scholarly journals Comparing the Outcome of Boost Dose of Intraoperative Radiotherapy with Electron (IOERT) and Low-kV X-Ray (IOXRT) and External Beam Radiotherapy (EBRT) in Breast Cancer After Neoadjuvant Chemotherapy

2019 ◽  
Vol 12 (8) ◽  
Author(s):  
Nazi Moini ◽  
Nahid Nafissi ◽  
Ebrahim Babaee ◽  
Hamidreza Mirzaei ◽  
Mohammad Esmaeil Akbari
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
External Beam Radiotherapy ◽  
Intraoperative Radiotherapy ◽  
External Beam ◽  
X Ray ◽  
Boost Dose

scholarly journals Outcomes of Radical and Boost Dose of Intraoperative Radiotherapy with Electron and Low KV X-Ray Based on Islamic Republic Intraoperative Radiotherapy (IRIORT) Consensus and the External Beam Radiotherapy in Pure Ductal Carcinoma in Situ (DCIS) in Breast Cancer Patients

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Solmaz Hashemi ◽  
Seyedmohammadreza Javadi ◽  
Mohammad Esmaeil Akbari ◽  
Hamid Reza Mirzaei ◽  
Seied Rabi Mahdavi
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
External Beam Radiotherapy ◽  
Intraoperative Radiotherapy ◽  
External Beam ◽  
X Ray ◽  
Boost Dose

Background: Radiotherapy plays an essential role in breast cancer treatment following breast conserving surgery even in good-risk patients with ductal carcinoma in situ (DCIS) histology. It can be delivered by many techniques, among which is intraoperative radiotherapy (IORT). In recent years, intraoperative radiation therapy has had the same outcome compared with EBRT. Objectives: We studied whether whole breast radiotherapy (WBRT) could safely be replaced by IORT and its ability to control local recurrence like EBRT in pure DCIS. Methods: We assigned 138 patients into the external beam radiotherapy (EBRT), radical, and boost groups. The patients were treated during the last 6 years in the Cancer Research Center of Shahid Beheshti University of Medical Sciences. A total of 57 patients received EBRT, 45 patients received the radical dose of radiotherapy by IORT (36 patients received intraoperative electron radiotherapy [IOeRT] and 9 patients received intraoperative X-ray radiotherapy [IOxRT]) according to the IRIORT consensus protocol, and 36 patients received the boost dose of radiotherapy by IORT (15 patients received IOeRT and 21 patients received IOxRT). The IORT and EBRT groups were compared. The primary endpoint was local recurrence and death and the secondary endpoint was the role of variables in local recurrence. Results: With the mean follow-up of 37 months for the IORT group and 40.1 months for the EBRT group, local recurrence occurred in 8.8% (5 patients), 13.9% (5 patients), and 2.2% (1 patient) of the patients in the EBRT, boost, and radical groups, respectively. Concerning the local recurrence, no significant difference was observed between the radical and EBRT groups (P = 0.058) and between the boost and EBRT groups (P = 0.12). Hazard ratios (HRs) of grade, hormone receptor (HR), tumor size, and age in disease-free survival were evaluated and none of these variables had a significant role in local recurrence. Conclusions: IORT is a good alternative for WBRT in DCIS patients because of its non-inferiority results in comparison with EBRT. Being careful about age, tumor size, biological markers, and margin status is of high importance when using IORT for DCIS.

scholarly journals Effect of intraoperative radiotherapy on wound healing in breast cancer patient post breast conserving surgery, KSUMC, Riyadh, Saudi Arabia: Case series and review of literature.

