Intraoperative radiation therapy (IORT)

Overview

Intraoperative radiation therapy, also called IORT, is a radiation treatment that's done during surgery.

IORT directs radiation to the target area while affecting the surrounding tissue as little as possible. IORT is used to treat cancers that are difficult to remove during surgery. And it's used when there's a concern that tiny amounts of unseen cancer might remain.

IORT is often combined with standard radiation therapy. Standard radiation therapy is usually done before surgery.

IORT delivers higher doses of radiation than does standard radiation therapy. It's not always possible to use such high doses during standard radiation therapy because of the possibility of radiation affecting nearby organs. IORT helps keep radiation away from nearby organs.

Why it's done

Intraoperative radiation therapy, also called IORT, can be used to treat many types of cancer. It's particularly useful for cancers that are hard to completely remove during surgery and cancers located close to sensitive structures and organs. Examples include cancers in the pelvis and the belly. IORT also can be helpful in areas where cancer has come back after other treatment.

Risks

As with most medical procedures, there are risks to intraoperative radiation therapy, also called IORT. IORT typically is safe, but the most common side effects include:

• Problems with the surgical incision as it heals.
• Injury and scarring to tissue around the treatment area, called fibrosis.
• Nerve damage, called neuropathy.
• Narrowing of passages in the body near the treatment area. For example, the intestines or the tubes that carry urine from the kidneys to the bladder, called ureters, may narrow due to IORT. This narrowing is called stenosis.
• An unusual opening or hole that forms between two parts of the body, called a fistula.

How you prepare

Preparing for intraoperative radiation therapy, also called IORT, often involves having imaging tests. These tests may include ultrasound, computerized tomography (CT) or magnetic resonance imaging (MRI) scans.

The images from these tests are used to make detailed pictures of the area to be treated. The healthcare team, including the surgeon and the radiation oncologist, uses those pictures to plan the surgery and IORT. This planning allows high doses of radiation to be delivered to the cancer while lowering the amount of radiation that reaches healthy tissue.

What you can expect

Intraoperative radiation therapy, also called IORT, happens during surgery. Many people who get IORT also have standard radiation therapy before surgery. Then during surgery, IORT is used to deliver a higher dose of radiation directly to the cancer than is possible with standard radiation therapy. Based on the treatment planning, radiation therapy delivered with IORT is carefully focused on the specific area that needs treatment.

Results

After intraoperative radiation therapy, you may have follow-up appointments to monitor the results. These appointments may include imaging tests to check if the cancer is gone. Talk with your healthcare team about your follow-up care.