To assess the safety, cosmetic effects, and clinical efficacy of breast-conserving surgery combined with intraoperative radiation therapy for the treatment of Chinese patients with breast cancer.
Methods
Breast-conserving surgery combined with intraoperative radiation therapy was performed in 64 breast cancer patients. The postoperative short-term efficacy, safety, and cosmetic effects were assessed.
Results
Of the 64 patients, 1 case (1.6%) had local recurrence one year later, 7 cases (10.9%) had grade I postoperative radiation-induced lung injury, 10 cases (15.6%) had local hardening at the surgical sites, 8 cases (12.5 %) had changes in skin color, and 8 cases (12.5%) had pain at the surgical sites. Excellent or good levels of cosmetic effects were achieved in 95.3% of the patients.
Conclusions
The application of intraoperative radiation therapy with breast-conserving surgery can yield satisfactory short-term curative efficacy, a high level of clinical safety, and good cosmetic effects.
RechtA., SolinL.J.: Breast-conserving surgery and radiotherapy in early-stage breast cancer: the importance of local control.Semin Radiat Oncol, 21: 3–9, 2011.
2.
NahabedianM.Y.: Microvascular breast reconstruction and lymph node transfer for postmastectomy lymphedema patients.Gland Surg, 1: 1–2, 2012.
3.
HustonT.L., PigalargaR., OsborneM.P., TousimisE.: The influence of additional surgical margins on the total specimen volume excised and the reoperative rate after breast-conserving surgery.Am J Surg, 192: 509–512, 2006.
4.
ArnedosM., WeigeltB., Reis-FilhoJ.S.: Anti-HER2 therapies: When more is more.Transl Cancer Res, 1: 49–54, 2012.
5.
PerezC.A.: Breast conservation therapy in patients with stage T1–T2 breast cancer: current challenges and opportunities.Am J Clin Oncol, 33: 500–510, 2010.
6.
Early Breast Cancer Trialists' Collaborative Group: Effects of radiotherapy and surgery in early breast cancer: An overview of the randomized trials.N Engl J Med, 333: 1444–1455, 1995.
7.
TsekerisP., CapizelloA., RoukosD.: Challenges in personalizing decisions on whole, partial or no breast irradiation and extent of surgery for early breast cancer.Ann Surg Oncol, 16: 2656–2657, 2009.
8.
PapademetriouK., ArdavanisA., KountourakisP.: Neoadjuvant therapy for locally advanced breast cancer: Focus on chemotherapy and biological targeted treatments' armamentarium.J Thorac Dis, 2: 160–170, 2010.
9.
GoyalS., ViciniF., BeitschP.D., KuererH., KeischM., MotwaniS., JerussJ.S., LydenM., HafftyB.G.: Ductal carcinoma in situ treated with breast-conserving surgery and accelerated partial breast irradiation: comparison of the Mammosite registry trial with intergroup study E5194.Cancer, 117: 1149–1155, 2011.
Sautter-BihlM.L., SedlmayerF., BudachW., DunstJ., Engenhart-CabillicR., FietkauR., FeyerP., HaaseW., HarmsW., RödelC., SouchonR., WenzF., SauerR.: Intraoperative radiotherapy as accelerated partial breast irradiation for early breast cancer: beware of one-stop shops?Strahlenther Onkol, 186: 651–657, 2010.
12.
VaidyaJ.S., JosephD.J., TobiasJ.S., BulsaraM., WenzF., SaundersC., AlvaradoM., FlygerH.L., MassarutS., EiermannW., KeshtgarM., DewarJ., Kraus-TiefenbacherU., SütterlinM., EssermanL., HoltvegH.M., RoncadinM., PigorschS., MetaxasM., FalzonM., MatthewsA., CoricaT., WilliamsN.R., BaumM.: Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial.Lancet, 376: 91–102, 2010.
13.
FanF.: Sentinel lymph node micrometastases and isolated tumor cells in breast cancer: An evolving field.Gland Surg, 1: 5–6, 2012.
14.
VeronesiU., OrecchiaR., LuiniA., GalimbertiV., ZurridaS., IntraM., VeronesiP., ArnoneP., LeonardiM.C., CioccaM., LazzariR., CaldarellaP., RotmenszN., SangalliC., SancesD., MaisonneuveP.: Intraoperative radiotherapy during breast conserving surgery: a study on 1,822 cases treated with electrons.Breast Cancer Res Treat, 124: 141–151, 2010.
15.
