Intra-Operative Radiotherapy in Breast Cancer Treatment: A Literature Review

Abstract

Context: The process of direct radiation to the tumor or tumor residue during surgery known as Intraoperative Radiation Therapy (IORT) is a new promising technique in the treatment of different cancers. For a detailed review of IORT application and effectiveness in breast cancer, we conducted a review of the present literature in the field. Evidence Acquisition: In this study, the most important technologies for IORT were identified through a comprehensive study. Relevant, critical, and highly cited articles and studies were selected based on experts' opinions. Data were summarized in sections of technology and physics, protocols, and treatment outcomes. Results: Electron beam and low-energy X-ray technologies were explained, and the physique of IORT was discussed. Due to the uncertainties of this modality and geometric complexities of post-excision treatment site, specialized treatment planning systems for IORT are necessary. In breast cancer treatment, regardless of the employed technology, IORT is applied with two main protocols: Partial Breast Irradiation and Intraoperative Boost Irradiation, each with their own advantages and disadvantages. Conclusions: Despite the controversies in acceptance and effectiveness of IORT, this technique seems to be promising for increased survival of breast cancer patients.