title: Intraoperative Boost Radiotherapy during Targeted Oncoplastic Breast Surgery: Overview and Single Center Experiences.
abstract: Breast-conserving surgery followed by whole-breast irradiation is the standard local therapy for early breast cancer. The international discussion of reduced importance of wider tumor-free resection margins than "tumor not touching ink" leads to the development of five principles in targeted oncoplastic breast surgery. IORT improves local recurrence risk and diminishes toxicity since there is less irradiation of healthy tissue. Intraoperative radiotherapy (IORT) can be delivered in two settings: an IORT boost followed by a conventional regimen of external beam radiotherapy or a single IORT dose. The data from TARGIT-A and ELIOT reinforce the conviction that intraoperative radiotherapy during breast-conserving surgery is a reliable alternative to conventional postoperative fractionated irradiation, but only in a carefully selected population at low risk of local recurrence. We describe our experiences with IORT boost (50 kV energy X-rays; 20 Gy) in combination with targeted oncoplastic breast surgery in a routine clinical setting. Our experiences demonstrate the applicability and reliability of combining IORT boost with targeted oncoplastic breast surgery in breast-conserving therapy of early breast cancer.
authors.affiliation: Breast Center, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany.
authors.forename: Wolfram
authors.identifier: 0000-0002-5693-3120
authors.initials: W
authors.lastname: Malter
authors.affiliation: Breast Center, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany ; Department of Obstetrics and Gynaecology, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany.
authors.forename: Verena
authors.identifier: 0000-0003-1517-0603
authors.initials: V
authors.lastname: Kirn
authors.affiliation: Breast Center, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany ; Department of Obstetrics and Gynaecology, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Richters
authors.affiliation: Breast Center, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany ; Department of Obstetrics and Gynaecology, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany.
authors.forename: Claudius
authors.initials: C
authors.lastname: Fridrich
authors.affiliation: Department of Pathology, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany.
authors.forename: Birgid
authors.initials: B
authors.lastname: Markiefka
authors.affiliation: Department of Radiotherapy, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Bongartz
authors.affiliation: Department of Radiotherapy, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Semrau
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Mallmann
authors.affiliation: Breast Center, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kraemer