiation therapy (IORT) is an electronic form of targeted radiation treatment and it was developed in London in 1998. This advanced technology delivers a concentrated dose of radiation therapy to a tumor bed during surgery. Breast surgeons work together with radiation oncologists in the operating room to deliver a single dose of radiation and simultaneously remove the lump while the patient is under anesthesia.
The IORT Procedure:
Step 1: The surgeon removes the tumor leaving a cavity where the tumor was located.
Step 2: The radiation oncologist places a catheter-like device inside that cavity.
Step 3: Once inside, the tip of the device inflates into a flexible balloon-shaped applicator, which contains a miniaturized x-ray source by Xoft System. Then the radiologists energize the x-ray source to deliver a full course of radiation directly to the tumor bed.
Step4: Radiation is given to the surrounding tissue for 20–30 minutes.
Step 5: After the radiation has been delivered, the balloon is deflated, removed, and the surgeon closes the cavity.
Advantages of IROT:
– Reducing treatments times: Standard radiation therapy involves five days of treatment, for a total five or six weeks for some patients. But IORT helps patients finish treatment and get back to their lives quicker as it reduces the need for additional radiation therapy.
– Spares healthy tissues and organs: During IORT, a precise radiation dose is applied while shielding healthy tissues or structures, such as the skin, that could be damaged using other techniques. This allows a higher radiation dose to be delivered to the tumor bed while sparing normal surrounding tissues. Critical organs within the radiation field, such as the lungs or heart, can also be protected.
– Maximum effect: The concentrated dose of radiation that IORT delivers to a tumor site after a tumor has been removed is helpful for destroying the microscopic tumor cells that may be left behind. The tumor site is typically at high risk for recurrence and traditional radiation therapy requires a recovery period after surgery, which leaves microscopic disease in the body for longer.
– Minor Side effects: IORT has been found to have minor side effects such as red rashes, soreness, and skin irritations when compared to traditional radiation therapy.
The ideal candidates for IORT are the candidates who would normally undergo a lumpectomy followed by radiation. Candidates typically are women with stage 1 or 2 cancer that has not progressed to the lymph nodes and women who are over the age of 50.