Early initiation of external beam radiotherapy (EBRT) may increase the risk of long-term toxicity in patients undergoing intraoperative radiotherapy (IORT) as a boost for breast cancer

Intraoperative Radiotherapy as a Boost During Breast-Conserving Surgery Using Low-Kilovoltage X-Rays: The First 5 Years of Experience With a Novel Approach

“…Intraoperative radiotherapy is a relatively novel approach to deliver additional dose during BCS. Reports about long-term outcome regarding effectiveness and toxicity of the IORT boost followed by whole-breast EBRT are rare (16,17,22,25). Here we report the first 5 years' experience in a single center using a novel approach by giving the IORT boost with low-kilovoltage X-rays.…”

“…Forty of these patients were included in the prospective TARGIT trial (9, 10), 18 patients received IORT alone for breast cancer in a previously irradiated breast, and 35 Intraoperative radiotherapy was given as previously reported (11,(20)(21)(22)(23). In short, after wide excision of the breast cancer, a single dose of 20 Gy was given (mean AE SD, 19.7 AE 1.5 Gy).…”

“…Clinical late toxicity at 3 years was scored by the treating radiation oncologists (F.W., U.K.T.) according to the modified Late Effects in Normal Tissues-Subjective, Objective, Management, and Analytic (LENT-SOMA) scoring system, as previously reported (22,24), in all 79 cases having a follow-up time of 3 years with an intact breast (range, 30-39 months). Date of evaluation was December 2008.…”

The Emerging Role of Intraoperative Radiation Therapy [IORT] in Breast Cancer

“…Wenz et al [ 66 ] cautions that starting EBRT too soon after IORT could lead to increased toxicity. The toxicity analysis involved 48 patients with a median follow-up of 36 months (range 30-56 months).…”

Radiobiological Comparison of Hypofractionated Accelerated Partial-Breast Irradiation (APBI) and Single-Dose Intraoperative Radiotherapy (IORT) with 50-kV X-Rays

“…APBI may be applied by interstitial brachytherapy, brachytherapy applicators, and intensity-modulated external-beam radiotherapy [19,21,25,32,36]. Furthermore, intraoperative radiotherapy (IORT) with high-energy electrons or low-energy X-rays is used either as a boost in combination with postoperative WBRT [13,23,28,35] or as sole treatment [11,13,17,27,29,31].…”