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Forschungsdatenbank PMU-SQQUID

Intraoperative radiotherapy given as a boost after breast-conserving surgery in breast cancer patients.
Reitsamer, R; Peintinger, F; Sedlmayer, F; Kopp, M; Menzel, C; Cimpoca, W; Glueck, S; Rahim, H; Kopp, P; Deutschmann, H; Merz, F; Brandis, M; Kogelnik, H;
Eur J Cancer. 2002; 38(12): 1607-1610.
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Deutschmann Heinz
Kopp Michael
Peintinger Florentia
Reitsamer Roland
Sedlmayer Felix

Abstract

Conventional radiotherapy after breast-conserving therapy is confined to 50-55 Gy external beam radiation therapy (EBRT) to the whole breast and 10-16 Gy external boost radiation to the tumour bed or brachytherapy to the tumour bed. Local recurrence rate after breast-conserving surgery varies between 5 and 18%. External boost radiation can partially miss the tumour bed and therefore can result in local failure. Intra-operative radiotherapy (IORT) as a high precision boost can prevent a "geographical miss". From October 1998 to December 2000, 156 patients with stage I and stage II breast cancer were operated upon in a dedicated IORT facility. After local excision of the tumour, the tumour bed was temporarily approximated by sutures to bring the tissue in the radiation planning target volume. A single dose of 9 Gy was applied to the 90% reference isodose with energies ranging from 4 to 15 MeV, using round applicator tubes 4-8 cm in diameter. After wound healing, the patients received additional 51-56 Gy EBRT to the whole breast. No acute complications associated with IORT were observed. In 5 patients, a secondary mastectomy had to be performed because of tumour multicentricity in the final pathological report or excessive intraductal component. 2 patients developed rib necroses. In 7 patients, wound healing problems occurred. After a mean follow-up of 18 months, no local recurrences were observed. Cosmesis of the breast was very good and comparable to patients without IORT. Preliminary data suggest that IORT given as a boost after breast-conserving surgery could be a reliable alternative to conventional postoperative fractionated boost radiation by accurate dose delivery and avoiding geographical misses, by enabling smaller treatment volumes and complete skin-sparing and by reducing postoperative radiation time by 7-14 days.


Useful keywords (using NLM MeSH Indexing)

Adult

Aged

Aged, 80 and over

Breast Neoplasms/radiotherapy*

Breast Neoplasms/surgery

Carcinoma, Ductal, Breast/radiotherapy*

Carcinoma, Ductal, Breast/surgery

Combined Modality Therapy

Female

Humans

Intraoperative Care/methods

Mastectomy, Segmental/methods

Middle Aged

Neoplasm Recurrence, Local/prevention*

control

Prospective Studies

Treatment Outcome


Find related publications in this database (Keywords)

breast cancer
breast-conserving surgery
intraoperative radiotherapy
boost radiation