title: Prospective trial of intraoperative radiation treatment for breast cancer.
abstract: BACKGROUND
  A new device, Intrabeam, is available for intraoperative radiotherapy. We have prospectively examined its feasibility and tolerability in delivering adjuvant breast cancer treatment.
  
  
  METHODS
  Thirty-five patients undergoing breast-conserving surgery received targeted tumour bed irradiation consisting of 5 Gy (at 10 mm) in a single fraction. This single intraoperative treatment was used to replace the external beam radiotherapy "boost" that would usually be given in 10 daily treatments following 5 weeks of whole breast irradiation. Patients later completed external beam radiotherapy as usual. Potential toxicities were prospectively assessed fortnightly prior to external beam radiotherapy, weekly during it, and 3 monthly subsequently.
  
  
  RESULTS
  The intraoperative radiotherapy was able to be delivered without difficulty, either at time of initial cancer surgery or as a second procedure. When performed as a separate procedure the median operating time was 56 min. The treatment was well tolerated, with only one patient experiencing any grade 3 or 4 toxicities--this was acute grade three itch. There was an overall early breast infection rate of 17%. No unexpected toxicities were seen.
  
  
  CONCLUSIONS
  This simple and well-tolerated treatment delivers a useful radiation dose to the area of highest risk of tumour recurrence. The early infection rate is similar to that reported in the literature, for treatments without intraoperative radiotherapy. Whether such a treatment may adequately replace the entire adjuvant radiation therapy treatment for low-risk patients is now being studied in a randomized trial.
authors.affiliation: Department of Radiation Oncology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Joseph
authors.forename: Sean
authors.initials: S
authors.lastname: Bydder
authors.forename: Lee R
authors.initials: LR
authors.lastname: Jackson
authors.forename: Tammy
authors.initials: T
authors.lastname: Corica
authors.forename: Diana J
authors.initials: DJ
authors.lastname: Hastrich
authors.forename: David J
authors.initials: DJ
authors.lastname: Oliver
authors.forename: David E
authors.initials: DE
authors.lastname: Minchin
authors.forename: Annette
authors.initials: A
authors.lastname: Haworth
authors.forename: Christobel M
authors.initials: CM
authors.lastname: Saunders
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D008408:Mastectomy; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000295:instrumentation*; D016896:Treatment Outcome