77424 Intraoperative radiation treatment delivery, x-ray, single treatment session

Name of the Procedure:

Intraoperative Radiation Treatment Delivery, X-Ray, Single Treatment Session

Summary

Intraoperative radiation treatment (IORT) with x-ray is a procedure where a concentrated dose of radiation is delivered directly to a tumor or tumor bed during surgery. This allows for a high dose of radiation to be administered to the target area while sparing the surrounding healthy tissues.

Purpose

IORT is primarily used to treat cancer, often during surgery to remove a tumor. The goal is to destroy residual cancer cells that remain in the area post-resection, thereby reducing the risk of recurrence.

Indications

• Presence of localized tumors that can be surgically removed.
• Patients with cancer types known to respond well to radiation therapy.
• Patients needing radiation who require protection of surrounding healthy tissues.

Preparation

• Patients may need to fast for a specified time before the surgery.
• Medication adjustments may be necessary.
• Preoperative imaging studies (e.g., CT scans, MRIs) and lab tests to assess suitability for surgery and radiation.

Procedure Description

1. The patient undergoes standard surgical procedures to remove the tumor.
2. Once the tumor is resected, a specialized x-ray device is positioned to deliver a focused radiation dose to the tumor bed.
3. Radiation is carefully administered to ensure maximum exposure to residual cancer cells with minimal impact on surrounding healthy tissue.
4. The surgical procedure is then completed, and the incision is closed.

Tools and Equipment

• X-ray radiation delivery system.
• Surgical instruments for tumor resection.

Anesthesia

• General anesthesia is typically used to ensure the patient remains unconscious and pain-free during the entire procedure.

Duration

The procedure duration varies but typically ranges from 1 to 3 hours, depending on the complexity of the tumor resection and radiation delivery.

Setting

Performed in a hospital operating room equipped with the necessary surgical and radiation equipment.

Personnel

• Surgeon
• Radiation oncologist
• Anesthesiologist
• Surgical nurses and technicians
• Radiation technologists

Risks and Complications

• Common risks: Skin irritation, mild pain, and fatigue.
• Rare risks: Damage to adjacent organs or tissues, infection, bleeding, or radiation burns.
• Complications are managed through appropriate postoperative care and monitoring.

Benefits

• High precision radiation minimizes damage to healthy tissues.
• Reduction in the recurrence rate of cancer.
• Potentially decreases the need for postoperative radiation sessions.

Recovery

• Patients usually stay in the hospital for observation and initial recovery.
• Pain management with prescribed medications.
• Follow-up appointments to monitor healing and effectiveness.
• Recovery time varies: typically a few weeks for surgical recovery and several months for full assessment of radiation effects.

Alternatives

• External beam radiation therapy, which involves multiple sessions of radiation post-surgery.
• Chemotherapy.
• Alternative surgical approaches.
• Pros and cons: IORT provides higher radiation precision and may reduce overall treatment time compared to external beam radiation, but it requires specialized equipment and expertise.

Patient Experience

• During the procedure: Patients do not experience anything due to general anesthesia.
• After the procedure: Some discomfort and pain at the surgical site, managed with pain relief measures.
• Patients may feel fatigued and require rest and limited physical activity for several weeks.