Intraoperative Radiation Therapy Market Size & Outlook, 2026-2034

Intraoperative Radiation Therapy Market Overview

The global intraoperative radiation therapy market size is valued at USD 129.01 million in 2025 and is estimated to reach USD 260.67 million by 2034, growing at a CAGR of 8.17% during the forecast period. The consistent market growth is supported by the growing demand for micro-targeted intraoperative radiobiology protocols tailored for rare pediatric sarcoma surgeries.

Key Market Trends & Insights

• North America held a dominant share of the global market, accounting for 42.64% in 2025.
• The Asia Pacific region is projected to grow at the fastest pace, with a CAGR of 9.82%.
• Based on products and services, the systems and accelerators segment held the highest revenue market share of 61.05% in 2025.
• By technology, the electron IORT segment dominated the market in 2025.
• Based on application, the breast cancer segment dominated the market in 2025 with a revenue share of 42.31%.
• The U.S. dominates the market, valued at USD 46.18 million in 2024 and reaching USD 49.75 million in 2025.

Table: U.S. Intraoperative Radiation Therapy Market Size (USD Million)

Source: Straits Research

Market Size & Forecast

• 2025 Market Size: USD 129.01 million
• 2034 Projected Market Size: USD 260.67 million
• CAGR (2026-2034): 8.17%
• Dominating Region: North America
• Fastest-Growing Region: Asia Pacific

The intraoperative radiation therapy market comprises specialized systems, applicators, treatment planning technologies, accessories, and service offerings designed to deliver targeted radiation during surgical procedures. It includes electron-based IORT and intraoperative brachytherapy solutions used across major cancer applications such as breast, brain, gastrointestinal, head and neck, and colorectal tumors. These technologies are adopted by hospitals, specialty oncology clinics, and other care facilities to enhance precision, reduce treatment cycles, and improve patient outcomes.

Latest Market Trends

Rising integration of real-time imaging in IORT procedures

A major trend in the intraoperative radiation therapy market is the growing incorporation of real-time imaging technologies such as intraoperative CT, ultrasound, and optical navigation to enhance dose precision during surgery. This integration allows clinicians to visualize tumor margins more accurately, adjust radiation delivery on the spot, and minimize exposure to surrounding healthy tissue. As hospitals modernize surgical suites, demand for image-guided IORT systems continues to accelerate, supporting more personalized and effective cancer treatment.

Growing deployment of mobile IORT systems for surgical flexibility

The increasing adoption of mobile IORT systems that offer greater flexibility for operating rooms is a key trend driving the market growth. These compact, movable units enable hospitals and specialty clinics to integrate radiation delivery without extensive infrastructure upgrades. Their ability to be rapidly positioned, used across multiple surgical suites, and streamline workflow is driving wider utilization, supporting faster treatment delivery, and improving clinical efficiency in cancer care.

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Market Drivers

Rising government support and reimbursement for advanced cancer therapies

A major driver in the intraoperative radiation therapy market is the expanding support from governments and insurers through strengthened reimbursement frameworks for advanced, targeted cancer treatments. Many healthcare systems are recognizing IORT’s ability to reduce postoperative radiation cycles, lower overall treatment costs, and improve patient outcomes. For instance, in April 2024, a bipartisan bill Radiation Oncology Case Rate (ROCR) Value-Based Payment Program Act introduced in the U.S. Congress. It aims to shift radiation oncology reimbursement from traditional fraction-based payments to episode-based payments, thereby fostering broader coverage for advanced radiotherapy techniques, including IORT.

Market Restraints

Stringent regulatory pathways are slowing technology adoption

A major restraint in the intraoperative radiation therapy market is the extensive regulatory scrutiny required for radiation-emitting medical technologies, which prolongs approval timelines. IORT systems, applicators, and radiation-delivery components must undergo rigorous safety validation, clinical performance assessments, and quality audits before receiving authorization. These complex requirements increase development costs, delay product launches, and limit the rapid adoption of next-generation IORT solutions, ultimately slowing innovation and restricting market expansion.

