Breast intraoperative radiotherapy: a review of available modalities, dedicated machines and treatment procedure

Abstract

AbstractBackgroundBreast intraoperative radiotherapy (IORT) is a partial irradiation technique that delivers a single fraction of radiation dose to the tumour bed during surgery. The use of this technique is increasing (especially in the Middle East), and therefore, it is essential to have a comprehensive approach to this treatment modality. The aim of this study is to conduct a literature review on available IORT modalities during breast irradiation as well as dedicated IORT machines and associated treatment procedures. The main IORT trials and corresponding clinical outcomes are also studied.Materials and MethodsA computerised search was performed through MEDLINE, PubMed, PubMed Central, ISI web of knowledge and reference list of related articles.ResultsIORT is now feasible through using two main modalities, including low-kilovolt IORT and intraoperative electron radiotherapy (IOERT). The dedicated machines employed and treatment procedure for mentioned modalities are quite different. The outcomes of implemented clinical trials showed that IORT is not inferior to external beam radiotherapy (EBRT) in specifically selected and well-informed patients and can be considered as an alternative to EBRT.ConclusionAlthough the clinical outcomes of introduced IORT methods are comparable, but based on the review results, it could be said that IOERT is the most effective technical method, in view of the treatment time and dose uniformity concepts. The popularity of IORT is mainly due to the distinguished obtained results during breast cancer treatment. Despite the presence of some technical challenges, it is expected that the IORT technique will become more widespread in the immediate future.