title: Acute and Chronic Complications in Patients with Ductal Carcinoma in Situ Treated with Intraoperative Radiation Therapy.
abstract: Intraoperative radiation therapy (IORT) delivers radiation therapy directly to the tumor bed at the time of surgery. Minimal data are available regarding IORT complications in patients diagnosed with ductal carcinoma in situ (DCIS) using the Xoft®Axxent eBx®System. 146 patients with pure DCIS received X-ray based IORT therapy using the Xoft®Axxent eBx®System at Hoag Memorial Hospital Presbyterian between June 2010 to April 2016 and were accrued to an IORT data registry study. The protocols were approved by the institutional review board and met the guidelines of their responsible governmental agency. Data were collected at 1 week, 1 month, 6 months, 1 year, and thereafter yearly. Acute complications were defined as those occurring within the first month. Chronic complications were those that persisted beyond 6 months. Acute complications were observed in 18% of patients and included hematomas that required drainage, an infection treated with antibiotics, and erythema. Chronic complications were observed in 12% of patients and included a seroma, fibrosis and hyperpigmentation. The majority of acute and chronic problems were mild (Grade I). If Grade I erythema, fibrosis, and hyperpigmentation are not included, only 11/146 patients (7.5%) had significant complications. The rate of acute and chronic complications from X-ray IORT in DCIS patients was low compared to historical toxicity rates observed in DCIS patients treated with whole breast irradiation. Our data indicate that X-ray IORT can be utilized safely in patients diagnosed with DCIS.
authors.affiliation: Hoag Institute for Research and Education, Hoag Memorial Hospital Presbyterian, Newport Beach, California.
authors.forename: Melinda S
authors.initials: MS
authors.lastname: Epstein
authors.affiliation: Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, California.|Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Melvin J
authors.initials: MJ
authors.lastname: Silverstein
authors.affiliation: Department of Radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California.
authors.forename: Kevin
authors.initials: K
authors.lastname: Lin
authors.affiliation: Department of Radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California.
authors.forename: Brian
authors.initials: B
authors.lastname: Kim
authors.affiliation: Hoag Institute for Research and Education, Hoag Memorial Hospital Presbyterian, Newport Beach, California.
authors.forename: Cristina
authors.initials: C
authors.lastname: De Leon
authors.affiliation: Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, California.|Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Sadia
authors.initials: S
authors.lastname: Khan
authors.affiliation: Breastlink, Newport Beach, California.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Guerra
authors.affiliation: Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, California.
authors.forename: Lincoln
authors.initials: L
authors.lastname: Snyder
authors.affiliation: Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, California.
authors.forename: Colleen
authors.initials: C
authors.lastname: Coleman
authors.affiliation: Department of Radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California.
authors.forename: January
authors.initials: J
authors.lastname: Lopez
authors.affiliation: Department of Radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California.
authors.forename: Ralph
authors.initials: R
authors.lastname: Mackintosh
authors.affiliation: Department of Radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California.
authors.forename: Peter
authors.initials: P
authors.lastname: Chen
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy* / Q000601:surgery*; D004890:Erythema / Q000209:etiology; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000209:etiology; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012189:Retrospective Studies
keywords: 
  DCIS
  ; 
  IORT
  ; IORT complications