title: Accelerated partial breast irradiation with intraoperative electrons: using GEC-ESTRO recommendations as guidance for patient selection.
abstract: OBJECTIVE
  To evaluate outcomes among early-stage breast cancer patients after conservative surgery and full-dose intraoperative radiotherapy electrons (ELIOT) by applying the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) recommendations for partial breast irradiation (APBI).
  
  
  METHODS
  One-thousand eight-hundred and twenty-two patients were stratified into the three GEC-ESTRO categories of "good candidates", "possible candidates" and "contraindication" in order to assess outcomes.
  
  
  RESULTS
  All the 1822 cases except 7 could be classified according to GEC-ESTRO groups: 573 patients met the criteria to be included in the "good candidates" group, 468 patients in the "possible candidates" group and 767 patients in the "contraindication" group. Median and mean follow-up length was 3.5 years (range 0-10.5 years) and 3.8 years (SD 2.2), respectively. The 5-year rate of in-breast tumor reappearances for "good candidates", "possible candidates" and "contraindication" groups were 1.9%, 7.4% and 7.7%, respectively (p 0.001). While the regional node relapse showed no difference, the rate of distant metastases was significantly different in the "contraindication" group compared to the other two categories, having a significant impact on survival.
  
  
  CONCLUSIONS
  Among the ELIOT population, the GEC-ESTRO recommendations enabled the selection of the good candidates with a low rate of local recurrence, but failed to differentiate the "possible candidates" and the "contraindication" groups.
authors.affiliation: Division of Radiation Oncology, European Institute of Oncology, Milan, Italy. cristina.leonardi@ieo.it
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Leonardi
authors.forename: Patrick
authors.initials: P
authors.lastname: Maisonneuve
authors.forename: Mauro Giuseppe
authors.initials: MG
authors.lastname: Mastropasqua
authors.forename: Anna
authors.initials: A
authors.lastname: Morra
authors.forename: Roberta
authors.initials: R
authors.lastname: Lazzari
authors.forename: Veronica
authors.initials: V
authors.lastname: Dell'Acqua
authors.forename: Annamaria
authors.initials: A
authors.lastname: Ferrari
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.forename: Claudia
authors.initials: C
authors.lastname: Sangalli
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
authors.forename: Umberto
authors.initials: U
authors.lastname: Veronesi
authors.forename: Roberto
authors.initials: R
authors.lastname: Orecchia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D004583:Electrons / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D018579:Patient Selection