Intraoperative Electron Radiation Therapy (IOERT)
PDF (Język Polski)


Intraoperative Radiation Therapy
mobile accelerators
in vivo dosimetry
breast cancer

How to Cite

Graczyk, K., Kruszyna-Mochalska, M., & Kijeska, W. (2022). Intraoperative Electron Radiation Therapy (IOERT). Letters in Oncology Science, 19(2).


Treatment tactics that combine sparing surgery with radiation therapy have become the standard in the treatment of early cancers. One example of combined treatment is intraoperative radiotherapy, which is performed during surgery while the patient is still under anesthesia in a sterile operating room.

The aim of this work is to discuss the technique of intraoperative electron beam radiotherapy (IOERT) generated by mobile accelerators.

The IOERT method is used in the treatment of neoplasms such as: breast, prostate, pancreas, colon and rectum. Based on the literature reports, the following were discussed: the course of the procedure, the most frequently used physical parameters and the challenges related to the quality control and radiological protection of personnel.
PDF (Język Polski)


Christiansen P, Carstensen SL, Ejlertsen B, et al. Breast conserving surgery versus mastectomy: overall and relative survival-a population based study by the Danish Breast Cancer Cooperative Group (DBCG). Acta Oncol. 2018;57(1):19-25.

Beck C. On external Roentgen treatment of internal structures eventration treatment. N. Y. Med. Journal. 89, 621–622 1909.

Schumann EA: Direct intra-abdominal radiation in advanced pel- vic carcinoma. Am J Obst Gyn.1933; 26:260-263.

Fairchild GC, Shorter A. Irradiation of gastric cancer. Br J Radiol. 1947;20(240):511-522.

Rich TA, Cady B, McDermott WV, Kase KR, Chaffey JT, Hellman S. Orthovoltage intraoperative radiotherapy: a new look at an old idea. Int J Radiat Oncol Biol Phys. 1984;10(10):1957-1965.

Abe M, Yabumoto E, Takahashi M, Tobe T, Mori K. Intraoperative radiotherapy of gastric cancer. Cancer. 1974;34(6):2034-2041.

Vaeth JM, Nomura Y. Intraoperative Radiation Therapy in the Treatment of Cancer.Front Radiat Ther Oncol. 1997; 31:65-70.

Mobetron® - Intraoperative Electron Radiation Therapy (IORT) - Dostęp na 21.11. 2022 r.

Electron beam intraoperative radiation therapy system NOVAC 11 - Dostęp na 21.11. 2022 r.

Beddar AS, Krishnan S. Intraoperative radiotherapy using a mobile electron LINAC: a retroperitoneal sarcoma case. J Appl Clin Med Phys. 2005;6(3):95-107.

Pimpinella M, Mihailescu D, Guerra AS, Laitano RF. Dosimetric char- acteristics of electron beams produced by a mobile accelerator for IORT. Phys Med Biol. 2007;52:6197–6214.

Fantini M, Santoni F, Soriani A, Creton G, Benassi M, Begnozzi L. IORT Novac7: a new linear accelerator for electron beam therapy. Front. Radiat Ther Oncol. 1997;31:54-59.

Hensley FW. Present state and issues in IORT Physics. Radiat Oncol. 2017;12(1):37.

Kruszyna-Mochalska M, Bijok M, Pawałowski B, Misiarz A, Kosiski K, Pracz J, Malicki J, et al. Zalecenia Polskiego Towarzystwa Fizyki Medycznej dotyczące kontroli jakości w radioterapii śródoperacyjnej promieniowaniem elektronowym (IOERT) za pomocą mobilnych akceleratorów. Inżynier i Fizyk Medyczny. 2019;8(1):7-25.

Alhamada H, Simon S, Philippson C, et al. Monte Carlo dose calculations of shielding disks with different material combinations in intraoperative electron radiation therapy (IOERT). Cancer Radiother. 2020;24(2):128-134.

Martigniano A, Menegotti L, Veronesi A. Monte Carlo investigation of breast intraoperative radiation therapy with metal attenuator plates. Med Phys. 2007;34:4578–84.

Neto AJD, Haddad CMK, Pelosi EL, Zevallos-Chavez JY, Yoriyaz H, Siqueira PDTD. Monte Carlo simulation as an auxiliary tool for electron beam quality specifi- cation for intra-operative radiotherapy. Braz J Phys 2005;35:801–4.

Pentiricci A, Paolucci M, Rossi G, DiLorenzo R, Felici G, Ciccotelli A.Two shielding protection disks systems in breast intraoperative irradiation. Phys Med 2016;32:321–35.

Severgnini M, de Denaro M, Bortul M, Vidali C, Beorchia A. In vivo dosimetry and shielding disk alignment verification by EBT3 GAFCHROMIC film in breast IOERT treatment. J Appl Clin Med Phys 2014;16:5065.

Hanna S, Barros A, Andrade F, Bevilacqua JLB, Roberto MP, Josa P, et al. Intra- operative Radiation Therapy in Early Breast Cancer Using a Linear Accelerator Outside of the Operative Suite: An “Image-Guided” Approach. Int J Radiat Oncol Biol Phys 2014;89:1015–23.

