Intraoperative Radiation Therapy for Breast Cancer

2021 
Adjuvant radiation represents a standard approach following breast conserving surgery. While traditionally delivered as whole breast irradiation (WBI), an alternative has emerged with the development of partial breast irradiation techniques. One such technique is intraoperative radiation therapy (IORT). The purpose of this review is to discuss the studies evaluating IORT as well as evaluating current guidelines and future directions. Review of two randomized trials (TARGIT-A and ELIOT) demonstrates that breast cancer patients treated with IORT had a higher risk of local recurrence (LR). However, patients with low-risk features and IORT performed at the time of surgery had similar rates of LR at 5 years, with longer follow-up needed. IORT as a boost is promising, and studies are ongoing. Further studies are needed to validate the role of IORT and which patients are appropriate for IORT, and longer follow-up is needed.
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