Intraoperative Radiation Therapy (IORT) (CPB 0721, reviewed 2025-10-20)
Summary
Aetna considers intraoperative radiation therapy (IORT) medically necessary for cervical cancer, colorectal cancer, soft tissue sarcoma (including retroperitoneal sarcoma), and uterine cancer, and considers single-fraction electron-beam IORT at the time of lumpectomy medically necessary for breast cancer when the selection criteria are met. For breast cancer, the criteria are a documented diagnosis of early stage (0, I or II) breast cancer, negative lymph nodes, technically clear surgical margins, and a tumor less than or equal to 5 cm in diameter. IORT is considered experimental, investigational, or unproven for brain tumors and brain metastasis, cholangiocarcinoma, conjunctival neoplasms, gastric cancer, glioma, head and neck cancers, osteosarcoma, pancreatic cancer, prostate cancer, renal cell carcinoma, spinal metastases, sporadic renal angiomyolipoma, thymoma, and vertebral metastases (the list is not all-inclusive).
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