RampinelliC., BellomiM., IvaldiG.B., IntraM., RaimondiS., MeroniS., OrecchiaR., VeronesiU.: Assessment of pulmonary fibrosis after radiotherapy (RT) in breast conserving surgery: comparison between conventional external beam RT (EBRT) and intraoperative RT with electrons (ELIOT).Technol Cancer Res Treat, 10: 323–329, 2011.
16.
OrecchiaR., IvaldiG.B., LeonardiM.C.: Integrated breast conservation and intraoperative radiation therapy.Breast, 18(Suppl 3): S98–S102, 2009.
17.
PietersB.R., HartA.A., RussellN.S., JansenE.P., PeterseJ.L., BorgerJ., RutgersE.J.: A comparison in cosmetic outcome between per-operative interstitial breast implants and delayed interstitial breast implants after external beam radiotherapy.Radiother Oncol, 67: 159–164, 2003.
18.
MussariS., Sabino Della SalaW., BusanaL., VanoniV., EccherC., ZaniB., MenegottiL., TomioL.: Full-dose intraoperative radiotherapy with electrons in breast cancer. First report on late toxicity and cosmetic results from a single-institution experience.Strahlenther Onkol, 182: 589–595, 2006.
19.
Kraus-TiefenbacherU., BauerL., SchedaA., FleckensteinK., KellerA., HerskindC., SteilV., MelchertF., WenzF.: Long-term toxicity of an intraoperative radiotherapy boost using low energy X-rays during breast-conserving surgery.Int J Radiat Oncol Biol Phys, 66: 377–381, 2006.
20.
KimpleR.J., Klauber-DeMoreN., KuzmiakC.M., PavicD., LianJ., LivasyC.A., EslerL., MooreD.T., SartorC.I., OllilaD.W.: Cosmetic outcomes for accelerated partial breast irradiation before surgical excision of early-stage breast cancer using single-dose intraoperative radiotherapy.Int J Radiat Oncol Biol Phys, 79: 400–407, 2011.
21.
ChuaB.H., HendersonM.A., MilnerA.D.: Intraoperative radiotherapy in women with early breast cancer treated by breast-conserving therapy.ANZ J Surg, 81: 65–69, 2011.
22.
LemanskiC., AzriaD., Gourgon-BourgadeS., GutowskiM., RouanetP., Saint-AubertB., AilleresN., FenogliettoP., DuboisJ.B.: Intraoperative radiotherapy in early-stage breast cancer: results of the montpellier phase II trial.Int J Radiat Oncol Biol Phys, 76: 698–703, 2010.
23.
VeronesiU., OrecchiaR., LuiniA., GalimbertiV., GattiG., IntraM., VeronesiP., LeonardiM.C., CioccaM., LazzariR., CaldarellaP., SimsekS., SilvaL.S., SancesD.: Full-dose intraoperative radiotherapy with electrons during breast-conserving surgery: experience with 590 cases.Ann Surg, 242: 101–106, 2005.
24.
DuboisJ.B., HayM., GelyS., Saint-AubertB., RouanetP., PujolH.: IORT in breast carcinomas.Front Radiat Ther Oncol, 31: 131–137, 1997.
25.
VaidyaJ.S., BaumM., TobiasJ.S., D'SouzaD.P., NaiduS.V., MorganS., MetaxasM., HarteK.J., SliskiA.P., ThomsonE.: Targeted intra-operative radiotherapy (Targit): an innovative method of treatment for early breast cancer.Ann Oncol, 12: 1075–1080, 2001.
26.
LemanskiC., AzriaD., ThezenasS., GutowskiM., Saint-AubertB., RouanetP., FenogliettoP., AilleresN., DuboisJ.B.: Intraoperative radiotherapy given as a boost for early breast cancer: long-term clinical and cosmetic results.Int J Radiat Oncol Biol Phys, 64: 1410–1415, 2006.
27.
VaidyaJ.S., BaumM., TobiasJ.S., MassarutS., WenzF., MurphyO., HilarisB., HoughtonJ., SaundersC., CoricaT., RoncadinM., Kraus-TiefenbacherU., MelchaertF., KeshtgarM., SainsburyR., DouekM., HarrisonE., ThompsonA., JosephD.: Targeted intraoperative radiotherapy (TARGIT) yields very low recurrence rates when given as a boost.Int J Radiat Oncol Biol Phys, 66: 1335–1338, 2006.
28.
SacchiniV., BealK., GoldbergJ., MontgomeryL., PortE., McCormickB.: Study of quadrant high-dose intraoperative radiation therapy for early-stage breast cancer.Br J Surg, 95: 1105–1110, 2008.
