Accelerated partial breast irradiation with intraoperative electrons: Using GEC–ESTRO recommendations as guidance for patient selection

Leonardi, Maria Cristina; Maisonneuve, Patrick; Mastropasqua, Mauro G.; Morra, Anna; Lazzari, Roberta; Dell’Acqua, V.; Ferrari, Annamaria; Rotmensz, Nicole; Sangalli, Claudia; Luini, Alberto; Veronesi, Umberto; Orecchia, Roberto

doi:10.1016/j.radonc.2012.10.018

Cited by 82 publications

(60 citation statements)

References 24 publications

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“…4 Single-arm studies have also reported higher rates of fair to poor cosmetic outcomes in approximately 20% of patients treated with EBRT-based APBI. 29,36,37 However, other clinical series of APBI delivered with 3D-CRT or IMRT reported acceptable cosmetic outcomes. 9,[38][39][40][41][42][43][44][45] These conflicting studies raise the hypothesis that subtle variations in planning techniques and/or dose constraints may substantially modify the therapeutic ratio of EBRT-based APBI.…”

Section: Comment On External Beam Apbimentioning

confidence: 98%

“…In the available trials, fat necrosis 26,27 was increased with IORT, whereas skin side effects were lower. 24,26 Mild breast fibrosis 26,28,29 occurred with electron beam radiation on ELIOT, with no significant difference compared with WBI in the ELIOT trial. 26 IORT techniques may allow improved critical organ sparing compared with WBI.…”

Section: Adverse Effectsmentioning

confidence: 99%

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Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement

Correa

Harris

Leonardi

et al. 2017

Practical Radiation Oncology

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Section: Comment On External Beam Apbimentioning

confidence: 98%

Section: Adverse Effectsmentioning

confidence: 99%

Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement

Correa

Harris

Leonardi

et al. 2017

Practical Radiation Oncology

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500

313

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“…The patients were not selected. The local recurrence rate was significantly higher with IOERT, but very low in both study arms [90,91,92,93,94,95,96]. …”

Section: Adjuvant Radiotherapymentioning

confidence: 99%

AGO Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2014

et al. 2014

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“…Certain anatomical sites, such as the brachial plexus, heart, lungs, that cannot be protected by conventional RT regimes can be protected by IORT techniques, and unnecessary exposure to radiation are avoided in these areas. In addition, seroma occurring after lumpectomy likely does not influence the radiation field in IORT (30)(31)(32).…”

Section: Breast Cancer and Iortmentioning

confidence: 99%

Intraoperative Period and Breast Cancer: Review

Akan

Simsek

2014

J Breasth Health

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Intraoperative radiation therapy in breast cancer (IORT) delivers a concentrated dose of radiation therapy to a tumor bed during surgery. IORT offers some of the following advantages with typically fewer complications like; maximum effect, sparing healthy tissues and organs, to help the patients finish treatment and get back to their normal activities. The goal of IORT is to improve local tumor control and survival rates for patients with breast cancer. IORT can both be performed with electron beams (ELIOT) and X-rays. Two main randomised trials testing intraoperative partial breast radiotherapy are TARGIT trial and the ELIOT (intraoperative radiotherapy with electrons) trial, but the techniques are fundamentally different. Whereas TARGIT delivers radiation from within the undisturbed tumour bed, for ELIOT, the mammary gland is mobilised, a prepectoral lead shield is inserted, the edges of the tumour bed are apposed, and radiation is delivered from without. Key words: Intraoperative period, breast cancer, treatment IntroductionCurrently, breast cancer is one of the leading causes of cancer in women. Nevertheless, there are rapid developments and changes in the diagnosis, treatment and follow-up methods of this disease. Today breast cancer can be diagnosed at earlier stages, with a chance for cure with limited surgery, and the patients have improved quality of life. Today, based on recent studies, the type of breast cancer surgery that led to complete loss of the breast has been replaced by breast-conserving surgery (BCS) in all appropriate patients (1-4). According to the results from large multicenter studies on early breast cancer, there were no significant differences in terms of disease-free survival and overall survival between mastectomy, and BCS and whole breast radiotherapy (RT). Therefore, conserving surgery and whole breast irradiation has been accepted as the standard treatment in early breast cancer, and it has been reported that local control also plays an important role on survival. One of the most feared clinical situations in the treatment of breast cancer, especially after BCS, is local recurrence (LR) at the site of operation. Undoubtedly, one of the most important ways to avoid this dreaded complication is application of RT to the tumor itself and around the tumor bed. Most of the LRs usually occur at the same quadrant with the tumor area that has been operated, due to the microscopic tumor remaining after BCS. A number of risk factors have been identified for the occurrence of LR, including large tumor size, high tumor grade, young patient age, lymph node involvement, and presence of tumor deposit close to surgical resection margin (5,6). There is a decrease in LR rates due to earlier diagnosis of breast cancer patients, high quality standards in pathological examinations, better individual treatment planning, and increased awareness on breast cancer. The focus of the discussion regarding the causes of LR and the developments leading to decreased LR rates is centered around mostly the...

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Accelerated partial breast irradiation with intraoperative electrons: Using GEC–ESTRO recommendations as guidance for patient selection

Cited by 82 publications

References 24 publications

Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement

Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement

AGO Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2014

Intraoperative Period and Breast Cancer: Review

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