Up to 5 years outcomes following intraoperative radiotherapy for early breast cancer

Abstract

Background: Whole breast radiation therapy (WBRT) is the standard of care for early breast cancer after lumpectomy, but it has side effects. For elderly women with good prognostic cancer, intra-operative radiotherapy (IORT) is an alternative. We report our results with IORT. Methods: We performed a retrospective cohort study to observe clinical outcomes after IORT, between 2012 and 2017. Patients had inclusion criteria for RIOP INCA (French national institute of cancer) (group A) or for TARGIT E (group B).Results: Ninety women were included (91 tumors). The mean age was 73.1 years (range, 56.0-87.0 years) and 95.6% of tumors were under 20 mm. After a median follow-up of 27.4 months (range, 3.0-51.0 months), overall survival was 100%, with two local recurrences out of the 84 tumors followed at least 3 months (2.4%).After IORT, 34.1% of patients had adjuvant WBRT; 70.2% of tumors had fibrosis at least once in the followup, 47.6% had cystosteatonecrosis, 25.8% had breast pain grades 1-2, 6% had over grade 2 toxicities, with no grade 4, and 94.0% had good to very good subjective global aspect. Conclusions:IORT is a good alternative to WBRT when ASTRO's guidelines indications are respected, with promising results, but need carry on following up with patients.

Comparison of Clinical Outcomes Between Low‐ and High‐Risk Groups of Early Breast Cancer Patients Treated with Intraoperative Radiotherapy in Addition to External Beam Radiation: A Multi‐Centre Prospective Study

“…A French retrospective study by d'Illiers et al found that the rate of severe infection was 3.3% [32].…”

“…All these patients were treated with intravenous antibiotics and drainage [31]. A French retrospective study by d'Illiers et al found that the rate of severe infection was 3.3% [32].…”

Impact of intraoperative radiotherapy on the perioperative period of patients after breast-conserving surgery

“…In our study, the incidence of seroma was 6.0% and the infection rate was 5.0%; the infection rate was thus slightly higher than that in the TARGIT-A study (Table 4), but was comparable to the matched patients undergoing BCS over the same period. The wound infection rate arising from IORT varies significantly in the currently available studies, ranging from 2.3% to 13.6% (27)(28)(29). This difference might be attributable to the different radiotherapy equipment and methods used in the studies, and to the effect that variable patient characteristics, surgical procedures, and postoperative therapies might have had on toxicity and side effects.…”

Biological and clinical review of IORT-induced wound fluid in breast cancer patients

“…To the best of our knowledge, in IORT, no results were reported regarding drainage tube removal time, length of hospitalization, and post-operative complications. However, IORT had promising results, both in terms of saving healthy tissue and local control (74% to 100% at 5 years) and 96.2% disease-free survival ( 101 , 103 ). The local relapse prompted a series of clinical trials and studies to investigate whether localized IORT could be as efficient at preventing recurrence at local site as standard postoperative radiotherapy of the whole breast while also being more patient-friendly in terms of decreasing the treatment duration.…”