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. 2018;7(2):167-173.
doi: 10.1007/s13566-017-0338-z. Epub 2017 Dec 19.

Intraoperative radiation therapy as part of planned monotherapy for early-stage breast cancer

Varun K Chowdhry  1 , Julie A Bushey  2 , Rebecca M Kwait  3 , Saveli Goldberg  1 , Jeannine Ritchie  4 , Yong-Li Ji  5 , Roderick McKee  3 , Diane Palladino  3 , Gary M Proulx  1
Affiliations

Intraoperative radiation therapy as part of planned monotherapy for early-stage breast cancer

Varun K Chowdhry et al. J Radiat Oncol. 2018.

Abstract

Introduction: Adjuvant whole breast radiation therapy has developed into the standard of care for patients following a lumpectomy for early-stage breast cancer. However, there is recent interest in intraoperative radiation therapy (IORT) to minimize toxicity while still improving local control beyond surgical resection and anti-estrogen therapy alone.

Materials and methods: All patients were evaluated pre-operatively in a multidisciplinary clinic setting at a community hospital for suitability for breast conservation therapy. A total of 109 patients were reviewed receiving 110 IORT treatments. Patients were followed with clinical breast examinations and mammography as clinically indicated.

Results: At a median follow-up of 29.9 months, 2/110 (1.8%) patients experienced a local failure. One patient (0.9%) experienced a regional failure. Local control, disease-free survival and overall survival at 3 years were 98.9% (95%CI 92.2-99.8), 97.2% (95%CI 88.9-99.3), and 96.0% (95%CI 84.9-99.0), respectively. Five-year local control, disease-free survival, and overall survival rates were 96.3% (95%CI 84.7-99.2), 94.6% (95%CI 83.2-98.3), and 92.5% (95%CI 80.4-97.3), respectively. Patient self-reported cosmetic outcome was available for 51 patients, with all patients reporting being either very pleased, pleased, or satisfied with their cosmetic outcome, and no patients reported being dissatisfied or worse.

Conclusions: The results of our series suggest the feasibility of utilizing IORT in a community-based cancer center with a high degree of local control, and patient satisfaction with regard to cosmesis. While the results of this series suggest that IORT may be a promising modality, longer follow-up is warranted to better understand exactly which clinicopathological features can predict long-term locoregional disease control.

Keywords: Early-stage breast cancer; Electronic brachytherapy; Intraoperative radiation therapy.

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Conflict of interest statement

Compliance with ethical standardsNo funding was received for this study.The authors declare that they have no conflict of interest.All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.Informed consent was obtained from all individual participants included in the study. A waiver of informed consent was obtained by the IRB to complete this retropective study.

Figures

Fig. 1
Fig. 1
a–c Local control, disease-free survival, and overall survival. a Local control at 3 years was LC: 98.9% (95%CI 92.2–99.8). Local control at 5 years was 96.3% (95%CI 84.7–99.2). b Disease-free survival at 3 years was: 97.2% (95%CI 88.9–99.3). Disease-free survival at 5 years 94.6% (95%CI 83.2–98.3). c Overall survival at 3 years was 96.0% (95%CI 84.9–99.0). Overall survival at 5 years, 86.5% (95%CI 63.3–95.5)
Fig. 2
Fig. 2
a–b Disease-free survival and overall survival by size. No significant differences were noted with regard to disease-free survival and overall survival as stratified by tumor size
See this image and copyright information in PMC

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