Claire Lemanski1, Celine Bourgier2, Roxanna Draghici1, Simon Thezenas3, Aurélie Morel4, Philippe Rouanet5, Pierre-Emmanuel Colombo5, Anne Mourregot5, Laure Delmond5, Pascal Fenoglietto4, Norbert Ailleres4, David Azria6, Marian Gutowski5. 1. Fédération universitaire d'oncologie radiothérapie, ICM, Institut régional du cancer Montpellier, rue Croix-Verte, 34298 Montpellier cedex 05, France. 2. Fédération universitaire d'oncologie radiothérapie, ICM, Institut régional du cancer Montpellier, rue Croix-Verte, 34298 Montpellier cedex 05, France; IRCM, Institut de recherche en cancérologie de Montpellier, Inserm U1194, université Montpellier, avenue des Apothicaires, 34298 Montpellier cedex 05, France. 3. Biometrics unit, ICM-Val d'Aurelle, université Montpellier, Montpellier, France. 4. Radiophysics Unit, ICM-Val d'Aurelle, université Montpellier, Montpellier, France. 5. Department of Surgical and Reconstructive Oncology, ICM-Val d'Aurelle, université Montpellier, Montpellier, France. 6. Fédération universitaire d'oncologie radiothérapie, ICM, Institut régional du cancer Montpellier, rue Croix-Verte, 34298 Montpellier cedex 05, France; IRCM, Institut de recherche en cancérologie de Montpellier, Inserm U1194, université Montpellier, avenue des Apothicaires, 34298 Montpellier cedex 05, France. Electronic address: david.azria@icm.unicancer.fr.
Abstract
PURPOSE: To evaluate our long-term experience on one-day breast intraoperative radiotherapy (IORT) given as sole radiation treatment to selected patients with breast cancer. METHODS AND MATERIALS: Inclusion criteria of INTRAOBS study (prospective observational study) were: ER+ T1N0 unifocal ductal carcinoma; absence of lymphovascular invasion or of extensive intraductal component (Scarff-Bloom-Richardson grade III and HER2+++ excluded). Two different linacs were used (20Gy/1 fraction): one dedicated electron linac (<October 2011), and afterwards a mobile linac (50kV photons). The primary endpoint was the local recurrence rate (=ipsilateral breast cancer recurrences number). Secondary endpoints were recurrence-free survival (RFS), overall and specific survival, cosmetic results, and patient satisfaction. RESULTS: Of the present pre-planned analysis for the first 200 patients (median age: 68 years; range, 59-87 years) who received IORT between January 2010 and October 2014 (median follow-up of 53.4 months). A total of 193 patients were still alive. The local recurrence rate was 2.5% (n=5). The 1- and 5-year local RFS rates were 100% and 95.2%, respectively. At 12 months post-surgery, satisfaction about IORT was excellent for 86.9% of patients. Cosmetic results were considered by patients and physicians as good or very good in 89.4% and 97.3% of cases, respectively. CONCLUSIONS: IORT for selected patients with breast cancer shows low recurrence rates, good cosmetic outcomes and excellent satisfaction.
PURPOSE: To evaluate our long-term experience on one-day breast intraoperative radiotherapy (IORT) given as sole radiation treatment to selected patients with breast cancer. METHODS AND MATERIALS: Inclusion criteria of INTRAOBS study (prospective observational study) were: ER+ T1N0 unifocal ductal carcinoma; absence of lymphovascular invasion or of extensive intraductal component (Scarff-Bloom-Richardson grade III and HER2+++ excluded). Two different linacs were used (20Gy/1 fraction): one dedicated electron linac (<October 2011), and afterwards a mobile linac (50kV photons). The primary endpoint was the local recurrence rate (=ipsilateral breast cancer recurrences number). Secondary endpoints were recurrence-free survival (RFS), overall and specific survival, cosmetic results, and patient satisfaction. RESULTS: Of the present pre-planned analysis for the first 200 patients (median age: 68 years; range, 59-87 years) who received IORT between January 2010 and October 2014 (median follow-up of 53.4 months). A total of 193 patients were still alive. The local recurrence rate was 2.5% (n=5). The 1- and 5-year local RFS rates were 100% and 95.2%, respectively. At 12 months post-surgery, satisfaction about IORT was excellent for 86.9% of patients. Cosmetic results were considered by patients and physicians as good or very good in 89.4% and 97.3% of cases, respectively. CONCLUSIONS: IORT for selected patients with breast cancer shows low recurrence rates, good cosmetic outcomes and excellent satisfaction.
Keywords:
Breast cancer; Cancer du sein; Cosmetics; IORT; Patient satisfaction; Radiothérapie intra-opératoire; Recurrence; Récidive; Résultats esthétiques; Satisfaction des patientes
Authors: Jayant Sharad Vaidya; Uma Jayant Vaidya; Michael Baum; Max Kishor Bulsara; David Joseph; Jeffrey S Tobias Journal: Front Oncol Date: 2022-08-11 Impact factor: 5.738