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Intraoperative full-dose of partial breast irradiation with electrons delivered by standard linear accelerators for early breast cancer.

Barros AC, Hanna SA, Carvalho HA, Martella E, Andrade FE, Piato JR, Bevilacqua JL - Int J Breast Cancer (2014)

Bottom Line: The cumulative incidence rates of LR, distant metastases, and BC death were 3.2%, 1.5%, and 1.5%, respectively.Complications were rare, and the cosmetic results were excellent or good in most of the patients.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Mastology Center, Hospital Sírio Libanês, Rua Dona Adma Jafet 91, 01308-050 São Paulo, SP, Brazil ; LIM 02, Discipline of Human Structural Topography, University of São Paulo Medical School, Avenida Dr. Arnaldo 455, 01246-903 São Paulo, SP, Brazil.

ABSTRACT
Purpose. To assess feasibility, efficacy, toxicity, and cosmetic results of intraoperative radiotherapy (IORT) with electrons delivered by standard linear accelerators (Linacs) during breast conserving surgeries for early infiltrating breast cancer (BC) treatment. Materials and Methods. A total of 152 patients with invasive ductal carcinoma (T ≤ 3.0 cm) at low risk for local relapses were treated. All had unicentric lesions by imaging methods and negative sentinel node. After a wide local excision, 21 Gy were delivered on the parenchyma target volume with electron beams. Local recurrences (LR), survival, toxicity, and cosmetic outcomes were analyzed. Results. The median age was 58.3 years (range 40-85); median follow-up was 50.7 months (range 12-101.5). There were 5 cases with LR, 2 cases with distant metastases, and 2 cases with deaths related to BC. The cumulative incidence rates of LR, distant metastases, and BC death were 3.2%, 1.5%, and 1.5%, respectively. Complications were rare, and the cosmetic results were excellent or good in most of the patients. Conclusions. IORT with electrons delivered by standard Linacs is feasible, efficient, and well tolerated and seems to be beneficial for selected patients with early infiltrating BC.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier cumulative local failure estimate.
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fig3: Kaplan-Meier cumulative local failure estimate.

Mentions: Five of the 152 patients presented LR (TR or SPT). The cumulative incidence of LR as the first unfavorable event was 3.2% (95% CI: 0.8–8.1) (Figure 3). Among the 5 cases of LR in the entire cohort 4 were considered to be a TR, and one had a failure in a quadrant other than the index lesion at 30-month follow-up, consistent with SPT. Regarding other failures, two patients (1.3%) developed distant metastases, three had axillary failure (1.9%), and one patient had a contralateral tumor (0.6%). It is worth noting that among the cases with TRs one had SN micrometastasis and one had lobular carcinoma, both identified only in the definitive histopathological analysis.


Intraoperative full-dose of partial breast irradiation with electrons delivered by standard linear accelerators for early breast cancer.

Barros AC, Hanna SA, Carvalho HA, Martella E, Andrade FE, Piato JR, Bevilacqua JL - Int J Breast Cancer (2014)

Kaplan-Meier cumulative local failure estimate.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4281392&req=5

fig3: Kaplan-Meier cumulative local failure estimate.
Mentions: Five of the 152 patients presented LR (TR or SPT). The cumulative incidence of LR as the first unfavorable event was 3.2% (95% CI: 0.8–8.1) (Figure 3). Among the 5 cases of LR in the entire cohort 4 were considered to be a TR, and one had a failure in a quadrant other than the index lesion at 30-month follow-up, consistent with SPT. Regarding other failures, two patients (1.3%) developed distant metastases, three had axillary failure (1.9%), and one patient had a contralateral tumor (0.6%). It is worth noting that among the cases with TRs one had SN micrometastasis and one had lobular carcinoma, both identified only in the definitive histopathological analysis.

Bottom Line: The cumulative incidence rates of LR, distant metastases, and BC death were 3.2%, 1.5%, and 1.5%, respectively.Complications were rare, and the cosmetic results were excellent or good in most of the patients.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Mastology Center, Hospital Sírio Libanês, Rua Dona Adma Jafet 91, 01308-050 São Paulo, SP, Brazil ; LIM 02, Discipline of Human Structural Topography, University of São Paulo Medical School, Avenida Dr. Arnaldo 455, 01246-903 São Paulo, SP, Brazil.

ABSTRACT
Purpose. To assess feasibility, efficacy, toxicity, and cosmetic results of intraoperative radiotherapy (IORT) with electrons delivered by standard linear accelerators (Linacs) during breast conserving surgeries for early infiltrating breast cancer (BC) treatment. Materials and Methods. A total of 152 patients with invasive ductal carcinoma (T ≤ 3.0 cm) at low risk for local relapses were treated. All had unicentric lesions by imaging methods and negative sentinel node. After a wide local excision, 21 Gy were delivered on the parenchyma target volume with electron beams. Local recurrences (LR), survival, toxicity, and cosmetic outcomes were analyzed. Results. The median age was 58.3 years (range 40-85); median follow-up was 50.7 months (range 12-101.5). There were 5 cases with LR, 2 cases with distant metastases, and 2 cases with deaths related to BC. The cumulative incidence rates of LR, distant metastases, and BC death were 3.2%, 1.5%, and 1.5%, respectively. Complications were rare, and the cosmetic results were excellent or good in most of the patients. Conclusions. IORT with electrons delivered by standard Linacs is feasible, efficient, and well tolerated and seems to be beneficial for selected patients with early infiltrating BC.

No MeSH data available.


Related in: MedlinePlus