Study of quadrant high-dose intraoperative radiation therapy for early-stage breast cancer

• Published in: British journal of surgery Vol. 95; no. 9; pp. 1105 - 1110
• Main Authors: Sacchini, V., Beal, K., Goldberg, J., Montgomery, L., Port, E., McCormick, B.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-09-2008; Wiley
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Breast Neoplasms - radiotherapy; Breast Neoplasms - surgery; Carcinoma, Ductal, Breast - radiotherapy; Carcinoma, Ductal, Breast - surgery; Feasibility Studies; Female; General aspects; Gynecology. Andrology. Obstetrics; Humans; Intraoperative Care - methods; Mammary gland diseases; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - prevention & control; Neoplasm Staging; Postoperative Complications - etiology; Radiation Injuries - etiology; Radiotherapy Dosage; Treatment Outcome; Tumors; Wound Healing; Breast disease; Intraoperative; Early stage; Breast cancer; Malignant tumor; Radiotherapy; Medicine; Mammary gland diseases; Treatment; Surgery; Mammary gland; High dose; Cancer
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.6208

Background:
Partial breast irradiation has been tested in limited pilot studies and shown to provide acceptable cosmesis, minimal toxicity and adequate local control. The aim of this study was to determine the feasibility of using quadrant high‐dose intraoperative radiation therapy (IORT) for the treatment of early‐stage breast cancer.
Methods:
Fifty‐two women with early‐stage breast cancer were treated with breast‐conserving therapy and IORT between October 2002 and January 2006. The first 18 women received a radiation dose of 20 Gy. The protocol was then amended and the remaining 34 women were treated with 18 Gy. Each patient was evaluated after surgery, and at 3, 6 and 12 months; complications, toxicity and cosmetic outcomes were recorded by the breast surgeon.
Results:
Women treated with 18 Gy appeared to have a more favourable cosmetic outcome compared with the earlier treatment group. At last follow‐up, none of the women treated on the protocol had a breast recurrence.
Conclusion:
Experience suggests that this IORT technique is feasible, although further follow‐up is necessary to assess its therapeutic value. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Feasible, but randomized trials needed