Single-Center Long-Term Follow-Up After Intraoperative Radiotherapy as a Boost During Breast-Conserving Surgery Using Low-Kilovoltage X-Rays

Blank, E.; Kraus-Tiefenbacher, U.; Welzel, Grit; Keller, Anke; Bohrer, Markus; Sütterlin, Marc; Wenz, Frederik

doi:10.1245/s10434-010-1265-z

Cited by 65 publications

(67 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[30][31][32][33] In contrast, other studies have reported outcomes with IORT followed by WBI that appear acceptable and comparable to either WBI alone or WBI with a conventional EBRT boost. [33][34][35] As such, the task force felt the combination of IORT and WBI should be used only with caution and limited to women with higher risk features on final pathology.…”

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

507

342

View full text Add to dashboard Cite

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

507

342

View full text Add to dashboard Cite

“…After LEX-IORT as APBI and also as a boost, low acute [6,18,19] and long term side effects and especially low chronic skin toxicities were reported [8,20,21]. In general patients with LEX-IORT as APBI were half at risk to develop higher grade late toxicities including fibrosis, breast edema, and edema of the arm, ulceration, hyperpigmentation, telangiectasia, retraction and pain [8].…”

Section: Discussionmentioning

confidence: 99%

“…In general patients with LEX-IORT as APBI were half at risk to develop higher grade late toxicities including fibrosis, breast edema, and edema of the arm, ulceration, hyperpigmentation, telangiectasia, retraction and pain [8]. After LEX-IORT as a boost, fibrosis rates are in range with standard treatments [20,21]. Further quality of life is significantly better in LEX-IORT patients in comparison to patients with whole breast radiotherapy [22,23].…”

Section: Discussionmentioning

confidence: 99%

A cohort analysis to identify eligible patients for intraoperative radiotherapy (IORT) of early breast cancer

et al. 2014

Self Cite

View full text Add to dashboard Cite

BackgroundSince the results from the randomized TARGIT A trial were published, intraoperative radiotherapy (IORT) is used more often. IORT can be provided as accelerated partial breast irradiation (APBI) or as a boost. The definition of suitable patients for IORT as APBI differs between different national societies (e.g. ESTRO and ASTRO) and different inclusion criteria of trials and so does the eligibility of patients. This analysis identifies eligible patients for IORT according to available consensus statements and inclusion criteria of the ongoing TARGIT trials.MethodsBetween 01/03 – 12/09, 1505 breast cancer cases were treated at the breast cancer center at the University Medical Center Mannheim. Complete data sets for age, stage (T, N, and M), histology and hormone receptor status were available in 1108 cases. Parameters to identify eligible patients are as follows: ESTRO: >50 years, invasive ductal carcinoma/other favorable histology (IDC), T1-2 (≤3 cm), N0, any hormone receptor status, M0; ASTRO: ≥60 years, IDC, T1, N0, positive estrogen hormone receptor status, M0; TARGIT E “elderly”, risk adapted radiotherapy with IORT followed by external beam radiotherapy in case of risk factors in final histopathology, phase II: ≥70 years, IDC, T1, N0, any hormone receptor status, M0; TARGIT C “consolidation”, risk adapted radiotherapy, phase IV: ≥50 years, IDC, T1, N0, positive hormone receptor status, M0; TARGIT BQR “boost quality registry”: every age, every histology, T1-2 (max. 3.5 cm), any hormone receptor status, N0/+, M0/+.ResultsOut of the 1108 cases, 379 cases (34.2%) were suitable for IORT as APBI regarding the ESTRO and 175 (15.8%) regarding the ASTRO consensus statements. 82 (7.4%) patients were eligible for the TARGIT E trial, 258 (23.3%) for the TARGIT C trial and 671 (60.6%) for the TARGIT BQR registry. According to the consensus statements of ASTRO (45.1%) and ESTRO (41.4%) about half of the eligible patients were treated with IORT as APBI. From the eligible patients fulfilling the criteria for IORT boost (35%) about one third was eventually treated.ConclusionsPatient selection for IORT should be restrictive. For IORT as APBI the TARGIT trials are even more restrictive including patients than the ESTRO and ASTRO consensus statements.

show abstract

“…lack of geographic and temporal miss [2], applying the boost already during surgery using IORT, i.e. optimal location and optimal timing, may be superior to the standard of care usually applied as an external-beam boost [28,29,30,31]. In order to test the superiority of a TARGIT IORT boost compared to an external-beam boost, the multicentric, prospective, randomized TARGIT-B study was initiated.…”

Section: Ongoing Clinical Studies On Apbi Combined With External-beammentioning

confidence: 99%

Accelerated Partial Breast Irradiation in Clinical Practice

et al. 2015

Self Cite

View full text Add to dashboard Cite

Accelerated partial breast irradiation (APBI) has been under clinical investigation for more than 15 years. There are several technical approaches that are clinically established, e.g. brachytherapy, intraoperative radiotherapy (IORT), or external-beam radiotherapy. The understanding of the underlying biology, optimal technical procedures, patient selection criteria, and imaging changes during follow-up has increased enormously. After completion of several phase III trials using brachytherapy or IORT, APBI is currently increasingly used either in phase IV studies, registries, or in selected patients outside of clinical studies. Consensus statements about suitable patients are available from several international and national societies like ASTRO, ESTRO, and DEGRO. One may expect that 15-25% of patients undergoing breast-conserving surgery may qualify for APBI, i.e. patients with small invasive ductal breast cancer without clinical lymph node involvement.

show abstract

Single-Center Long-Term Follow-Up After Intraoperative Radiotherapy as a Boost During Breast-Conserving Surgery Using Low-Kilovoltage X-Rays

Abstract: After IORT as a tumor bed boost with low-kilovoltage x-rays followed by whole-breast radiotherapy, low local recurrence and chronic toxicity rates were seen after 5-year follow-up.

Cited by 65 publications

References 46 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

A cohort analysis to identify eligible patients for intraoperative radiotherapy (IORT) of early breast cancer

Accelerated Partial Breast Irradiation in Clinical Practice

Contact Info

Product

Resources

About