IORT-Intraoperative Radiation Therapy

Exciting Radiation Therapy Options for Early Stage Breast Cancer Treatment

Unlike external beam irradiation, where beams of radiation are directed from a machine outside the body through air and into the target tissue, brachytherapy involves placing the radiation directly into or immediately adjacent to the tumor or tissue at risk. Brachytherapy techniques generally allow for reduced exposure of surrounding healthy tissue to radiation, compared to external beam techniques. In the past brachytherapy could only be performed using live radioactive sources (radioisotopes) which continuously emit radiation and need special shielding, handling, and safety considerations. In the last few years brachytherapy to treat the lumpectomy cavity (partial breast irradiation) after breast surgery has been performed with radioactive seeds and needles using guides/ catheters or balloons. The breast brachytherapy treatment can generally be completed in as little as one week.

In an effort to reduce the radiation exposure, safety, and handling concerns associated with traditional radioisotope-based systems , electronic brachytherapy technology, like the Xoft eBx system, has been developed and has revolutionized the field of brachytherapy . The Xoft electronic brachytherapy (eBx) system uses a miniaturized x-ray source that can be turned on and off. Because of less shielding requirements for the Xoft eBx system, the treatment can be performed in almost any room, unlike the traditional radioisotope-based systems which require treatment in a shielded vault.

The ability to perform brachytherapy using the Xoft electronic source has now allowed for another exciting and promising treatment for patients with early stage breast cancer--intraoperative radiation therapy (IORT). With IORT, the radiation is delivered in a single treatment right to the target tissue (lumpectomy cavity) in the operating room at the time of surgery. With the Xoft eBx system, a typical IORT treatment for breast cancer can be completed in as little as eight minutes. IORT has been performed successfully over the past several years with good results, but very few centers around the country could afford to have the specially shielded operating rooms that were necessary. With the Xoft electronic brachytherapy system, IORT for breast cancer can now be made more easily available to patients all across the country. Last year, a landmark breast IORT study (TARGIT trial) published in the journal Lancet offers tremendous hope that a single radiation treatment at the time of lumpectomy might be able to replace the more cumbersome and time-consuming radiation treatment options commonly used today to treat patients with early stage breast cancer.

If the excellent results with breast IORT hold up long-term, as hoped and expected, then this approach to early stage breast cancer treatment has the potential to significantly increase the speed and efficiency of patient care while at the same time decreasing the overall cost of care. Unfortunately, not all patients with early stage breast cancer are candidates for IORT or even other types of breast brachytherapy because of technical and/or anatomical difficulties. However, if we continue our efforts to catch more cases of breast cancer in the earlier stages, then breast IORT using the Xoft eBx system has the potential to improve the quality of the lives of millions of patients over time by freeing them up to move on with their lives more quickly after receiving the breast cancer diagnosis.