2019 ◽  
Vol 6 (06) ◽  
pp. 4505-4510
Author(s):  
Dr. Maha Alamodi Alghamdi ◽  
Abdulaziz Saleh Altwjri ◽  
Abdullah Alsuhaibani ◽  
Abdulaziz Alsaif
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
External Beam Radiotherapy ◽  
Intraoperative Radiotherapy ◽  
Breast Conserving Surgery ◽  
Hormone Receptor Status ◽  
Wound Complications ◽  
External Beam ◽  
X Rays ◽  
Receptor Status

Intraoperative radiotherapy during breast-conserving surgery is being studied as an alternative to 6 weeks of external beam radiotherapy (EBRT) for low-risk women; it can be delivered using electrons (intraoperative electron radiotherapy, IOERT) or 50-kV X-rays. Intraoperative radiation therapy (IORT) may pose a risk for wound complications.  Between March 2018 and June 2018, 5 breast cancer patients, all eligible for breast conserving surgery (BCS), were treated at the King Saud Medical city with IORT using the IOERT. Complete data sets for age, stage (T, N, and M), and histology and hormone receptor status were available in 5 cases. Parameters to identify eligible patients are as follows: ESTRO: >50 years, invasive ductal carcinoma/other favourable histology (IDC), T1-2 (≤3 cm), N0, any hormone receptor status, M0; ASTRO: ≥60 years, IDC, T1, N0, positive estrogen hormone receptor status, M0; TARGIT E “elderly”, risk adapted radiotherapy with IORT followed by external beam radiotherapy in case of risk factors in final histopathology. Consecutive patients operated on with the same surgical technique and given IORT were included. Wound complications were evaluated.

Cosmetic outcome 1, 2, 3, and 4 years after intraoperative radiotherapy or external beam radiotherapy for early breast cancer: An objective assessment of patients from a randomized controlled trial.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 94-94
Author(s):  
M. R. Keshtgar ◽  
N. R. Williams ◽  
T. Corica ◽  
C. Saunders ◽  
M. Bulsara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Controlled Trial ◽  
Tumour Size ◽  
External Beam Radiotherapy ◽  
Objective Assessment ◽  
Intraoperative Radiotherapy ◽  
Cosmetic Outcome ◽  
External Beam ◽  
Randomized Controlled

94 Background: The randomized controlled TARGIT Trial was designed to determine noninferiority between the novel technique of TARGIT [intra-operative radiotherapy with Intrabeam (Carl Zeiss, Germany)] and conventional external beam radiotherapy (EBRT) in women with early breast cancer. The main outcome objective is risk of local relapse within the treated breast. We report here data from a subprotocol assessing cosmesis in 114 women over 50 years old participating in the TARGIT Trial from one center (Perth, Australia). Methods: Frontal view digital photographs from were assessed, blind to treatment, using specialist software (BCCT.core 2.0, INESC Porto, Portugal) that produces an objective composite score based on symmetry, color, and scar. Data on patient and tumor characteristics were obtained from hospital notes. Statistical analysis was by generalized estimating equations (GEE) on all data, and logistic regression analysis at year 1 only. Results: Photographs were taken at baseline (before surgery) and 1, 2, 3, and 4 years after initial breast-conserving surgery; none of the 114 patients had subsequent breast surgery. Median age at randomization was 62 years (IQR 56 to 68). The composite scores were dichotomized into Excellent and Good (EG), and Fair and Poor (FP). There was a nonsignificant 45% increase in the odds of having an outcome of EG for patients in the TARGIT group relative to the EBRT group (OR=1.45, 95%CI 0.78 – 2.69, p=0.245) after adjusting for tumour size. The results were similar when adjusted for tumor grade and age of the patient. For year 1 there was a statistically significant 2.35 fold increase in the odds of having an outcome of EG for patients in the TARGIT group relative to the EBRT group (OR=2.35, 95%CI 1.02 – 5.45, p=0.047) after adjusting for age of the patient, tumor size, and grade. Conclusions: These results confirm a significantly better cosmetic outcome with TARGIT compared to EBRT in the first year after surgery.

