Cosmetic Outcome and Chronic Breast Toxicity After Intraoperative Radiation Therapy (IORT) as a Single Modality or as a Boost Using ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-06-12

AUTHORS

Stéphane Key, Petra Miglierini, Pierre-François Dupré, Sandrine Guilbert, Anne-Sophie Lucia, Ronan Abgral, Virginie Conan-Charlet, Arnaud Uguen, Olivier Pradier, Ulrike Schick

ABSTRACT

PurposeWe aim to report our results in terms of chronic toxicities and cosmetic outcomes after intraoperative radiotherapy (IORT) using kV X-rays in women treated for early breast cancer at our institution.MethodsPatients with early breast carcinoma were recruited between April 2011 and November 2014. After breast-conserving surgery, patients were treated with IORT using the Intrabeam® device. IORT was completed by whole-breast radiotherapy (WBRT) at a dose of 46–50.4 Gy in 23–28 fractions in case of adverse pathologic criteria on the final specimen examination. Skin toxicity was graded using the Late Effects in Normal Tissues—Subjective, Objective, Management and Analytic (LENT-SOMA) scale every 6 months, and cosmetic outcomes were evaluated at 36 months by patient self-evaluation and by two radiation oncologists, on a 1–10 scale.ResultsForty-one women received IORT only and 30 patients received IORT followed by WBRT (IORT + WBRT group). After a median follow-up of 38.9 months, no locoregional or distant recurrence occurred. After IORT only, 2.4% of grade 2 or higher breast fibrosis, and no other grade 2 or higher disease, was observed. In the IORT + WBRT group, grade 2 or higher fibrosis and grade 2 or higher breast retraction were observed in 43.3 and 23.3% of patients, respectively. Objective cosmetic outcomes were very good and significantly better in the IORT-only group compared with the IORT + WBRT group (8.87 vs. 6.96) (p < 0.001).ConclusionIORT using the Intrabeam® is well-tolerated, with very little chronic toxicity and good cosmetic outcome. However, a high rate of grade 2 or higher chronic breast toxicity was observed when IORT had to be completed by WBRT. More... »

PAGES

2547-2555

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-017-5920-5

DOI

http://dx.doi.org/10.1245/s10434-017-5920-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1085988111

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28608120


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33 schema:description PurposeWe aim to report our results in terms of chronic toxicities and cosmetic outcomes after intraoperative radiotherapy (IORT) using kV X-rays in women treated for early breast cancer at our institution.MethodsPatients with early breast carcinoma were recruited between April 2011 and November 2014. After breast-conserving surgery, patients were treated with IORT using the Intrabeam® device. IORT was completed by whole-breast radiotherapy (WBRT) at a dose of 46–50.4 Gy in 23–28 fractions in case of adverse pathologic criteria on the final specimen examination. Skin toxicity was graded using the Late Effects in Normal Tissues—Subjective, Objective, Management and Analytic (LENT-SOMA) scale every 6 months, and cosmetic outcomes were evaluated at 36 months by patient self-evaluation and by two radiation oncologists, on a 1–10 scale.ResultsForty-one women received IORT only and 30 patients received IORT followed by WBRT (IORT + WBRT group). After a median follow-up of 38.9 months, no locoregional or distant recurrence occurred. After IORT only, 2.4% of grade 2 or higher breast fibrosis, and no other grade 2 or higher disease, was observed. In the IORT + WBRT group, grade 2 or higher fibrosis and grade 2 or higher breast retraction were observed in 43.3 and 23.3% of patients, respectively. Objective cosmetic outcomes were very good and significantly better in the IORT-only group compared with the IORT + WBRT group (8.87 vs. 6.96) (p < 0.001).ConclusionIORT using the Intrabeam® is well-tolerated, with very little chronic toxicity and good cosmetic outcome. However, a high rate of grade 2 or higher chronic breast toxicity was observed when IORT had to be completed by WBRT.
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40 INTRABEAM
41 MethodsPatients
42 Normal Tissues-Subjective
43 PurposeWe
44 ResultsForty-one women
45 WBRT group
46 X-ray
47 analytics
48 boost
49 breast cancer
50 breast carcinoma
51 breast fibrosis
52 breast retraction
53 breast toxicity
54 breast-conserving surgery
55 cancer
56 carcinoma
57 cases
58 chronic toxicity
59 cosmetic outcome
60 criteria
61 devices
62 disease
63 distant recurrence
64 dose
65 early breast cancer
66 early breast carcinoma
67 effect
68 examination
69 fibrosis
70 fraction
71 good cosmetic outcome
72 grade 2
73 group
74 high rate
75 higher disease
76 higher fibrosis
77 institutions
78 intraoperative radiation therapy
79 intraoperative radiotherapy
80 kV X-rays
81 late effects
82 management
83 modalities
84 months
85 objective
86 objective cosmetic outcome
87 oncologists
88 outcomes
89 pathologic criteria
90 patients
91 prospective study
92 radiation oncologists
93 radiation therapy
94 radiotherapy
95 rate
96 recurrence
97 results
98 retraction
99 scale
100 single modality
101 skin toxicity
102 specimen examination
103 study
104 surgery
105 terms
106 therapy
107 toxicity
108 whole breast radiotherapy
109 women
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