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Implementation and experiences of an intraoperative radiotherapy service

Published online by Cambridge University Press:  30 November 2006

K. Armoogum ,
C. Ackland  and
J. Gardner
K. Armoogum
Affiliation:
Department of Medical Physics, Ninewells Hospital and Medical School, Tayside University Hospitals NHS Trust, Dundee, UK
C. Ackland
Affiliation:
Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, Tayside University Hospitals NHS Trust, Dundee, UK
J. Gardner
Affiliation:
Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, Tayside University Hospitals NHS Trust, Dundee, UK
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Abstract

Intraoperative radiotherapy (IORT) using a miniature X-ray source has the potential to impart the same clinical benefit as external beam radiotherapy (EBRT), in a single fraction. The patient benefits are significant, since IORT could replace several weeks of fractionated EBRT. We present our initial experiences of IORT using the Zeiss Intrabeam™ system for treating early stage breast cancer and intracranial malignancies. Implementing this treatment modality requires a multidisciplinary approach drawing on the expertise of surgeons, oncologists, medical physicists, anaesthesiologists, nursing staff and pathologists. Team coherence is facilitated by a nurse co-ordinator. We have treated 66 patients in 24 months. For breast tumours, the mean treatment time was 28.54 min and the applicator sizes ranged from 3.0 to 5.0cm (mode = 4.5cm). A dose of 5Gy is prescribed to spherical volume of 1cm from the applicator surface. For brain tumours, the mean treatment time was 19.70 min and the applicator sizes ranged from 1.5 to 3.5cm (mode = 2.5cm). Mean dose was 11.1Gy prescribed to a spherical volume of 0.5cm from the applicator surface.

A multidisciplinary team is essential for the successful implementation of IORT. This paper describes how, through reliance on an oncology nurse specialist to co-ordinate the programme, we have successfully set-up an IORT service.

Keywords

Intraoperative radiotherapy servicebreast cancerphoton radiosurgery systemIntrabeam™
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 5 , Issue 4 , December 2006 , pp. 203 - 210
Copyright
2006 Cambridge University Press

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