Intraoperative Radiation Therapy (IORT): A Targeted Cancer Treatment Guide
Learn about Intraoperative Radiation Therapy (IORT), a targeted cancer treatment during surgery. Explore procedure, benefits, risks, and who is eligible.
Written by Dr. Mohammed Kamran
Reviewed by Dr. Rohinipriyanka Pondugula MBBS
Last updated on 26th Sep, 2025
%20A%20Targeted%20Cancer%20Treatment%20Guide.webp?tr=q-80,f-webp,w-350,dpr-2,c-at_max 700w)
Introduction
Facing a cancer diagnosis often means navigating a whirlwind of complex treatment options. You may have heard terms like chemotherapy, surgery, and radiation. But what if a significant part of radiation treatment could be completed in a single moment, during your surgery? This is the promise of intraoperative radiation therapy (IORT), an advanced form of brachytherapy that is changing the landscape of cancer care for many patients. This guide will demystify IORT, explaining how this targeted approach works, its significant benefits, and for whom it might be the right choice. We'll walk you through the entire process, from preparation to recovery, empowering you with the knowledge to have informed discussions with your healthcare team about this innovative intra operative radiation technique.
What is Intraoperative Radiation Therapy (IORT)? A Clear Definition
Intraoperative radiation therapy (IORT) is a specialised treatment that delivers a concentrated, high dose of radiation directly to a tumour site during surgery. The term "intraoperative" literally means "during the operation." Unlike traditional radiation that is delivered from outside the body over several weeks, IORT administers the radiation from within the surgical cavity immediately after the surgeon has removed the visible tumour.
IORT vs. Traditional Radiation: What’s the Difference?
The key difference lies in precision and timing.
• Traditional External Beam Radiation Therapy (EBRT): This involves a linear accelerator machine that directs radiation beams through the skin and other healthy tissues to reach the cancer area. Treatment is typically given daily, five days a week, for three to six weeks.
• IORT Brachytherapy: Here, the radiation source is placed inside the body, directly at the site where the tumour was. This allows for a single, powerful dose to be applied precisely where it's needed most, while shielding or moving nearby healthy organs out of the way.
The Core Idea: Precision and Protection
The fundamental goal of IORT is twofold. First, to eradicate any microscopic cancer cells that might remain after the tumour is removed, thereby reducing the risk of the cancer coming back (local recurrence). Second, and just as importantly, to minimise radiation exposure to the surrounding healthy tissues and organs. This precision is what leads to fewer side effects and a better quality of life for patients.
Consult a Radiation Oncologist for the best advice
How Does IORT Brachytherapy Work? The Step-by-Step Procedure
Understanding the IORT procedure steps can help alleviate anxiety. It’s a carefully choreographed dance between your surgical and radiation oncology teams.
Before Surgery: Planning and Preparation
Your journey begins with a comprehensive evaluation. A multidisciplinary team, including your surgical oncologist and radiation oncologist, will determine if you are a good candidate for IORT. This involves reviewing your medical imaging (like CT or MRI scans) to understand the tumour's size and location. The team plans the surgery and the specific radiation dose to be delivered.
During Surgery: The Critical Moment of Radiation
The surgery proceeds as planned. The surgeon removes the tumour. Then, the critical phase begins:
1. Access and Placement: The radiation oncologist brings a specialised applicator into the operating room. This device, which can be a balloon catheter or a cone-shaped probe, is carefully placed into the now-empty tumour bed (the cavity left by the tumour removal).
2. Shielding: In some cases, healthy tissues or organs near the treatment area are physically moved or protected with shields to block stray radiation.
3. Radiation Delivery: The team temporarily leaves the operating room, and a radioactive source is robotically guided into the applicator. The treatment lasts for about 10 to 40 minutes, depending on the dose required. You are monitored closely from outside the room.
4. Completion: Once the treatment is complete, the radioactive source is retracted, and the applicator is removed. The surgeon then finishes the operation by closing the incision.
After the Procedure: Recovery and Next Steps
Your initial recovery is primarily from the surgery itself, not the radiation. Because the IORT treatment time is condensed into one session, you avoid the daily trips to the hospital for weeks. You will have follow-up appointments with your oncology team to monitor your healing and overall progress. In some cases, your doctor might recommend a short course of external beam radiation after IORT to ensure comprehensive treatment.
Major Benefits of Choosing IORT
The benefits of IORT for breast cancer and other cancers are significant and contribute to a better patient experience.
Shorter Overall Treatment Time
This is one of the most appreciated advantages. Instead of weeks of daily treatments, the radiation component is completed in one session. This reduces the physical and emotional burden on patients and their families, allowing for a faster return to normal life.
Reduced Radiation Exposure to Healthy Tissues
By delivering radiation directly to the target area while protecting surrounding organs, IORT significantly lowers the risk of damage to healthy skin, muscle, lungs, or the heart. This leads to fewer short-term and long-term side effects, such as skin irritation or organ damage.
Potential for Improved Cosmetic Outcomes
In breast cancer treatment, for example, partial breast irradiation with IORT can lead to better cosmetic results compared to whole-breast radiation. Because a smaller area is treated, there is less likelihood of long-term changes to the breast’s appearance or texture.
What Types of Cancer Can Be Treated with IORT?
While initially pioneered for breast cancer, IORT's applications are expanding.
Breast Cancer: The Most Common Application
For early-stage breast cancer patients undergoing a lumpectomy, IORT is a well-established option. It serves as a form of accelerated partial breast irradiation, effectively targeting the area at highest risk for recurrence.
