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Intraoperative Radiation Therapy (IORT)

Intraoperative radiation therapy (IORT) from ZEISS enables a targeted, risk-adapted and interdisciplinary treatment of tumors. By using low energy x-rays intraoperative radiation can be given with a high dose, precisely into the tumor or directly after resection to the tumor bed.

Radiation with INTRABEAM^® from ZEISS enables an individual treatment that minimizes collateral tissue damage and has a shorter duration of the radiation therapy.

Oncological Indications

Brain Tumors

For brain tumors, postoperative dose reconstructions demonstrated that in many patients the post-resection cavities are normally of complex shape; the treatment by a spherical applicator with an isotropic dose distribution is the only feasible way to avoid angle errors.²Consequently newly diagnosed brain tumor patients showed good local tumor control with relatively good long term survival.³

Breast Cancer

Radiation therapy is an important element of the breast-conserving treatment for the mamma carcinoma. With the INTRABEAM, radiation is given with a spherical applicator directly into the tumor bed, where the risk of recurrence is highest, right after tumor resection.

Gastrointestinal Tumors

In cancer surgery, the primary goal is to completely excise the tumor. However, a complete resection may not be possible for some patients. Intraoperative radiation with the INTRABEAM can be used for local control of colorectal tumors, and locally advanced and recurrent rectal cancer.^4,5

Head & Neck Tumors

With INTRABEAM, deliver precise and targeted radiation directly and only to the target volume, and avoid the normal tissue and sensitive structures in the head and neck area.

Skin Cancer

The versatility of the INTRABEAM is also displayed in the treatment of skin cancer using electronic brachytherapy with photons. For the treatment of non-melanoma skin cancer, kilovoltage irradiation is an important therapeutic option.⁷

Spinal Metastases

Kypho-IORT, a combination of intraoperative radiation and Kyphoplasty, enables the sterilization of the metastasis and offers immediate stabilization as the radiation exposure takes place directly in the target volume. The combined procedure of Kypho-IORT offers immediate structural stabilization and provides local control of the tumor growth.⁸

For FDA-cleared INTRABEAM Indications for Use, see indications 510k.

Products

INTRABEAM 600

As the third generation of IORT device from ZEISS, the new INTRABEAM 600 is the first fully integrated and connected treatment platform for IORT addressing multiple clinical needs in one solution.

INTRABEAM System

The second generation of IORT device from ZEISS is the INTRABEAM System*, providing a stand-alone targeted local therapy for intraoperative radiation therapy and electronic brachytherapy treatment.

Applicators

For each treatment of a tumor or tumor bed, and specifically with non-melanoma skin tumors using electronic brachytherapy with photons, the best possible irradiation has to be ensured. ZEISS offers multiple applicators which ensure an adapted geometric dose distribution to the target tissue, depending on the location, type, size and shape of the tumor, an adapted geometric dose distribution to the target tissue.

TARGIT Academy

For INTRABEAM users, the TARGIT Academy offers a practical firsthand training course including an intensive hands-on training which is conducted on a peer-to-peer basis from experts for experts in the field of IORT/electronic brachytherapy. Due to the fact that the learning curve increases immediately, the TARGIT Academy is equally suitable for all users.

^{* The ZEISS INTRABEAM System consists of: INTRABEAM PRS 500 with XRS, INTRABEAM Cart and NC32 INTRABEAM Floor Stand}

The INTRABEAM^® System is indicated for radiation therapy treatments. The INTRABEAM^® Spherical Applicators used with the INTRABEAM System are able to deliver a prescribed dose of intraoperative radiation in conjunction with whole breast irradiation, based upon the medical judgment of the physician. The safety and effectiveness of the INTRABEAM System as a replacement for whole breast irradiation in the treatment of breast cancer has not been established.

¹ Vaidya, J. S., Wenz, F., Bulsara, M., Tobias, J. S., Joseph, D. J., Keshtgar, M., … Baum, M. (2014). Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer: 5-year results for local control and overall survival from the TARGIT-A randomised trial. The Lancet, 383(9917), 603–613.
² Giordano, F. A., Brehmer, S., Abo-Madyan, Y., Welzel, G., Sperk, E., Keller, A., … Wenz, F. (2014). INTRAGO: intraoperative radiotherapy in glioblastoma multiforme – a Phase I/II dose escalation study. BMC Cancer, 14(1), 992.
³ Han, X., Fu, B., Wu, M., Zhang, H., Li, D., Zhang, J., … Sun, S. (2014). Intraoperative Radiotherapy with INTRABEAM in primary brain tumors after resection: Preliminary reports of 26 cases. Neuro-Oncology, 16.
⁴ Guo, S., Reddy, C. A., Kolar, M., Woody, N., Mahadevan, A., Deibel, F., … Suh, J. H. (2012). Intraoperative radiation therapy with the photon radiosurgery system in locally advanced and recurrent rectal cancer: retrospective review of the Cleveland clinic experience. Radiation Oncology, 7(1), 110.
⁵ Algur, E., Mahadevan, A., & Deibel, C. (2005). Interstitial photon radiosurgery system for re-current and locally advanced rectal cancer: a retrospective review of 24 patients. ASCO Gastrointestinal Cancers Symposium, Jan 27–29, Hollywood, Florida, USA, Abstract No 208.
⁶ Rutkowski, T., Wygoda, A., Hutnik, M., Składowski, K., Wydmański, J., Maciejewski, A., … Maciejewski, B. (2010). Intraoperative Radiotherapy (IORT) with Low-Energy Photons as a Boost in Patients with Early-Stage Oral Cancer with the Indications for Postoperative Radiotherapy. Strahlentherapie Und Onkologie, 186(9), 496–501.
⁷ Cognetta, A. B., Howard, B. M., Heaton, H. P., Stoddard, E. R., Hong, H. G., & Green, W. H. (2012). Superficial x-ray in the treatment of basal and squamous cell carcinomas: a viable option in select patients. Journal of the American Academy of Dermatology, 67(6), 1235–41.
⁸ Wenz, F., Schneider, F., Neumaier, C., Kraus-Tiefenbacher, U., Reis, T., Schmidt, R., & Obertacke, U. (2010). Kypho-IORT - a novel approach of intraoperative radiotherapy during kyphoplasty for vertebral metastases. Radiation Oncology, 5(1), 11.