New York-Presbyterian/Columbia University Medical Center has developed a new method to treat cancer by delivering personalized radiation therapy during a surgical procedure. Intraoperative radiotherapy (IORT) reduces the threat of recurrence, shortens the duration of post-operative external radiation, and minimizes the risk to healthy tissue associated with external radiation.

New York-Presbyterian first offered IORT to women with certain breast cancers in 2012, the first hospital in New York City to do so. In 2014, a team employed IORT for the first time on a non-breast cancer.

A woman with recurrent colon cancer in the pelvic cavity required treatment in separate areas of her body, but she had already received high cumulative doses of radiation therapy. In addition, anatomy prevented the surgeon, Ravi Kiran, MD, from cutting too close to vital blood vessels and organs.

As a result, Clifford Chao, MD, the chair of radiation oncology at NewYork-Presbyterian/Columbia, opted to pursue IORT to eradicate leftover tumor cells. Chao used a flat radiotherapy applicator to deliver radiation near blood vessels along the pelvic wall and a spherical applicator for regions in the pelvic cavity. A protective wrap protected the bowel and blood vessels from scatter radiation. Since then, Chao has partnered with surgeon Tomoaki Kato, MD, to treat a 23 year-old woman with a bile duct tumor and chief of gynecologic oncology Jason Wright, MD, to treat gynecologic cancer.

“Because of the way the tumor needs to be removed, or because the spaces between a tumor and large vessels and nerves are too small, microscopic lesions are more likely to be attached to the surface of blood vessels and nerves. IORT allows us to treat those areas and lower the risk of recurrence,” Chao said.

In some instances of breast cancer, IORT has enabled patients to forego 6 to 7 weeks of radiation therapy while yielding the same results as conventional full-breast radiation. Chao sees the therapy as a step toward personalized care, and has partnered with engineers and physicists from NewYork Presbyterian/Columbia and NewYork-Presbyterian/Weill Cornell Medical Center to design and develop applicators for colorectal, head and neck, lung, and gynecologic cancers.

For more information, visit New York-Presbyterian Hospital and Columbia University Medical Center.