Intraoperative Radiation May Work as Well as Standard Delivery Method

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Intraoperative radiation therapy is an experimental way to give radiation therapy. During surgery to remove the breast cancer, the radiation is given as a single dose directly to the area where the cancer used to be.

A study, called the TARGIT study, shows that intraoperative radiation therapy and traditional external beam radiation had similar results 4 years after surgery. The results were presented at the 2010 American Society of Clinical Oncology (ASCO) annual meeting.

All 2,000 women in the TARGIT study were 45 or older and diagnosed with early-stage breast cancer. All the women had lumpectomy to remove the cancer.

Half the women were treated with one dose of intraoperative radiation therapy during surgery after the cancer was removed.

The other half were treated with traditional external beam radiation therapy. Traditional external beam radiation aims radiation at the whole breast or to the area of the breast where the cancer was. The source of the radiation is outside the breast, which is why it's called "external beam."

Many studies have shown the short- and long-term effectiveness of traditional radiation therapy. The drawbacks of traditional radiation therapy include daily trips to the hospital or cancer center to get treated -- typically 5 days a week for 4 to 6 weeks. Maintaining this schedule can be difficult for some women. Traditional radiation therapy also may expose healthy tissue, such as the heart and lungs, to radiation. These drawbacks make intraoperative radiation therapy attractive if it's proven to be just as effective and safe as traditional radiation therapy.

After 4 years of follow-up, the researchers found that both radiation techniques were equally effective at reducing the risk of the cancer coming back in the breast area and equally safe:

  • six women who got intraoperative radiation therapy had the cancer come back
  • five women who got traditional external beam radiation therapy had the cancer come back

Radiation therapy is given after lumpectomy specifically to reduce the risk of the cancer coming back in the breast area.

While both approaches were equally safe, each treatment caused somewhat different side effects:

  • 2.1% of women who got intraoperative radiation therapy had a seroma compared to only 0.8% of women who got traditional external beam radiation therapy

A seroma is a build-up of fluid at the site of surgery that may require more than one procedure to drain.

  • 2.1% of women who got traditional external beam radiation therapy had significant skin reactions compared to only 0.5% of women who got intraoperative radiation therapy

These results suggest that intraoperative radiation therapy may be a good alternative to traditional external beam radiation therapy. Still, more research with longer follow-up time is needed before doctors can confidently recommend intraoperative radiation therapy.

There are other alternatives to traditional external beam radiation therapy that deliver more focused radiation therapy over a shorter period of time that are already approved by the U.S. Food and Drug Administration to treat breast cancer, including:

  • two types of internal radiation therapy (brachytherapy)
    • multi-catheter internal radiation
    • balloon internal radiation (brand name: MammoSite)
  • 3-D conformal external beam radiation

You can learn more about radiation therapy options in the Breastcancer.org Radiation Therapy section.

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