The American Brachytherapy Society consensus statement on intraoperative radiation therapy Guidelines


Authors: Tom, M. C.; Joshi, N.; Vicini, F.; Chang, A. J.; Hong, T. S.; Showalter, T. N.; Chao, S. T.; Wolden, S.; Wu, A. J.; Martin, D.; Husain, Z.; Badiyan, S. N.; Kolar, M.; Sherertz, T.; Mourtada, F.; Cohen, G. N.; Shah, C.
Title: The American Brachytherapy Society consensus statement on intraoperative radiation therapy
Abstract: Purpose: Although radiation therapy has traditionally been delivered with external beam or brachytherapy, intraoperative radiation therapy (IORT) represents an alternative that may shorten the course of therapy, reduce toxicities, and improve patient satisfaction while potentially lowering the cost of care. At this time, there are limited evidence-based guidelines to assist clinicians with patient selection for IORT. As such, the American Brachytherapy Society presents a consensus statement on the use of IORT. Methods: Physicians and physicists with expertise in intraoperative radiation created a site-directed guideline for appropriate patient selection and utilization of IORT. Results: Several IORT techniques exist including radionuclide-based high-dose-rate, low-dose-rate, electron, and low-energy electronic. In breast cancer, IORT as monotherapy should only be used on prospective studies. IORT can be considered in the treatment of sarcomas with close/positive margins or recurrent sarcomas. IORT can be considered in conjunction with external beam radiotherapy for retroperitoneal sarcomas. IORT can be considered for colorectal malignancies with concern for positive margins and in the setting of recurrent gynecologic cancers. For thoracic, head and neck, and central nervous system malignancies, utilization of IORT should be evaluated on a case-by-case basis. Conclusions: The present guidelines provide clinicians with a summary of current data regarding IORT by treatment site and guidelines for the appropriate patient selection and safe utilization of the technique. High-dose-rate, low-dose-rate brachytherapy methods are appropriate when IORT is to be delivered as are electron and low-energy based on the clinical scenario. © 2019 American Brachytherapy Society
Keywords: breast cancer; sarcoma; radiation therapy; head and neck; colorectal; iort; intraoperative radiation; gynecologic
Journal Title: Brachytherapy
Volume: 18
Issue: 3
ISSN: 1538-4721
Publisher: Elsevier Science, Inc.  
Date Published: 2019-05-01
Start Page: 242
End Page: 257
Language: English
DOI: 10.1016/j.brachy.2019.01.015
PROVIDER: scopus
PUBMED: 31084904
DOI/URL:
Notes: Article -- Export Date: 3 June 2019 -- Source: Scopus
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  1. Suzanne L Wolden
    560 Wolden
  2. Gilad N Cohen
    180 Cohen
  3. Abraham Jing-Ching Wu
    399 Wu