My ePortfolio Register   
 

Abstract | Full HTML Article | PDF ecancer 11 750 / https://doi.org/10.3332/ecancer.2017.750

Review

Intraoperative radiotherapy: review of techniques and results

Intraoperative radiotherapy (IORT) is a technique that involves precise delivery of a large dose of ionising radiation to the tumour or tumour bed during surgery. Direct visualisation of the tumour bed and ability to space out the normal tissues from the tumour bed allows maximisation of the dose to the tumour while minimising the dose to normal tissues. This results in an improved therapeutic ratio with IORT. Although it was introduced in the 1960s, it has seen a resurgence of popularity with the introduction of self-shielding mobile linear accelerators and low-kV IORT devices, which by eliminating the logistical issues of transport of the patient during surgery for radiotherapy or building a shielded operating room, has enabled its wider use in the community.

Electrons, low-kV X-rays and HDR brachytherapy are all different methods of IORT in current clinical use. Each method has its own unique set of advantages and disadvantages, its own set of indications where one may be better suited than the other, and each requires a specific kind of expertise.

IORT has demonstrated its efficacy in a wide variety of intra-abdominal tumours, recurrent colorectal cancers, recurrent gynaecological cancers, and soft-tissue tumours. Recently, it has emerged as an attractive treatment option for selected, early-stage breast cancer, owing to the ability to complete the entire course of radiotherapy during surgery. IORT has been used in a multitude of roles across these sites, for dose escalation (retroperitoneal sarcoma), EBRT dose de-escalation (paediatric tumours), as sole radiation modality (early breast cancers) and as a re-irradiation modality (recurrent rectal and gynaecological cancers).

This article aims to provide a review of the rationale, techniques, and outcomes for IORT across different sites relevant to current clinical practice.

Keywords: IORT, techniques, indications, outcomes, complications

Categories:

Cytotoxics Radiotherapy

Loading Article Metrics ... Please wait

Related articles

Research: Evidence on the cost of breast cancer drugs is required for rational decision making

Abstract | Full Article | PDF Published: 16 Apr 2018 / https://doi.org/10.3332/ecancer.2018.825

Conference Report: Highlights from the 10th Breast, Gynaecological and Immunotherapy International Cancer Conference (BGICC), 18–19 January 2018, Cairo, Egypt

Abstract | Full Article | PDF Published: 22 Mar 2018 / https://doi.org/10.3332/ecancer.2018.820

Research: Cosmesis after early stage breast cancer treatment with surgery and radiation therapy: experience of patients treated in a Chilean radiotherapy centre

Abstract | Full Article | PDF Published: 21 Mar 2018 / https://doi.org/10.3332/ecancer.2018.819

Review: Cystic brain metastases in ALK-rearranged non-small cell lung cancer

Abstract | Full Article | PDF Published: 14 Mar 2018 / https://doi.org/10.3332/ecancer.2018.818

Case Report: Neoadjuvant chemotherapy in locally advanced duodenal adenocarcinoma

Abstract | Full Article | PDF | Spanish Published: 05 Mar 2018 / https://doi.org/10.3332/ecancer.2018.816



Founding partners

European Cancer Organisation European Institute of Oncology

Founding Charities

Foundazione Umberto Veronesi Fondazione IEO Swiss Bridge

Published by

Cancer Intelligence