Intraoperative Radiation Therapy (IORT)

Author: Courtney Misher, MPH, BS R.T.(T)
Last Reviewed: December 07, 2022

Intraoperative radiation therapy (IORT) is radiation therapy that is given during surgery. The radiation is given in one dose using electron beams, x-rays, or high-dose-rate brachytherapy. IORT can be used alone, but more often it is used with daily radiation therapy after IORT. IORT aims the radiation right at the target, lowering the amount of radiation that the normal nearby tissues and organs get. IORT is used:

  • To treat cancers that are hard to remove.
  • To kill any cancer cells left after surgery.

Who can have IORT?

IORT can be used for many types of cancer. Some of the common types of cancer are:

  • Early-stage breast cancer.
  • Head and neck cancers.
  • Abdominal cancers.
  • Colorectal cancer.
  • Gynecologic cancers.
  • Soft tissue tumors such as sarcomas.

How does IORT work?

Your surgeon and radiation oncologist will work together to plan your treatment. What often happens is:

  • Your tumor is taken out by your surgeon.
  • The radiation is delivered by your radiation oncologist.
  • The surgeon closes the incision (cut).

The IORT itself takes about 20-40 minutes, depending on the type of radiation used. You will be asleep during the procedure.

What are the benefits of IORT?

Depending on the type of radiation used and the area of your body being treated, some of the benefits of IORT are:

  • Fewer side effects like skin reactions.
  • Radiation is given in one dose instead of weeks of treatment.
  • No delay between surgery and radiation compared to traditional radiation therapy.
  • The beam is aimed right at the tumor or tumor bed, lowering the amount of radiation to the normal tissues and organs.
  • Higher than normal doses can be given because nearby critical organs can be shielded or moved out of the beam path.

What are the challenges of IORT?

Some of the challenges of IORT include:

  • Special equipment is needed that not all cancer care centers have.
  • Treatment is usually given before final information about tumor size, surgical margins, and lymph node status are known.

What are the side effects of IORT?

Side effects from IORT are rare. It is more common to have side effects from the surgery. Your provider will tell you about any side effects you can expect.

What can I expect after the treatment?

Your provider will give you instructions to follow after treatment. Often there is no extra recovery time. You will want to get lots of rest, drink plenty of fluids, and eat a well-balanced diet.

Is IORT right for me?

IORT is not a treatment option for everyone. Talk to your provider about your diagnosis and whether IORT is an option for you.

References

Pilar, A., Gupta, M., Laskar, S. G., & Laskar, S. (2016). Intraoperative radiotherapy: review of techniques and results. ecancermedicalscience, 11. https://doi.org/10.3332/ecancer.2017.750

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