Cosmetic outcome after intraoperative radiotherapy or external beam radiotherapy for early breast cancer: An objective assessment of patients from a randomized controlled trial.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1110-1110
Author(s):  
Mohammed R. Keshtgar ◽  
Norman R. Williams ◽  
Tammy Corica ◽  
Max Bulsara ◽  
Christobel Saunders ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Assessment Tool ◽  
Controlled Trial ◽  
External Beam Radiotherapy ◽  
Objective Assessment ◽  
Intraoperative Radiotherapy ◽  
Cosmetic Outcome ◽  
High Dose ◽  
External Beam

1110 Background: The international randomised contolled TARGeted Intraoperative radioTherapy (TARGIT) trial has demonstrated non-inferiority between the novel technique of TARGIT (intra-operative radiotherapy with Intrabeam) and conventional whole-breast external beam radiotherapy (EBRT) in women with early breast cancer, in terms of the primary outcome measure of risk of local relapse within the treated breast. With very low recurrence rates, cosmesis becomes an increasingly important outcome of breast conserving treatment with both surgery and radiotherapy. This study was performed to determine if the single high dose of TARGIT leads to impaired cosmesis. Methods: A validated, objective assessment tool for evaluation of cosmetic outcome was used. Frontal digital photographs were taken at baseline (before TARGIT or EBRT) and yearly thereafter for up to five years. The photographs were analysed by BCCT.core software which produces a composite score based on symmetry, colour and scar. Results: 342 patients were assessed, all over 50 years old with a median age at baseline of 64 years (IQR 59 to 68). The scores were dichotomised into Excellent and Good (EG), and Fair and Poor (FP). There were statistically significant increases in the odds of having an outcome of EG for patients in the TARGIT group relative to the EBRT group at year 1 (OR = 2.07, 95%CI 1.12 to 3.85, p = 0.021) and year 2 (OR = 2.11, 95%CI 1.0 to 4.45, p = 0.05). Conclusions: Following an objective assessment of aesthetic outcome in patients from a randomised setting, this study demonstrates that those treated with targeted intraoperative radiotherapy have a superior cosmetic result compared with those patients who received conventional whole-breast external beam radiotherapy.

Cosmetic outcome after intraoperative radiotherapy or external beam radiotherapy for early breast cancer: An objective assessment of patients from a randomized controlled trial.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 59-59
Author(s):  
Mohammed R. Keshtgar ◽  
Norman R. Williams ◽  
Tammy Corica ◽  
Max Bulsara ◽  
Christobel Saunders ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Assessment Tool ◽  
Controlled Trial ◽  
External Beam Radiotherapy ◽  
Objective Assessment ◽  
Intraoperative Radiotherapy ◽  
Cosmetic Outcome ◽  
High Dose ◽  
External Beam

59 Background: The international randomised contolled TARGeted Intraoperative radioTherapy (TARGIT) trial has demonstrated non-inferiority between the novel technique of TARGIT (intra-operative radiotherapy with Intrabeam) and conventional whole-breast external beam radiotherapy (EBRT) in women with early breast cancer, in terms of the primary outcome measure of risk of local relapse within the treated breast. With very low recurrence rates, cosmesis becomes an increasingly important outcome of breast conserving treatment with both surgery and radiotherapy. This study was performed to determine if the single high dose of TARGIT leads to impaired cosmesis. Methods: A validated, objective assessment tool for evaluation of cosmetic outcome was used. Frontal digital photographs were taken at baseline (before TARGIT or EBRT) and yearly thereafter for up to five years. The photographs were analysed by BCCT.core software which produces a composite score based on symmetry, colour and scar. Results: 342 patients were assessed, all over 50 years old with a median age at baseline of 64 years (IQR 59 to 68). The scores were dichotomised into Excellent and Good (EG), and Fair and Poor (FP). There were statistically significant increases in the odds of having an outcome of EG for patients in the TARGIT group relative to the EBRT group at year 1 (OR = 2.07, 95% CI 1.12 to 3.85, p = 0.021) and year 2 (OR = 2.11, 95% CI 1.0 to 4.45, p = 0.05). Conclusions: Following an objective assessment of aesthetic outcome in patients from a randomised setting, this study demonstrates that those treated with targeted intraoperative radiotherapy have a superior cosmetic result compared with those patients who received conventional whole-breast external beam radiotherapy.

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