Late Toxicity and Cosmetic Outcome in Patients With Breast Cancer Treated With Intraoperative Radiation Therapy as an Electron Boost

2012 ◽  
Vol 84 (3) ◽  
pp. S253-S254
Author(s):  
M. Govers ◽  
R. Weytjens ◽  
K. Erven ◽  
P. van Dam ◽  
S. Van Laere ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Late Toxicity ◽  
Cosmetic Outcome ◽  
Intraoperative Radiation Therapy ◽  
Intraoperative Radiation ◽  
Electron Boost

Early clinical results of intraoperative radiation therapy (IORT) during breast conservation using an electronic brachytherapy (EBX) technique.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 83-83
Author(s):  
V. Elayne Arterbery ◽  
Pamela Johnson
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Postoperative Complications ◽  
Breast Conservation ◽  
Clinical Results ◽  
Cosmetic Outcome ◽  
Intraoperative Radiation Therapy ◽  
Intraoperative Radiation ◽  
Electronic Brachytherapy

83 Background: Intraoperative radiation therapy (IORT) as an alternative to whole breast irradiation (WBI) has been described for patients with early-stage breast cancer. The randomized phase III TARGiT trial demonstrated similar recurrence rates to WBI and a lower overall toxicity profile. IORT-related effects and early postoperative outcome were assessed. We report our clinical experience using a 50 Kv EBX HDR radiotherapy delivery system using a balloon technique. We assessed institutional postoperative complications, clinical outcome and histological findings in patients undergoing IORT for breast cancer on a physician sponsored study. Methods: 22 patients (median age 71 years, negative LN and tumor less than 3 cm) underwent lumpectomy, sentinel lymph node (SLN) biopsy, and concurrent IORT from December 2010 to January 2013. 18 were treated on the study and 4 refused enrollment and elected to be treated off protocol. Patients received IORT (20 Gy) during breast conserving surgery using an EBX technique. WBI was added according to clinical guidelines. Cosmetic results and quality of life were evaluated. Results: Postoperative complications and toxicity was rare without grade 3/4 toxicities. The most frequent postoperative side effects were palpable seroma (8.3%). Erythema grade 1-2 of the breast was found in (13%); whereas in some (3.4%), mastitis. In 80% of the cases patient had IFDCA, the remainder DCIS and tumor size ranged between 0.7 and 2.6 cm (median = 1.0cm). At median 1 year follow-up, no patient suffered a local recurrence. Cosmetic outcome was perceived excellent in most patients and 100% would recommend the procedure. One patient required WBI due to close margins at re-excision. No patient had positive SLN on final path. Conclusions: IORT using electronic brachytherapy as part of breast conservation is safe. The potential advantages of IORT are minimal time needed for cellular repopulation between surgery and radiation treatment, cosmetic outcome and significant logistical advantages and reduced cost. Careful surgical assessment minimizes the need for WBI. Longer follow-up will determine clinical results for cosmetic outcome and local control.

scholarly journals Changes in peripheral immune cells after intraoperative radiation therapy in low-risk breast cancer

2020 ◽  
Vol 62 (1) ◽  
pp. 110-118
Author(s):  
Isabel Linares-Galiana ◽  
Miguel Angel Berenguer-Frances ◽  
Rut Cañas-Cortés ◽  
Monica Pujol-Canadell ◽  
Silvia Comas-Antón ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Single Dose ◽  
Cancer Patients ◽  
Antitumor Immunity ◽  
Low Risk ◽  
Intraoperative Radiation Therapy ◽  
Breast Cancer Patients ◽  
Intraoperative Radiation ◽  
Risk Breast Cancer

Abstract A detailed understanding of the interactions and the best dose-fractionation scheme of radiation to maximize antitumor immunity have not been fully established. In this study, the effect on the host immune system of a single dose of 20 Gy through intraoperative radiation therapy (IORT) on the surgical bed in low-risk breast cancer patients undergoing conserving breast cancer has been assessed. Peripheral blood samples from 13 patients were collected preoperatively and at 48 h and 3 and 10 weeks after the administration of radiation. We performed a flow cytometry analysis for lymphocyte subpopulations, natural killer cells (NK), regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSCs). We observed that the subpopulation of NK CD56+high CD16+ increased significantly at 3 weeks after IORT (0.30–0.42%, P < 0.001), while no changes were found in immunosuppressive profile, CD4+CD25+Foxp3+Helios+ Treg cells, granulocytic MDSCs (G-MDSCs) and monocytic MDSCs (Mo-MDSCs). A single dose of IORT may be an effective approach to improve antitumor immunity based on the increase in NK cells and the non-stimulation of immunosuppressive cells involved in immune escape. These findings support future combinations of IORT with immunotherapy, if they are confirmed in a large cohort of breast cancer patients.

scholarly journals PD-0479: Intraoperative radiation therapy for breast cancer with INTRABEAMÆ: minimizing cost analysis

