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Review
. 2018 Jul;13(3):162-167.
doi: 10.1159/000489637. Epub 2018 May 30.

Intraoperative Electron Radiotherapy (IOERT) in the Treatment of Primary Breast Cancer

Julia Kaiser  1 , Roland Reitsamer  2 , Peter Kopp  1 , Christoph Gaisberger  1 , Michael Kopp  1 , Thorsten Fischer  2 , Franz Zehentmayr  1 , Felix Sedlmayer  1 , Gerd Fastner  1
Affiliations
Review

Intraoperative Electron Radiotherapy (IOERT) in the Treatment of Primary Breast Cancer

Julia Kaiser et al. Breast Care (Basel). 2018 Jul.

Abstract

IOERT (intraoperative electron radiotherapy) in breast cancer is used either as a boost (10-12 Gy) followed by whole breast irradiation (WBI) or as full-dose partial breast irradiation (PBI, 20-24 Gy) during breast-conserving surgery. IOERT has the longest evidence of all IORT techniques. When administered as a boost, excellent low local recurrence rates were observed in long-term follow-up >5 years. Even in high-risk groups like triple-negative or locally advanced breast cancers, IOERT contributes to long-term local control rates of more than 90%. For selected low-risk groups, IOERT as PBI with 21 Gy seems to be a viable treatment alternative to standard WBI. IOERT has been shown to be advantageous for several reasons: Geographic misses are avoided due to direct visualization of the tumor bed; thus, a high single dose is delivered with utmost precision to small volumes, completely sparing the skin and ensuring good long-term cosmetic outcome. Furthermore, high single doses seem to induce biological mechanisms with verifiable antitumor capability in in-vitro cell-line studies. In addition, IOERT markedly shortens the overall treatment time both in combination with (now mostly hypofractionated) WBI or as a PBI in selected low-risk constellations.

Keywords: Boost; Breast cancer; Electrons; IOERT; Intraoperative electron radiotherapy; Tumor bed.

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Figures

Fig. 1
Fig. 1
Maximum dose (Dmax, 100%), D90, D45, and their corresponding tissue depths (d) should be specified along the central beam and the clinical axis (in mm), respectively.
Fig. 2
Fig. 2
a Tissue depth calculation by ultrasound and b corresponding dose profile.
Fig. 3
Fig. 3
a Tube positioning and b fixation.
Fig. 4
Fig. 4
Treatment position.
See this image and copyright information in PMC

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