Complication Rates After Intraoperative Radiation Therapy: Do Applicator Size and Distance to Skin Matter?

Area of Science:

• Oncology
• Radiation Oncology
• Surgical Oncology

Background:

• Intraoperative radiation therapy (IORT) is increasingly used for early-stage breast cancer.
• Limited research exists on demographic and technical risk factors for IORT complications.
• This study investigates applicator size and skin distance as potential risk factors.

Purpose of the Study:

• To determine if applicator size is a significant risk factor for complications after IORT for early-stage breast cancer.
• To assess if skin distance is a significant risk factor for complications after IORT for early-stage breast cancer.
• To identify demographic and technical factors associated with IORT complications.

Main Methods:

• Prospective data collection from 219 patients undergoing lumpectomy with IORT (2013-2018).
• Exclusion of patients with prior radiation or breast cancer history.
• Statistical analysis using Student's t-test, Fisher's exact test, and odds ratios for demographic and technical factors.

Main Results:

• No Clavien-Dindo grade 2 or higher complications occurred.
• Minor complications were observed in 21.0% of patients, most commonly seroma (n=37).
• Diabetes was the only significant comorbidity (OR 3.2), while applicator size and skin distance were not significant risk factors.

Conclusions:

• Neither applicator size nor closest skin distance were associated with increased complications.
• Traditional risk factors like BMI and smoking were not predictive.
• Findings support the potential expansion of IORT utilization without increasing complication rates.