Colorectal and Pancreatic Cancers
For cancers in the abdomen, like colorectal or pancreatic cancer, IORT is valuable because it allows doctors to safely deliver a high dose of radiation while moving sensitive organs like the small intestine out of the way. This is crucial for reducing complications.
Other Cancers: Brain, Sarcoma, and More
IORT is also used in treating recurrent cancers, brain tumours, and sarcomas (cancers of the bone and soft tissue), where precise targeting is critical to avoid neurological damage or functional impairment.
Who is a Good Candidate for IORT?
Not every patient is eligible. Ideal candidates for IORT treatment often have:
1. Early-stage, localised cancer.
2. Tumours that are operable and accessible.
3. Certain tumour biology (e.g., low-risk breast cancer subtypes).
4. No evidence of cancer spread to distant organs.
Your oncology team will conduct thorough tests to determine if IORT is the most appropriate strategy for your specific situation. If you have been diagnosed with cancer, consulting a specialist team through a platform like Apollo24|7 can help you understand all your treatment options, including advanced therapies like IORT.
Potential Risks and Side Effects of IORT
As with any medical procedure, there are potential side effects of IORT brachytherapy. These are generally less severe than those associated with traditional radiation.
General Surgical Risks
These include pain, bleeding, infection, and risks associated with anaesthesia at the surgical site.
Specific IORT-Related Concerns
Specific risks can include temporary inflammation, fluid collection (seroma) in the treated area, or, rarely, damage to nearby nerves or tissues. The risk of long-term complications is typically lower.
Conclusion: Is IORT the Right Choice for You?
Intraoperative radiation therapy (IORT) represents a significant advancement in targeted cancer treatment. By consolidating weeks of radiation into a single, precise dose delivered during surgery, it offers compelling benefits: a shorter treatment timeline, enhanced protection of healthy organs, and potentially fewer side effects. While it is not suitable for every cancer or every patient, for those who are eligible, it can be a highly effective and convenient option. The decision to pursue IORT is a personal one that should be made in close consultation with a multidisciplinary medical team. By understanding the procedure, benefits, and candidacy requirements, you can take an active role in determining the best path forward in your cancer care journey.
Consult a Radiation Oncologist for the best advice
Consult a Radiation Oncologist for the best advice
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
Dr. Jayasree Kuna
Radiation Specialist Oncologist
4 Years • MD
Chinagadila
Apollo Hospitals Health City Unit, Chinagadila
Dr Mukti Mukherjee
Radiation Specialist Oncologist
12 Years • MBBS (Hons.), MD (Radiation Oncology), PDCR, CCEPC (Palliative Care) Consultant Oncologist
Kolkata
Apollo Multispeciality Hospitals , Kolkata, Kolkata
Dr. Shilpa Reddy K
Radiation Specialist Oncologist
10 Years • MBBS,DNB Radiation oncology,
Hyderabad
Apollo Hospitals Jubilee Hills, Hyderabad
Dr. Satyesh Nadella
Radiation Specialist Oncologist
10 Years • MBBS, MD
Hyderabad
Apollo Hospitals Jubilee Hills, Hyderabad
Consult a Radiation Oncologist for the best advice
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
Dr. Jayasree Kuna
Radiation Specialist Oncologist
4 Years • MD
Chinagadila
Apollo Hospitals Health City Unit, Chinagadila
Dr Mukti Mukherjee
Radiation Specialist Oncologist
12 Years • MBBS (Hons.), MD (Radiation Oncology), PDCR, CCEPC (Palliative Care) Consultant Oncologist
Kolkata
Apollo Multispeciality Hospitals , Kolkata, Kolkata
Dr. Shilpa Reddy K
Radiation Specialist Oncologist
10 Years • MBBS,DNB Radiation oncology,
Hyderabad
Apollo Hospitals Jubilee Hills, Hyderabad
Dr. Satyesh Nadella
Radiation Specialist Oncologist
10 Years • MBBS, MD
Hyderabad
Apollo Hospitals Jubilee Hills, Hyderabad
More articles from General Medical Consultation
Frequently Asked Questions
1. Is IORT safer than traditional radiation?
IORT is generally considered very safe. Its main advantage is reducing radiation exposure to healthy tissues, which lowers the risk of certain side effects. However, 'safety' depends on your specific cancer. Your doctor can best advise on which option carries the most benefit and least risk for you.
2. How long does the IORT procedure itself take?
The radiation delivery part of the IORT procedure typically takes between 10 and 40 minutes. However, this is part of a longer surgical operation to remove the tumour. The entire surgery time will vary depending on the complexity of the tumour removal.
3. What is the success rate of IORT for breast cancer?
For carefully selected patients with early-stage breast cancer, large clinical trials have shown that the long-term outcomes of IORT are equivalent to traditional whole-breast radiation in preventing cancer from returning locally, with success rates exceeding 95% over five years.
4. Does insurance cover the cost of intraoperative radiation therapy?
Most major insurance providers, including Medicare, cover IORT when it is medically necessary and deemed the standard of care for a specific cancer type. It's essential to check with your insurance provider and hospital billing department beforehand to understand your coverage.
5. Can IORT be used if my cancer comes back?
Yes, IORT is sometimes an excellent option for treating recurrent cancer, especially in areas that have already received the maximum safe dose of traditional external beam radiation. It allows doctors to deliver an additional focused dose to a new tumour while minimising damage to previously treated tissues.