Intraoperative radiotherapy (IORT) as a boost in patients with early-stage breast cancer -- acute toxicity.
BACKGROUND
We report on acute toxicities as well as the early cosmetic outcome of patients receiving intraoperative radiotherapy (IORT) followed by whole-breast radiotherapy (WBRT) compared to patients treated with standard WBRT alone.


METHODS
From 2/2002 until 2/2005, 84 breast cancer patients were treated with IORT during breast-conserving surgery (BCS) as a boost (20 Gy/50 kV X-rays) followed by WBRT. After wound healing, all IORT patients were treated with WBRT at a total dose of 46 Gy. For the purpose of comparison, 53 patients treated consecutively between 1/2003 and 12/2004 in our institution with BCS followed by WBRT at a total dose of 50-66 Gy, were analyzed. All patients had a defined followup schedule. Toxicities were prospectively documented using the CTC/EORTC Score. Cosmesis was evaluated after 6 months using a 1-4 score.


RESULTS
Treatment was well tolerated with no grade 3/4 acute toxicity. Rare adverse effects following IORT included wound healing problems (2%), erythema grade I-II (3%), palpable seroma (6%) and mastitis (2-4%). The number of patients with induration of the tumor bed was comparably low.


CONCLUSIONS
IORT with the IntrabeamTM system applied as a boost during BCS, followed by 46 Gy WBRT, exerts similar acute toxicity as standard WBRT. Further follow-up is needed to assess long-term toxicity and efficacy.
Kraus-Tiefenbacher
Uta
U
Department of Radiation Oncology, Universitätsklinikum Mannheim, Germany. uta.kraus-tiefenbacher@radonk.ma.uni-heidelberg.de
Bauer
Lelia
L
Kehrer
Tanja
T
Hermann
Brigitte
B
Melchert
Frank
F
Wenz
Frederik
F
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology / Q000528:radiation effects*; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D044584:Carcinoma, Ductal / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D004867:Equipment Design; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000295:instrumentation*; D014916:Whole-Body Irradiation; D014945:Wound Healing / Q000528:radiation effects