Intraoperative radiation therapy (IORT)

A BRIEF HISTORY OF INTEROPERATIVE RADIATION THERAPY (IORT):

Intraoperative electron beam radiotherapy (IORT) is a new combined modality therapy in the treatment of cancer. IORT is delivered during a surgical procedure to a tumor or tumor bed and areas of possible local regional spread, with the ability to shield or physically move normal tissues and organs out of the treatment volume”

STAGES IN THE DEVELOPMENT OF INTEROPERATIVE RADIATION THERAPY (IORT):

Intraoperative radiotherapy (IORT) is a treatment delivery technique with reports starting in the early twentieth century with the use of orthovoltage energy with limited applicability due to the energy characteristics (1). This technology had a resurgence in approximately the 1960s with the use of electron energy in Japan (2) and subsequently the literature is replete with numerous other publications. Initially, the use of IORT was restricted by the cumbersome nature of treatment delivery as a shielded operating room was needed requiring large capital expenditure as well as expertise of staff with limited patient applicability. Over time the technology has evolved from requiring a shielded room to the development of a mobile device that can move into a standard operating room with minimal shielding requirements.”

PIONEERS IN THE DEVELOPMENT OF INTEROPERATIVE RADIATION THERAPY (IORT):

European pioneers in the field of IORT are Spain, Italy, Austria, and Germany. Although it is true that most of the scientific information generated before 1980 was anecdotal and of little practical influence in the oncology community, the first known similar experiment of IORT was documented by Comas and Prio in 1905 [2], in a case of endometrial cancer. “

“The modern approach to IORT began with studies by Abe at the University of Kyoto [2] in the 1960s by using high doses (25–30 Gy) of gamma rays from cobalt unit and betatron electrons. In the 1970s, special facilities dedicated to performing IORT procedures with conventional linear accelerators were set up at Howard University Hospital and Massachusetts General Hospital. In the early 1990s, mobile linear electron accelerators and low-energy miniature x-ray machines were introduced into clinical practice in a series of radiation therapy centres worldwide.”

REFERENCES:

https://www.ncbi.nlm.nih.gov/pubmed/3119944

https://www.frontiersin.org/articles/10.3389/fonc.2018.00234/full

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3757959/

https://link.springer.com/chapter/10.1007%2F978-1-59259-696-6_1

https://www.radiologyinfo.org/en/info.cfm?pg=stereotactic

https://www.mayoclinic.org/tests-procedures/intraoperative-radiation-therapy/about/pac-20385150

https://ascopubs.org/doi/10.1200/JCO.2006.10.0255

http://www.aetna.com/cpb/medical/data/700_799/0721.html

https://www.karger.com/Article/Fulltext/454673

https://clinicaltrials.gov/ct2/show/NCT03216421