Anesthetic Considerations for Intraoperative Radiation Therapy

Area of Science:

• Oncology
• Anesthesiology
• Radiation Oncology

Background:

• Intraoperative radiation therapy (IORT) traditionally required patient transport from the operating room (OR) to a linear accelerator.
• Mobile accelerators now enable IORT delivery directly within the OR, introducing new anesthetic considerations.

Purpose of the Study:

• To review the applications and advantages of IORT.
• To identify operative and anesthetic challenges associated with IORT.
• To discuss unique issues pertinent to IORT delivery in the OR.

Main Methods:

• Literature review focusing on IORT, its benefits, and challenges.
• Analysis of the anesthesiologist's role in OR-based IORT.
• Examination of patient safety and radiation delivery aspects.

Main Results:

• Patient safety and accurate radiation dose delivery are paramount in IORT.
• Anesthesiologist's responsibilities include selecting appropriate anesthesia for immobility and sentinel node mapping.
• Continuous vital sign monitoring and sterile field maintenance are crucial anesthetic roles during IORT.

Conclusions:

• While in-OR IORT simplifies logistics, it necessitates anesthesiologist vigilance.
• Proactive planning by anesthesiologists is essential to address potential complications.
• Successful IORT outcomes depend on careful anesthetic management within the OR environment.