Maria Leonardi1, Agnese Cecconi2,3, Rosa Luraschi4, Elena Rondi4, Federica Cattani4, Roberta Lazzari1, Anna Morra1, Santos Soto5, Vanna Zanagnolo6, Viviana Galimberti7, Oreste Gentilini7,8, Fedro Peccatori9, Barbara Jereczek-Fossa1,3, Roberto Orecchia2,3,10. 1. Advanced Radiotherapy Center, European Institute of Oncology, Milan, Italy. 2. Scientific Direction, European Institute of Oncology, Milan, Italy. 3. University of Milan, Milan, Italy. 4. Unit of Medical Physics, European Institute of Oncology, Milan, Italy. 5. Medica Sur Hospital Breast Center, Mexico City, Mexico. 6. Gynecologic Cancer Surgery, European Institute of Oncology, Milan, Italy. 7. Breast Cancer Surgery, European Institute of Oncology, Milan, Italy. 8. Current address: Breast Surgery Unit, San Raffaele University Hospital, Milan, Italy. 9. Fertility and Procreation Unit, European Institute of Oncology, Milan, Italy. 10. National Center of Oncology Hadrontherapy (CNAO foundation), Pavia, Italy.
Abstract
BACKGROUND: The aim of this study was to confirm our preliminary results with in vivo dosimetry in non-pregnant breast cancer patients receiving electron beam intraoperative radiotherapy (ELIOT) and to report on the first treatment in a pregnant woman. PATIENTS AND METHODS: Following our previous experience, 5 non-pregnant patients receiving ELIOT to the tumor bed after breast-conserving surgery (BCS) were studied with thermoluminescent dosimeters positioned in the subdiaphragmatic region, within the uterus, and in the ovarian region. In December 2011, the first pregnant breast cancer patient underwent BCS and ELIOT (21 Gy at 90% isodose) during the 15th week of gestation. RESULTS: The mean dose to the subdiaphragmatic external region in the 5 non-pregnant patients was 5.57 mGy, while pelvic measurements were below 1 mGy. The actual dosimetry of the pregnant patient showed a mean subdiaphragmatic dose of 4.34 mGy, a mean suprapubic dose of 1.64 mGy, and mean ovarian doses of 1.48 mGy (right-sided) and 1.44 mGy (left-sided). The expected dose to the fetus was estimated as 0.84 mGy (0.004% of the prescribed dose). CONCLUSION: ELIOT as an anticipated boost to the breast could be considered in pregnant women in the early second trimester, postponing whole-breast irradiation after delivery.
BACKGROUND: The aim of this study was to confirm our preliminary results with in vivo dosimetry in non-pregnant breast cancer patients receiving electron beam intraoperative radiotherapy (ELIOT) and to report on the first treatment in a pregnant woman. PATIENTS AND METHODS: Following our previous experience, 5 non-pregnant patients receiving ELIOT to the tumor bed after breast-conserving surgery (BCS) were studied with thermoluminescent dosimeters positioned in the subdiaphragmatic region, within the uterus, and in the ovarian region. In December 2011, the first pregnant breast cancer patient underwent BCS and ELIOT (21 Gy at 90% isodose) during the 15th week of gestation. RESULTS: The mean dose to the subdiaphragmatic external region in the 5 non-pregnant patients was 5.57 mGy, while pelvic measurements were below 1 mGy. The actual dosimetry of the pregnant patient showed a mean subdiaphragmatic dose of 4.34 mGy, a mean suprapubic dose of 1.64 mGy, and mean ovarian doses of 1.48 mGy (right-sided) and 1.44 mGy (left-sided). The expected dose to the fetus was estimated as 0.84 mGy (0.004% of the prescribed dose). CONCLUSION: ELIOT as an anticipated boost to the breast could be considered in pregnant women in the early second trimester, postponing whole-breast irradiation after delivery.
Entities:
Keywords:
Breast cancer; Pregnancy; Radiation therapy