title: Intraoperative radiotherapy during breast-conserving surgery using a miniature x-ray generator (Intrabeam®): theoretical and experimental background and clinical experience.
abstract: Breast cancer is currently the most frequent indication for intraoperative radiotherapy with increasing numbers worldwide. Intraoperative radiotherapy can be used as a tumor bed boost followed by whole breast radiotherapy, or as a distinct form of accelerated partial breast irradiation in selected patients. This article summarizes the theoretical background including pattern of recurrence and distribution of tumor cell foci in the breast and discusses the rationale for intraoperative radiotherapy, especially using a miniature x-ray generator (Intrabeam(®)). The concepts of how to avoid geographic and temporal miss by giving radiotherapy during surgery to the open wound cavity are described. Experimental and clinical experience is presented based on in vitro experiments and more than 300 treated patients in a single department with mature follow-up.
authors.affiliation: Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany. frederik.wenz@umm.de
authors.forename: Frederik
authors.initials: F
authors.lastname: Wenz
authors.forename: Elena
authors.initials: E
authors.lastname: Blank
authors.forename: Grit
authors.initials: G
authors.lastname: Welzel
authors.forename: Frank
authors.initials: F
authors.lastname: Hofmann
authors.forename: Daniela
authors.initials: D
authors.lastname: Astor
authors.forename: Christian
authors.initials: C
authors.lastname: Neumaier
authors.forename: Carsten
authors.initials: C
authors.lastname: Herskind
authors.forename: Axel
authors.initials: A
authors.lastname: Gerhardt
authors.forename: Marc
authors.initials: M
authors.lastname: Suetterlin
authors.forename: Uta
authors.initials: U
authors.lastname: Kraus-Tiefenbacher
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D011829:Radiation Dosage; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D016387:Women's Health