Intraoperative radiotherapy boost as part of breast-conservation therapy for breast cancer: a single-institution retrospective analysis
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| Názov: | Intraoperative radiotherapy boost as part of breast-conservation therapy for breast cancer: a single-institution retrospective analysis |
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| Autori: | Stoian, Raluca, Erbes, Thalia, Zamboglou, Constantinos, Scholber, Jutta Ursula, Gainey, Mark, Sachpazidis, Ilias, Haehl, Erik, Spohn, Simon, Verma, Vivek, Krug, David, Rühle, Alexander, Juhasz-Böss, Ingolf, Grosu, Anca-Ligia, Nicolay, Nils H., Sprave, Tanja |
| Zdroj: | Strahlenther Onkol |
| Informácie o vydavateľovi: | Springer Science and Business Media LLC, 2021. |
| Rok vydania: | 2021 |
| Predmety: | Female [MeSH], Mastectomy, Segmental [MeSH], Radiotherapy, Adjuvant/methods [MeSH], Adjuvant radiation therapy, Humans [MeSH], Breast Neoplasms/drug therapy [MeSH], Retrospective Studies [MeSH], Breast Neoplasms/radiotherapy [MeSH], Boost, Original Article, Early breast cancer, Breast-conservation therapy, Neoplasm Recurrence, Local [MeSH], Breast Neoplasms/surgery [MeSH], Breast/radiation effects [MeSH], Intraoperative radiotherapy, Breast Neoplasms, Mastectomy, Segmental, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Humans, Female, Radiotherapy, Adjuvant, Breast, Neoplasm Recurrence, Local, Retrospective Studies |
| Popis: | Background There are currently no data from randomized controlled trials on the use of intraoperative radiotherapy (IORT) as a tumor bed boost as part of a breast-conservation approach for breast cancer. This study retrospectively reviewed the safety and efficacy of IORT as a boost treatment at a tertiary cancer center. Methods From 2015 to 2019, patients underwent breast-conserving surgery with axillary lymph node staging and a single dose of 20 Gy IORT with 50-kV photons, followed by whole-breast irradiation (WBI) and adjuvant systemic therapy (if applicable). Patients were followed for assessment of acute and late toxicities (using the Common Terminology Criteria for Adverse Events version 5.0) at 3–6-month intervals. Outcomes included ipsilateral (IBTR) and contralateral breast progression-free survival (CBE), distant metastasis-free survival (DMFS), and overall survival (OS). Results Median follow-up for the 214 patients was 28 (range 2–59) months. Most patients had T1 disease (n = 124) and were clinically node negative. Only few patients had high-grade and/or triple-negative disease. The vast majority of patients underwent sentinel node biopsy, and 32 (15%) required re-resection for initially positive margins. Finally, all tumor bed margins were clear. Nine (4.2%) and 48 (22.4%) patients underwent neoadjuvant and adjuvant chemotherapy, respectively. WBI was predominantly performed as conventionally fractionated WBI (n = 187, 87.4%), and the median time from BCS to WBI was 54.5 days. IORT was delivered with a single dose of 20 Gy. The median WBI dose was 50 Gy (range 29.4–50.4 Gy). No patients experienced grade 4 events; acute grade 3 toxicities were limited to 17 (8%) cases of radiation dermatitis. Postoperative toxicities were mild. After WBI only one case of late grade ≥ 2 events was reported. There were two recurrences in the tumor bed and one contralateral breast event. Conclusion This investigation provides additional preliminary data supporting the using of IORT in the boost setting and corroborates the existing literature. These encouraging results should be prospectively validated by the eventual publication of randomized studies such as TARGIT‑B. |
| Druh dokumentu: | Article Other literature type |
| Popis súboru: | |
| Jazyk: | English |
| ISSN: | 1439-099X 0179-7158 |
| DOI: | 10.1007/s00066-021-01785-2 |
| Prístupová URL adresa: | https://link.springer.com/content/pdf/10.1007/s00066-021-01785-2.pdf https://pubmed.ncbi.nlm.nih.gov/33938966 https://link.springer.com/content/pdf/10.1007/s00066-021-01785-2.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397646 https://europepmc.org/article/MED/33938966 https://link.springer.com/article/10.1007/s00066-021-01785-2 https://repository.publisso.de/resource/frl:6448667 |
| Rights: | CC BY |
| Prístupové číslo: | edsair.doi.dedup.....9a2cbb1589ae335633aab75bdf1e4e93 |
| Databáza: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Background There are currently no data from randomized controlled trials on the use of intraoperative radiotherapy (IORT) as a tumor bed boost as part of a breast-conservation approach for breast cancer. This study retrospectively reviewed the safety and efficacy of IORT as a boost treatment at a tertiary cancer center. Methods From 2015 to 2019, patients underwent breast-conserving surgery with axillary lymph node staging and a single dose of 20 Gy IORT with 50-kV photons, followed by whole-breast irradiation (WBI) and adjuvant systemic therapy (if applicable). Patients were followed for assessment of acute and late toxicities (using the Common Terminology Criteria for Adverse Events version 5.0) at 3–6-month intervals. Outcomes included ipsilateral (IBTR) and contralateral breast progression-free survival (CBE), distant metastasis-free survival (DMFS), and overall survival (OS). Results Median follow-up for the 214 patients was 28 (range 2–59) months. Most patients had T1 disease (n = 124) and were clinically node negative. Only few patients had high-grade and/or triple-negative disease. The vast majority of patients underwent sentinel node biopsy, and 32 (15%) required re-resection for initially positive margins. Finally, all tumor bed margins were clear. Nine (4.2%) and 48 (22.4%) patients underwent neoadjuvant and adjuvant chemotherapy, respectively. WBI was predominantly performed as conventionally fractionated WBI (n = 187, 87.4%), and the median time from BCS to WBI was 54.5 days. IORT was delivered with a single dose of 20 Gy. The median WBI dose was 50 Gy (range 29.4–50.4 Gy). No patients experienced grade 4 events; acute grade 3 toxicities were limited to 17 (8%) cases of radiation dermatitis. Postoperative toxicities were mild. After WBI only one case of late grade ≥ 2 events was reported. There were two recurrences in the tumor bed and one contralateral breast event. Conclusion This investigation provides additional preliminary data supporting the using of IORT in the boost setting and corroborates the existing literature. These encouraging results should be prospectively validated by the eventual publication of randomized studies such as TARGIT‑B. |
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| ISSN: | 1439099X 01797158 |
| DOI: | 10.1007/s00066-021-01785-2 |