2015 ◽  
Vol 115 ◽  
pp. S236-S237
Author(s):  
B. Pinar ◽  
N. Rodriguez-Ibarria ◽  
M.A. Cabezon-Pons ◽  
D. Rey-Baltar ◽  
J.M. Blanco-Suarez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cost Analysis ◽  
Intraoperative Radiation Therapy ◽  
Intraoperative Radiation

scholarly journals Intraoperative radiation therapy for early stage breast cancer: experiences from Iran

2020 ◽  
Author(s):  
Vahid Zangouri ◽  
Hamid Nasrollahi ◽  
Ali Taheri ◽  
Majid Akrami ◽  
Peyman Arasteh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Patient Selection ◽  
Tumor Size ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Intraoperative Radiation Therapy ◽  
Study Patient ◽  
Intraoperative Radiation

Abstract Background and objective Currently no definite guideline exists on the use of intraoperative radiation therapy (IORT) among patients with early stage BC. We report our experiences with IORT among breast cancer (BC) patients in our region.Methods All patient who received radical IORT from April 2014 on to March 2020 were included in the study. Patient selection criteria were as followed: age equal or older than 45 years old; all cases of invasive carcinomas, moreover in lobular carcinomas only after MRI and confirmation, and in cases with ductal carcinoma in-situ (DCIS) only those with low, intermediate grade, tumor size of equal or less than 2.5cm and a margin of 2-3mm; those between 45 and 50 years old with a tumor size of 0-2cm, those between 50 and 55 years old with a tumor size of 2-2.5cm, and those ≥55 years old with a tumor size of 2.5-3cm; those with invasive tumors a negative margin and in cases of DCIS a margin of 3mm; a negative nodal status (exception in patients with micrometastasis); and a positive estrogen receptor status. Results Overall, 252 patients entered the study. Mean (SD) age of patients was 56.43±7.79 years. In total, 32.9% of patients had a family history of BC. Mean tumor size was 1.56±0.55 cm. Median (IQR) follow-up of patients was 24 (13, 36) months. Overall, 6 patients (2.4%) experienced recurrence in follow-up visits, among which three (1.2%) were local recurrence, two (0.8%) were regional recurrence and one patients (0.4%) had metastasis.Median (IQR) time to recurrence was 23 (13, 36) among the six patient who had recurrence. Overall, 11 patients (4.3%) with DCIS in our study received IORT. All these patients had free margins in histopathology examination. None of these patients experience recurrence.Conclusion For the first time, we categorized patients according to age and tumor size and older patients with larger tumor sizes were considered appropriate candidates for IORT. Our series showed a successful experience with the use of IORT in a region where facilities for IORT are limited using our modified criteria for patient selection.

Surgical and Oncologic Outcomes With Intraoperative Radiation Therapy for Early Breast Cancer

2021 ◽  
pp. 000313482110474
Author(s):  
Orli Friedman-Eldar ◽  
Christina Layton ◽  
Iago De Castro Silva ◽  
Mecker G Moller ◽  
Ahkeel Allen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Early Stage ◽  
Oncologic Outcomes ◽  
Intraoperative Radiation Therapy ◽  
Perioperative Outcomes ◽  
Wound Complications ◽  
Intraoperative Radiation ◽  
Areola Complex

Background For selected patients with early-stage breast cancer (BC), intraoperative radiation therapy (IORT) has emerged as a convenient alternative to standard whole breast irradiation (WBI). We report a single institution experience with IORT in terms of oncologic outcomes, toxicities, and cosmesis. Methods Clinicopathological and perioperative outcomes of patients who underwent IORT for early-stage BC at a public hospital from 2017 to 2020 were retrospectively retrieved. Toxicity was categorized to acute or chronic based on 6 months post-IORT cutoff. Results 85 patients underwent IORT and had complete data, aged 49‐85 years (mean 62). Intraoperative radiation therapy added 23 minutes on average to the total operative time. Final stage was 0, I, and II in 40%, 58.9%, and 1.1% of patients, respectively. Mean tumor size was 0.8 cm (range .1-2.1), with ductal histology comprising 94% of cases. Surgical margins were positive in 2 patients, and adjuvant WBI was required in 5 patients. After a median follow‐up of 17 months (range 3-41), none of the patients had local recurrence and no mortality was recorded. Early wound complications included wound dehiscence (n = 1), seroma/hematoma (n = 15), and re-operation with loss of nipple-areola complex (n = 1). Chronic skin toxicities were reported in 10 (12%) patients and good or excellent cosmetic outcome was reported in 93% of patients. Conclusions Utilizing IORT among low-risk early BC patients may be a safe and more convenient alternative to traditional WBI, with low toxicity rate, acceptable cosmetic results, and good oncologic outcomes at 17 months. Longer follow-up and further prospective controlled studies are needed to confirm these findings.

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