F Thangarajah1,2, J Heilmann3, W Malter4,5, S Kunze6, S Marnitz6, P Mallmann4, F Wenz3, E Sperk3. 1. Department of Gynecology and Obstetrics, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Kerpener Str. 34, 50931, Cologne, Germany. Fabinshy.Thangarajah@uk-koeln.de. 2. Breast Center, University Hospital of Cologne, University of Cologne, Cologne, Germany. Fabinshy.Thangarajah@uk-koeln.de. 3. Department of Radiation Oncology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany. 4. Department of Gynecology and Obstetrics, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Kerpener Str. 34, 50931, Cologne, Germany. 5. Breast Center, University Hospital of Cologne, University of Cologne, Cologne, Germany. 6. Department of Radiation Oncology, University Hospital of Cologne, University of Cologne, Cologne, Germany.
Abstract
PURPOSE: Mastectomy is the standard procedure in patients with in-breast tumor recurrence (IBTR) or breast cancer after irradiation of the chest due to Hodgkin's disease. In certain cases a second breast conserving surgery (BCS) in combination with intraoperative radiotherapy (IORT) is possible. To date, data concerning BCS in combination with IORT in pre-irradiated patients are limited. This is the first pooled analysis of this special indication with a mature follow-up of 5 years. METHODS: Patients with IBTR after external beam radiotherapy (EBRT; treated in two centers) for breast cancer were included. Patients with previous EBRT including the breast tissue due to other diseases were also included. IORT was performed with the Intrabeam™-device using low kV X-rays. Clinical data including outcome for all patients and toxicity for a representative cohort (LENT-SOMA scales) were obtained. Statistical analyses were done including Kaplan-Meier estimates for local recurrence, distant metastasis and overall survival. RESULTS: A total of 41 patients were identified (39 patients with IBTR, 2 with Hodgkin`s disease in previous medical history). Median follow-up was 58 months (range 4-170). No grade 3/4 acute toxicity occurred within 9 weeks. Local recurrence-free survival rate was 89.9% and overall survival was 82.7% at 5 years. Seven patients developed metastasis within the whole follow-up. CONCLUSIONS: BCS in combination with IORT in IBTR in pre-irradiated patients is a feasible method to avoid mastectomy with a low risk of side effects and an excellent local control and good overall survival.
PURPOSE: Mastectomy is the standard procedure in patients with in-breast tumor recurrence (IBTR) or breast cancer after irradiation of the chest due to Hodgkin's disease. In certain cases a second breast conserving surgery (BCS) in combination with intraoperative radiotherapy (IORT) is possible. To date, data concerning BCS in combination with IORT in pre-irradiated patients are limited. This is the first pooled analysis of this special indication with a mature follow-up of 5 years. METHODS:Patients with IBTR after external beam radiotherapy (EBRT; treated in two centers) for breast cancer were included. Patients with previous EBRT including the breast tissue due to other diseases were also included. IORT was performed with the Intrabeam™-device using low kV X-rays. Clinical data including outcome for all patients and toxicity for a representative cohort (LENT-SOMA scales) were obtained. Statistical analyses were done including Kaplan-Meier estimates for local recurrence, distant metastasis and overall survival. RESULTS: A total of 41 patients were identified (39 patients with IBTR, 2 with Hodgkin`s disease in previous medical history). Median follow-up was 58 months (range 4-170). No grade 3/4 acute toxicity occurred within 9 weeks. Local recurrence-free survival rate was 89.9% and overall survival was 82.7% at 5 years. Seven patients developed metastasis within the whole follow-up. CONCLUSIONS: BCS in combination with IORT in IBTR in pre-irradiated patients is a feasible method to avoid mastectomy with a low risk of side effects and an excellent local control and good overall survival.
Authors: Coco J E F Walstra; Robert-Jan Schipper; Yvonne E van Riet; Peter-Paul G van der Toorn; Marjolein L Smidt; Maurice J C Vd Sangen; Adri C Voogd; Grard A P Nieuwenhuijzen Journal: Breast Cancer Res Treat Date: 2021-03-13 Impact factor: 4.872
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Authors: Robert W Mutter; J Isabelle Choi; Rachel B Jimenez; Youlia M Kirova; Marcio Fagundes; Bruce G Haffty; Richard A Amos; Julie A Bradley; Peter Y Chen; Xuanfeng Ding; Antoinette M Carr; Leslie M Taylor; Mark Pankuch; Raymond B Mailhot Vega; Alice Y Ho; Petra Witt Nyström; Lisa A McGee; James J Urbanic; Oren Cahlon; John H Maduro; Shannon M MacDonald Journal: Int J Radiat Oncol Biol Phys Date: 2021-05-25 Impact factor: 8.013