Market Opportunities

Growing penetration of IORT in emerging oncology centers

A major opportunity in the intraoperative radiation therapy market lies in its expanding adoption across emerging cancer treatment centers in developing regions. As healthcare systems invest in advanced surgical oncology infrastructure, demand for compact, cost-efficient IORT systems is rising. These facilities are increasingly integrating IORT to reduce treatment cycles, improve postoperative outcomes, and offer modern radiotherapy options, creating growth prospects for manufacturers targeting high-potential, underserved markets.

Regional Analysis

North America dominated the intraoperative radiation therapy market in 2025, accounting for 42.64% market share. The growth is supported by the region’s concentration of leading academic cancer centers that actively conduct clinical trials and early adoption of advanced radiation technologies. This research-driven environment accelerates technology validation, encourages surgeon familiarity, and fosters widespread integration of IORT systems across top-tier hospitals.

In the U.S., the widespread adoption of compact and mobile intraoperative radiation systems in regional and community hospitals is expanding access beyond major cancer centers. This accessibility enables smaller hospitals across diverse geographies to offer advanced IORT treatments, notably broadening the patient base and accelerating market penetration.

Asia Pacific Market Insights

Asia Pacific is emerging as the fastest-growing region with a CAGR of 9.82% from 2026 to 2034. This growth is augmented by the emergence of regionally manufactured, cost-efficient, compact IORT systems. These devices allow smaller hospitals and cancer centers across urban and semi-urban areas to adopt advanced intraoperative radiation therapies, expanding patient access and accelerating regional market penetration.

Japan’s market growth is supported by the combination of robotic-assisted surgery with IORT. Japanese hospitals are increasingly integrating robotic surgery platforms with intraoperative radiation delivery, allowing ultra-precise tumor resection and radiation in complex anatomical areas; this synergy boosts demand for IORT systems nationwide.

Regional Market share (%) in 2025

Source: Straits Research

Europe Market Insights

Europe’s intraoperative radiation therapy market is experiencing strong growth due to the harmonization of medical-device regulations under the European Medicines Agency (EMA), which accelerates approval processes across EU member states. This streamlined pathway reduces time-to-market and promotes wider adoption of advanced intraoperative radiation therapy systems.

Germany’s market growth is supported by its well-established network of academic university hospitals that run extensive clinical research and evidence gathering for IORT across multiple cancer types. These robust research clinical collaborations accelerate clinical validation of IORT techniques, boosting adoption among German oncology centers.

Latin America Market Insights

Latin America’s market is growing steadily due to increasing adoption of compact, low‑cost IORT devices in large urban cancer centers that lack traditional radiotherapy bunkers. These systems allow metropolitan hospitals in São Paulo, Rio de Janeiro, and Mexico City to implement IORT without major infrastructure, expanding access to advanced surgical radiation therapy.

Argentina's intraoperative radiation therapy market is expanding rapidly due to the establishment of a regional cancer care hub by Comisión Nacional de Energía Atómica (CNEA), designated as an IAEA Rays of Hope Anchor Centres, the only such hub in Latin America, which boosts local capacity building, training, and radiation infrastructure, fostering broader IORT adoption nationwide.

Middle East and Africa Market Insights

The Middle East and Africa market growth is propelled by the emergence of “pay‑per‑use” financing models for radiation therapy systems in low‑resource African countries. This approach, pioneered by collaborations such as MedAccess with Elekta, lowers upfront capital burdens, enabling underfunded hospitals to adopt IORT equipment without full purchase costs, thereby expanding access to advanced intraoperative radiotherapy across underserved regions.

South Africa's intraoperative radiation therapy market is witnessing growth driven by the expansion of advanced radiotherapy infrastructure in public hospitals, including modern LINAC and brachytherapy suites at Groote Schuur Hospital, enabling precise intraoperative radiation delivery and broader adoption without full-scale cancer center upgrades.

Products & Services Insights

The systems and accelerators segment dominated the market in 2025, accounting for 61.05% revenue share, owing to the rising demand for compact, low scatter electron accelerators engineered specifically for constrained hybrid operating rooms. These systems allow precise radiation delivery without major room shielding upgrades, making them highly attractive for infrastructure-limited surgical oncology programs.

