title: Preliminary results of electron intraoperative therapy boost and hypofractionated external beam radiotherapy after breast-conserving surgery in premenopausal women.
abstract: OBJECTIVE
  To report the acute and preliminary data on late toxicity of a pilot study of boost with electron intraoperative therapy followed by hypofractionated external beam radiotherapy (HEBRT) of the whole breast.
  
  
  METHODS
  Between June 2004 and March 2007, 211 women with a diagnosis of early-stage breast cancer were treated with breast-conserving surgery. During surgery, an electron intraoperative therapy boost of 12 Gy was administered to the tumor bed. Adjuvant local treatment was completed with HEBRT, consisting of a course of 13 daily fractions of 2.85 Gy to the whole breast to a total dose of 37.05 Gy. Acute toxicity of the breast was evaluated at the end of HEBRT and at 1 month of follow-up. Late toxicity was recorded at 6 and 12 months of follow-up.
  
  
  RESULTS
  We report the data from 204 patients. The maximal acute skin toxicity was observed at the end of HEBRT (182 patients evaluable) with 7 (3.8%) Grade 3, 52 (28.6%) Grade 2, 123 (67.6%) Grade 1, and no Grade 0 or Grade 4 cases. A total of 108 patients were evaluated for late toxicity. The recorded late skin toxicity was Grade 4 in 1 patient (0.9%), Grade 3 in 1 patient, and Grade 2 or less in 106 patients (98.2%).
  
  
  CONCLUSIONS
  The results of this study have shown that electron intraoperative therapy followed by HEBRT allows for the delivery of a high dose to the tumor bed and an adequate dose to the whole breast. This treatment is feasible, compliance is high, and the rate of acute toxicity and the preliminary data on chronic toxicity seem acceptable.
authors.affiliation: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy. giovanni.ivaldi@ieo.it
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Ivaldi
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Leonardi
authors.forename: Roberto
authors.initials: R
authors.lastname: Orecchia
authors.forename: Dario
authors.initials: D
authors.lastname: Zerini
authors.forename: Anna
authors.initials: A
authors.lastname: Morra
authors.forename: Viviana
authors.initials: V
authors.lastname: Galimberti
authors.forename: Giovanna
authors.initials: G
authors.lastname: Gatti
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
authors.forename: Paolo
authors.initials: P
authors.lastname: Veronesi
authors.forename: Mario
authors.initials: M
authors.lastname: Ciocca
authors.forename: Claudia
authors.initials: C
authors.lastname: Sangalli
authors.forename: Cristiana
authors.initials: C
authors.lastname: Fodor
authors.forename: Umberto
authors.initials: U
authors.lastname: Veronesi
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D019583:Dose Fractionation, Radiation; D004583:Electrons / Q000009:adverse effects / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D015412:Mastectomy, Segmental; D008875:Middle Aged; D010865:Pilot Projects; D017697:Premenopause; D011855:Radiodermatitis / Q000209:etiology / Q000473:pathology; D018714:Radiotherapy, Adjuvant