The technique, known as Intraoperative Radiation Therapy, or IORT,
involves administering a single dose of radiation at the same time a
patient is having lumpectomy surgery to remove a tumor. A large, randomized controlled trial concluded
that IORT has fewer side effects and appears to prevent the return of
cancer nearly as well as traditional treatment, in which patients
undergo radiation sessions five days a week for up to seven weeks.
Oncologists
with opposing opinions have been debating that conclusion in letters
and editorials in major medical journals, including the Lancet and BMJ.
Some critics point out that the study found women who had IORT face
twice the risk of a cancer recurrence compared with traditional
radiation (3.3% versus 1.3% over five years). Some also criticize the design of the IORT study and say patients
haven’t been followed long enough to draw conclusions. “A lot of us are
scratching our heads as to why [IORT] would be appropriate,” says David
Wazer, chair of radiation oncology at Brown and Tufts.
Yet proponents of IORT say the risk of recurrence with either
radiation treatment over five years is tiny, and IORT’s advantages could
outweigh the higher risk of recurrence for some patients.
“A lot of women who hear about this option make an informed decision to use it,” says Stephen Grobmyer,
director of the breast center at the Cleveland Clinic, which is
collecting data on nearly 1,000 patients who have had the treatment at
19 U.S. centers.
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