Intrabeam radiotherapy system for adjuvant treatment of early breast cancer

The Intrabeam radiotherapy system (Carl Zeiss UK) is a mobile irradiation system. It is designed to deliver a single dose of targeted low-energy radiation (X‑rays) directly to the tumour bed, while limiting the exposure of healthy tissue to radiation. Because it delivers low energy radiation, it can be used in an ordinary operating theatre at the time of surgery. The Intrabeam radiotherapy system provides a source of 50 kV energy from a spherical applicator of between 1.5 cm and 5.0 cm diameter. The applicator is sutured to the tumour bed so that breast tissue at risk of local recurrence receives the prescribed dose while skin and deeper structures are protected. Radiation is delivered over 20 to 30 minutes.

The Intrabeam radiotherapy system was granted a CE (Conformité Européene) mark in 1999 for use in radiotherapy.

Intrabeam can be used as an intraoperative radiotherapy system given as the sole treatment or as a boost treatment followed by external beam radiotherapy (EBRT). When intraoperative radiotherapy is given as a boost treatment with Intrabeam and followed by EBRT, there is no need for further external boost treatment. Six NHS centres in the UK have used Intrabeam for adjuvant treatment of early breast cancer.

Adverse reactions are mostly related to wound-related complications and radiotherapy-related complications.

The surface of the tumour bed typically receives a single fraction of 20 grays, which attenuates to 5 grays to 7 grays at a depth of 1 cm.

The cost of the Intrabeam radiotherapy system (including the spherical applicators) is £435,000 (excluding VAT, Carl Zeiss UK personal notification). The company estimates that device maintenance and servicing costs are about £35,000 per year. Costs may vary in different settings because of negotiated procurement discounts.