Wootton LS, Meyer J, Kim E, Phillips M. Commissioning, clinical implementation, and performance of the Mobetron 2000 for intraoperative radiation therapy. J Appl Clin Med Phys. 2017;18(1):230-242.

Krengli M, Sedlmayer F, Calvo F, Wenz F, Alessandro M, Mazzarotto R, et al. Intraoperative radiotherapy (IORT) in breast cancer: analysis of 7,054 cases from ISIORT database.à_compatibilità_.pdf. Dostęp na 21.11.2022 r.

Krengli M, Sedlmayer F, Calvo F, Sperk E, Pisani C, Sole CV. ISIORT pooled analysis 2013 update: Clinical and technical characteristics of intraoperative radiotherapy. Transl Cancer Res.2014;3:48-58.

Calvo FA, Sole CV, Rutten HJ, et al. ESTRO/ACROP IORT recommendations for intraoperative radiation therapy in locally recurrent rectal cancer. Clin Transl Radiat Oncol. 2020;24:41-48.

Roeder F, Morillo V, Saleh-Ebrahimi L, Calvo FA, Poortmans P, Ferrer Albiach C. Intraoperative radiation therapy (IORT) for soft tissue sarcoma - ESTRO IORT Task Force/ACROP recommendations. Radiother Oncol. 2020;150:293-302.

Calvo FA, Krengli M, Asencio JM, et al. ESTRO IORT Task Force/ACROP recommendations for intraoperative radiation therapy in unresected pancreatic cancer. Radiother Oncol. 2020;148:57-64.

Holman FA, Bosman SJ, Haddock MG, et al. Results of a pooled analysis of IOERT containing multimodality treatment for locally recurrent rectal cancer: Results of 565 patients of two major treatment centres. Eur J Surg Oncol. 2017;43(1):107-117.

Roeder F, Ulrich A, Habl G, et al. Clinical phase I/II trial to investigate preoperative dose-escalated intensity-modulated radiation therapy (IMRT) and intraoperative radiation therapy (IORT) in patients with retroperitoneal soft tissue sarcoma: interim analysis. BMC Cancer. 2014;14:617.

Kanda T, Fukuda S, Fukui N, et al. Favorable outcome of intraoperative radiotherapy to the primary site in patients with metastatic prostate cancer. Int J Clin Oncol. 2016;21(4):764-772.

Rozporządzenie Ministra Zdrowia z dnia 12.11.2015 w sprawie warunków bezpiecznego stosowania promieniowania jonizującego dla wszystkich rodzajów ekspozycji medycznej, załącznik 6 (Dz. U. z 2015 r.).

Almond PR, Biggs PJ, Coursey BM, et al. AAPM's TG-51 protocol for clinical reference dosimetry of high-energy photon and electron beams. Med Phys. 1999;26(9):1847-1870.

Stefano Andreoli, Antonella Ciabattoni, Cinzia De Angelis, Maria Cristina Leonardi, Loris Menegotti, Maria Pimpinella, Antonella Rosi. Assicurazione di qualità nella radioterapia intraoperatoria. Aggiornamento del Rapporto ISTISAN 03/1. 2021. ISS.

Agazaryan N, Solberg TD, DeMarco JJ. Patient specific quality assurance for the delivery of intensity modulated radiotherapy. J Appl Clin Med Phys. 2003;4(1):40-50.

Mijnheer B, Beddar S, Izewska J, Reft C. In vivo dosimetry in external beam radiotherapy. Med Phys. 2013;40(7):070903.

Petoukhova A, Rüssel I, Nijst-Brouwers J, et al. In vivo dosimetry with MOSFETs and GAFCHROMIC films during electron IORT for Accelerated Partial Breast Irradiation. Phys Med. 2017;44:26-33.

Consorti R, Petrucci A, Fortunato F, Soriani A, Marzi S, Iaccarino G, et al. In vivo dosimetry with MOSFETs: dosimetric characterization and first clinical results in intraoperative radiotherapy. Int J Radiat Oncol Biol Phys 2005;63:952–60.

Ciocca M, Piazzi V, Lazzari R, Vavassori A, Luini A, Veronesi P, et al. Real-time in vivo dosimetry using micro-MOSFET detectors during intraoperative electron beam radiation therapy in early-stage breast cancer. Radiother Oncol 2006;78:213–6.

Soriani A, Felici G, Fantini M, Paolucci M, Borla O, Evangelisti G, Benassi M, Strigari L. Radiation protection measurements around a 12 MeV mobile dedicated IORT accelerator. Med Phys. 2010;37:995–1003.

Daves JL, Mills MD. Shielding assessment of a mobile electron accelerator for intraoperative radiotherapy. J Appl Clin Med Phys. 2001;2(3):165-173.

Wootton LS, Meyer J, Kim E, Phillips M. Commissioning, clinical implementation, and performance of the Mobetron 2000 for intraoperative radiation therapy. J Appl Clin Med Phys. 2017;18(1):230-242.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Copyright (c) 2022 Letters in Oncology Science


Download data is not yet available.