Intraoperative radiotherapy given as a boost for early breast cancer: long-term clinical and cosmetic results.
OBJECTIVE
The standard radiotherapy (RT) of breast cancer consists of 50 Gy external beam RT (EBRT) to the whole breast followed by an electron boost of 10-16 Gy to the tumor bed, but this has several cosmetic disadvantages. Intraoperative radiotherapy (IORT) could be an alternative to overcome these.


METHODS
We evaluated 50 women with early breast cancer operated on in a dedicated IORT facility. Median dose of 10 Gy was delivered using 9-MeV electron beams. All patients received postoperative EBRT (50 Gy in 2 Gy fractions). Late toxicity and cosmetic results were assessed independently by two physicians according to the Common Terminology Criteria for Adverse Event v3.0 grading system and the European Organization for Research and Treatment of Cancer questionnaires.


RESULTS
After a median follow-up of 9.1 years (range, 5-15 years), two local recurrences were observed within the primary tumor bed. At the time of analysis, 45 patients are alive with (n = 1) or without disease. Among the 42 disease-free remaining patients, 6 experienced Grade 2 late subcutaneous fibrosis within the boost area. Overall, the scores indicated a very good quality of life and cosmesis was good to excellent in the evaluated patients.


CONCLUSIONS
Our results confirm that IORT given as a boost after breast-conserving surgery is a reliable alternative to conventional postoperative fractionated boost radiation.
Lemanski
Claire
C
Department of Radiation Oncology, Val d'Aurelle Cancer Institute, Montpellier, France.
Azria
David
D
Thezenas
Simon
S
Gutowski
Marian
M
Saint-Aubert
Bernard
B
Rouanet
Philippe
P
Fenoglietto
Pascal
P
Ailleres
Norbert
N
Dubois
Jean-Bernard
JB
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D002278:Carcinoma in Situ / Q000532:radiotherapy / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010865:Pilot Projects; D011788:Quality of Life; D011832:Radiation Injuries / Q000473:pathology; D011879:Radiotherapy Dosage; D012867:Skin / Q000528:radiation effects; D016896:Treatment Outcome