CPT® Code 77425

1. Indications

Intraoperative radiation therapy (IORT) is indicated for the treatment of various malignant tumors. The specific indications include:

• Gastric Tumors Tumors located in the stomach that require targeted radiation therapy during surgical intervention.
• Pancreatic Tumors Malignant tumors of the pancreas that can benefit from localized radiation treatment.
• Colonic Tumors Tumors found in the colon that necessitate precise radiation delivery to minimize damage to surrounding tissues.
• Rectal Tumors Malignant growths in the rectum that are treated with IORT to enhance therapeutic outcomes.
• Anal Tumors Tumors in the anal region that require focused radiation therapy during surgery.
• Cervical Tumors Malignant tumors of the cervix that can be treated with intraoperative radiation to improve local control.
• Uterine Tumors Tumors located in the uterus that may benefit from targeted radiation during surgical procedures.
• Ovarian Tumors Malignant tumors of the ovaries that are addressed with IORT for enhanced treatment efficacy.
• Prostatic Tumors Tumors of the prostate gland that can be treated with intraoperative radiation therapy.
• Bladder Tumors Malignant tumors in the bladder that require localized radiation treatment.
• Kidney Tumors Tumors located in the kidneys that can be effectively treated with IORT.
• Soft Tissue Sarcomas Malignant tumors of soft tissues that are addressed with intraoperative radiation therapy to improve outcomes.

2. Procedure

The procedure for intraoperative radiation therapy (IORT) involves several critical steps to ensure effective treatment delivery. First, the surgeon performs a separate surgical procedure to excise as much of the tumor as possible. This initial step is crucial as it allows for the maximum removal of malignant tissue. Following tumor resection, the surgeon carefully repositions healthy organs away from the radiation field to minimize exposure and protect surrounding tissues. This repositioning is essential for ensuring that the radiation is focused solely on the tumor site. Next, specialized tubes are utilized to direct the radiation precisely to the tumor. These tubes help in concentrating the radiation dose on the target area while limiting the impact on adjacent healthy structures. Once the setup is complete, the radiation treatment is delivered. The use of electron beams in intraoperative electron radiation therapy (IOERT) allows for a rapid drop-off of radiation dose beneath the target site, further reducing the risk of damage to underlying healthy tissues. IOERT may be conducted in a dedicated operating room equipped with a radiation therapy machine and appropriate shielding or in a standard operating room using a self-shielded, mobile linear accelerator designed for IOERT.

3. Post-Procedure

After the completion of intraoperative radiation therapy (IORT), patients may require specific post-procedure care to monitor for any potential side effects or complications. The recovery process typically involves close observation of the surgical site and management of any discomfort or pain that may arise following the procedure. Patients may also need follow-up imaging studies to assess the effectiveness of the treatment and to ensure that there are no residual tumor cells. It is important for healthcare providers to provide patients with detailed instructions regarding activity restrictions, wound care, and signs of complications that should prompt immediate medical attention. The overall recovery time may vary depending on the extent of the surgery performed and the individual patient's health status.