The Institut Mèdic Onco-Radiotherapy (IMOR) , which specializes in cancer patient care center pioneered intraoperative radiotherapy treatments performed in Spain in 2014. Two years later, they performed 100 such treatments a year, two a week. The radiation oncologist Dr. Ferran Guedea Edo and medical director of the IMOR Foundation, Dr. Benjamin Guix Melcior, tell us what this innovative cancer treatment.
What is intraoperative radiotherapy?
Dr. Guix: Intraoperative radiation therapy is a type of procedure used in the operating room. Treatment comprises administering at the same time of the operation, ie when the patient intervenes to remove the tumor. Right in the area where the tumor was, a cavity is known as "tumor bed" or "surgical bed" is; it is in this area where it is likely to remain tumor cells.
How does it apply?
Dr. Guedea: To perform this treatment requires a next - generation operating room, but especially a small accelerator which can move in all directions with minimal effort and allows coupling radiation in the area indicated. With one hand you can easily move the head. said head is placed with a cone or cylinder within the tumor bed and a dose of radiation is used to destroy these microscopic cells, at first glance, are not. The session lasts 20 minutes, which causes the lengthening surgery is approximately 30 minutes.
What are the advantages?
Dr. Guedea: The main advantage of intraoperative radiotherapy is that it can treat with great precision the area where the tumor was. To manage all organs near the affected area depart, preventing proliferation and reduces side effects.
Dr. Guix: Another advantage is that shortens the duration of treatment, since in many cases it is sufficient with one session at the time of the operation and thus avoid having to manage external beam radiotherapy.
You can be used in any cancer? What patients are candidates?
Dr. Guix: It applies mainly in cases of breast cancer, but also in some cases of abdominal cavity cancer, rectum, pancreas head, stomach and liver.
Dr. Guedea: Used in very good prognosis tumors, small, well located and no involved nodes. When the tumor is small or no involved nodes is necessary to complete the treatment with external radiotherapy.
Why a multidisciplinary team is required for this technique?
Dr. Guix: It is a treatment that can not do an oncologist alone, but the collaboration of a multidisciplinary team is required. First of all, a radiodiagnostic equipment delimiting the area where the tumor has to be removed. Thereafter, the surgeon and the patient involved tumor extracts. Then, intraoperative radiation therapy, the radiation oncologist assigns radiation dose to be applied and study what should be protected adjacent structures, such as nerves or blood vessels. Finally, physical ensures that the treatment is performed as prescribed by oncologist.
Dr. Guedea: The decision to make this treatment varies depending on many factors and must decide with different specialists.