title: Electrons for intraoperative radiotherapy in selected breast-cancer patients: late results of the Montpellier phase II trial.
abstract: BACKGROUND
  The Montpellier cancer institute phase II trial started in 2004 and evaluated the feasibility of intraoperative radiotherapy (IORT) technique given as a sole radiation treatment for patients with an excellent prognostic and very low recurrence risk.
  
  
  METHODS
  Forty-two patients were included between 2004 and 2007. Inclusion criteria were patients ≥ 65 years old, T0-T1, N0, ductal invasive unifocal carcinoma, free-margin > 2 mm. IORT was delivered using dedicated linear accelerator. One fraction of 21 Gy was prescribed and specified at the 90% isodose using electrons. In vivo dosimetry was performed for all patients. Primary end-point was the quality index. Secondary endpoints were quality of life, local recurrences, cosmetic results, specific and overall survival.
  
  
  RESULTS
  At inclusion, median age was 72 years (range, 66-80). Median tumor diameter was 10 mm. All patients received the total prescribed dose. No acute grade 3 toxicities were observed. Late cosmetic results were good at 5 years despite the poor agreement of accuracy assessment between patients and physicians. Four patients (9.5%) experienced a local failure and underwent salvage mastectomy. The 5 year-disease free survival is 92.7% (range 79.1-97.6). All patients are still alive with a median follow-up of 72 months (range 66-74).
  
  
  CONCLUSIONS
  Our results confirm with a long-term follow-up that exclusive partial breast IORT is feasible for early-breast cancer in selected patients. IORT provides good late cosmetics results and should be considered as a safe and very comfortable "one-step" treatment procedure. Nevertheless, patient assessments are essential for long-term quality results.
authors.affiliation: Department of Radiation Oncology and Medical Physics, I,C,M, - Institut regional du Cancer Montpellier, INSERM U896, Montpellier cedex 5, F-34298, France. David.Azria@icm.unicancer.fr.
authors.forename: Claire
authors.initials: C
authors.lastname: Lemanski
authors.forename: David
authors.initials: D
authors.lastname: Azria
authors.forename: Sophie
authors.initials: S
authors.lastname: Gourgou-Bourgade
authors.forename: Norbert
authors.initials: N
authors.lastname: Ailleres
authors.forename: Aurelie
authors.initials: A
authors.lastname: Pastant
authors.forename: Philippe
authors.initials: P
authors.lastname: Rouanet
authors.forename: Pascal
authors.initials: P
authors.lastname: Fenoglietto
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Dubois
authors.forename: Marian
authors.initials: M
authors.lastname: Gutowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000532:radiotherapy*; D018572:Disease-Free Survival; D004583:Electrons / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D053208:Kaplan-Meier Estimate; D011878:Radiotherapy / Q000379:methods*; D016896:Treatment Outcome
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