PMID- 33938966
OWN - NLM
STAT- MEDLINE
DCOM- 20220331
LR  - 20220401
IS  - 1439-099X (Electronic)
IS  - 0179-7158 (Print)
IS  - 0179-7158 (Linking)
VI  - 197
IP  - 9
DP  - 2021 Sep
TI  - Intraoperative radiotherapy boost as part of breast-conservation therapy for 
      breast cancer: a single-institution retrospective analysis.
PG  - 812-819
LID - 10.1007/s00066-021-01785-2 [doi]
AB  - BACKGROUND: There are currently no data from randomized controlled trials on the 
      use of intraoperative radiotherapy (IORT) as a tumor bed boost as part of 
      a breast-conservation approach for breast cancer. This study retrospectively 
      reviewed the safety and efficacy of IORT as a boost treatment at a tertiary 
      cancer center. METHODS: From 2015 to 2019, patients underwent breast-conserving 
      surgery with axillary lymph node staging and a single dose of 20 Gy IORT with 
      50-kV photons, followed by whole-breast irradiation (WBI) and adjuvant systemic 
      therapy (if applicable). Patients were followed for assessment of acute and late 
      toxicities (using the Common Terminology Criteria for Adverse Events version 5.0) 
      at 3-6-month intervals. Outcomes included ipsilateral (IBTR) and contralateral 
      breast progression-free survival (CBE), distant metastasis-free survival (DMFS), 
      and overall survival (OS). RESULTS: Median follow-up for the 214 patients was 28 
      (range 2-59) months. Most patients had T1 disease (n = 124) and were clinically 
      node negative. Only few patients had high-grade and/or triple-negative disease. 
      The vast majority of patients underwent sentinel node biopsy, and 32 (15%) 
      required re-resection for initially positive margins. Finally, all tumor bed 
      margins were clear. Nine (4.2%) and 48 (22.4%) patients underwent neoadjuvant and 
      adjuvant chemotherapy, respectively. WBI was predominantly performed as 
      conventionally fractionated WBI (n = 187, 87.4%), and the median time from BCS to 
      WBI was 54.5 days. IORT was delivered with a single dose of 20 Gy. The median WBI 
      dose was 50 Gy (range 29.4-50.4 Gy). No patients experienced grade 4 events; 
      acute grade 3 toxicities were limited to 17 (8%) cases of radiation dermatitis. 
      Postoperative toxicities were mild. After WBI only one case of late grade >/= 2 
      events was reported. There were two recurrences in the tumor bed and one 
      contralateral breast event. CONCLUSION: This investigation provides additional 
      preliminary data supporting the using of IORT in the boost setting and 
      corroborates the existing literature. These encouraging results should be 
      prospectively validated by the eventual publication of randomized studies such as 
      TARGIT‑B.
CI  - (c) 2021. The Author(s).
FAU - Stoian, Raluca
AU  - Stoian R
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
FAU - Erbes, Thalia
AU  - Erbes T
AD  - Department of Obstetrics and Gynecology, Medical Center, University of Freiburg, 
      Freiburg, Germany.
AD  - Faculty of Medicine, University of Freiburg, Freiburg, Germany.
FAU - Zamboglou, Constantinos
AU  - Zamboglou C
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
FAU - Scholber, Jutta
AU  - Scholber J
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
FAU - Gainey, Mark
AU  - Gainey M
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
FAU - Sachpazidis, Ilias
AU  - Sachpazidis I
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
FAU - Haehl, Erik
AU  - Haehl E
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
FAU - Spohn, Simon K B
AU  - Spohn SKB
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
FAU - Verma, Vivek
AU  - Verma V
AD  - Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA, 
      USA.
FAU - Krug, David
AU  - Krug D
AD  - Department of Radiation Oncology, University Hospital Schleswig-Holstein, 
      Arnold-Heller-Str. 3, 24105, Kiel, Germany.
FAU - Ruhle, Alexander
AU  - Ruhle A
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
AD  - Department of Molecular and Radiation Oncology, German Cancer Research Center 
      (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
FAU - Juhasz-Boss, Ingolf
AU  - Juhasz-Boss I
AD  - Department of Obstetrics and Gynecology, Medical Center, University of Freiburg, 
      Freiburg, Germany.
FAU - Grosu, Anca-Ligia
AU  - Grosu AL
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
FAU - Nicolay, Nils H
AU  - Nicolay NH
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
AD  - Department of Molecular and Radiation Oncology, German Cancer Research Center 
      (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany.
FAU - Sprave, Tanja
AU  - Sprave T
AD  - Department of Radiation Oncology, University Hospital of Freiburg, 
      Robert-Koch-Strasse 3, 79106, Freiburg, Germany. 
      tanja.sprave@uniklinik-freiburg.de.
AD  - German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research 
      Center (dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany. 
      tanja.sprave@uniklinik-freiburg.de.
LA  - eng
PT  - Journal Article
DEP - 20210430
PL  - Germany
TA  - Strahlenther Onkol
JT  - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et 
      al]
JID - 8603469
SB  - IM
MH  - Breast/radiation effects
MH  - *Breast Neoplasms/drug therapy/radiotherapy/surgery
MH  - Female
MH  - Humans
MH  - *Mastectomy, Segmental
MH  - Neoplasm Recurrence, Local
MH  - Radiotherapy, Adjuvant/methods
MH  - Retrospective Studies
PMC - PMC8397646
OTO - NOTNLM
OT  - Adjuvant radiation therapy
OT  - Boost
OT  - Breast-conservation therapy
OT  - Early breast cancer
OT  - Intraoperative radiotherapy
COIS- R. Stoian, T. Erbes, C. Zamboglou, J. Scholber, M. Gainey, I. Sachpazidis, 
      E. Haehl, S. K. B. Spohn, V. Verma, A. Ruhle, I. Juhasz-Boss, A.-L. Grosu, 
      N. H. Nicolay, and T. Sprave declare that they have no competing interests. 
      D. Krug has received honoraria from Merck Sharp & Dome outside the submitted 
      work.
EDAT- 2021/05/04 06:00
MHDA- 2022/04/01 06:00
PMCR- 2021/04/30
CRDT- 2021/05/03 12:38
PHST- 2021/01/10 00:00 [received]
PHST- 2021/04/07 00:00 [accepted]
PHST- 2021/05/04 06:00 [pubmed]
PHST- 2022/04/01 06:00 [medline]
PHST- 2021/05/03 12:38 [entrez]
PHST- 2021/04/30 00:00 [pmc-release]
AID - 10.1007/s00066-021-01785-2 [pii]
AID - 1785 [pii]
AID - 10.1007/s00066-021-01785-2 [doi]
PST - ppublish
SO  - Strahlenther Onkol. 2021 Sep;197(9):812-819. doi: 10.1007/s00066-021-01785-2. 
      Epub 2021 Apr 30.