The services segment is estimated to register the fastest CAGR of 8.76% during the forecast period. This growth is fuelled by the increasing demand for on-site dosimetry validation services tailored for intraoperative scenarios, where real-time calibration support ensures accurate dose delivery. Hospitals rely on specialized service teams to optimize treatment parameters during surgery, improving safety and clinical confidence.

By Products & Services Market Share (%), 2025

Source: Straits Research

Technology Insights 

The electron IORT segment dominated the market and accounted for the highest revenue share in 2025. This growth is attributed to rising utilization of ultra-short electron beam pulses that minimize tissue scattering, enabling highly localized radiation during complex tumor resections. This precision appeals to surgeons seeking maximal tumor control with minimal collateral damage.

The intraoperative brachytherapy segment is projected to register the fastest CAGR of 8.93% during the forecast timeframe, owing to the development of customized, 3D printed applicators that conform precisely to patient-specific tumor cavities, enhancing radiation coverage and minimizing exposure to surrounding healthy tissues, thereby increasing procedural effectiveness and adoption in complex surgeries.

Application Insights

The breast cancer segment dominated the market, accounting for 42.31% of revenue share in 2025, owing to the preference for single-dose IORT during lumpectomy, reducing treatment duration, minimizing healthy tissue exposure, and improving cosmetic outcomes, driving higher adoption rates compared to other cancers.

The head and neck cancer segment is expected to register the fastest CAGR during the forecast period, owing to the increasing use of intraoperative brachytherapy combined with customized 3D printed oral cavity molds, enabling precise radiation delivery in anatomically complex regions and reducing damage to critical structures like salivary glands and nerves.

End User Insights

The hospitals segment dominated the market with a revenue share of 63.82% in 2025. This growth is driven by the integration of hybrid operating suites combining surgical and radiation capabilities, allowing hospitals to perform intraoperative radiation therapy seamlessly within existing infrastructure, enhancing workflow efficiency and attracting high patient volumes for advanced cancer treatments.

Competitive Landscape

The global intraoperative radiation therapy market is moderately fragmented, with leading medical device companies holding major shares. Market leaders sustain dominance through continuous product innovation, strategic collaborations, and expansion of service and distribution networks to enhance accessibility. Key players include Carl Zeiss Meditec AG, Elekta AB, Novacure, Xoft Inc., and Mobetron, among others, driving technological advancements and clinical adoption across hospitals and specialty oncology centers worldwide.

Xoft Inc.: An emerging market player

Xoft Inc., a U.S.-based medical technology company, is gaining prominence in the market with its electronic brachytherapy solutions. In 2023, Xoft expanded its adoption across oncology centers in North America and Europe through FDA-cleared devices and hospital partnerships. By offering portable, high precision IORT systems with streamlined clinical integration, Xoft is establishing itself as an emerging player in the market.

List of key players in Intraoperative Radiation Therapy Market

1. Elekta AB
2. Carl Zeiss Meditec AG
3. Novacure, Inc.
4. Xoft, Inc.
5. Accuray Incorporated
6. Varian Medical Systems, Inc. (Siemens Healthineers)
7. Brainlab AG
8. IntraOp Medical, Inc.
9. Ion Beam Applications SA (IBA)
10. Mevion Medical Systems, Inc.
11. AAPM Technologies
12. RaySearch Laboratories AB
13. Innovative Radiation Solutions, Inc.
14. Theragenics Corporation
15. Sensus Healthcare, Inc.
16. IZI Medical Products
17. Best Theratronics Ltd.
18. ViewRay, Inc.
19. Others

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Strategic Initiatives

• September 2025: Accuray Incorporated launched the Accuray Stellar Solution in the U.S. market to address the evolving treatment of patients undergoing radiotherapy.
• April 2025: Carl Zeiss received the FDA’s 510(k) clearance to the ZEISS INTRABEAM 700 platform, allowing its use as a robotic-assisted system to support intraoperative radiation therapy in neuro-oncology and breast cancer surgery.