Maria Laplana1, Marta García-Marqueta2, Juan José Sánchez-Fernández3, Evelyn Martínez-Pérez2, Héctor Pérez-Montero2, Irene Martínez-Montesinos2, Arantxa Eraso4, Pablo Saldaña5, Roberto Martín5, Marta Irene Martín2, Maria Jesús Pla6, Amparo García-Tejedor6, Ferran Guedea2. 1. Department of Radiation Oncology, Catalan Institute of Oncology, University of Barcelona, L'Hospitalet de Llobregat, Avinguda de la Gran Via de l'Hospitalet, 199-203, 08907, Barcelona, Spain. mlaplana@iconcologia.net. 2. Department of Radiation Oncology, Catalan Institute of Oncology, University of Barcelona, L'Hospitalet de Llobregat, Avinguda de la Gran Via de l'Hospitalet, 199-203, 08907, Barcelona, Spain. 3. Department of Radiology, Imaging Diagnostic Institute, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain. 4. Department of Radiation Oncology, Catalan Institute of Oncology, University of Barcelona and Girona, Girona, Spain. 5. Department of Medical Physics, Catalan Institute of Oncology, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain. 6. Department of Gynecology, Bellvitge Hospital, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
Abstract
PURPOSE: To evaluate treatment outcomes in patients with early-stage breast cancer (ESBC) treated with targeted intraoperative radiation therapy (IORT) administered as accelerated partial breast irradiation (APBI). METHODS: Between December 2014 and May 2019, 50 patients diagnosed with ESBC were treated with a 50 kilovoltage (kV) X-ray source with a single dose of 20 Gy using the Intrabeam® radiotherapy delivery system. All patients were followed prospectively to assess local control (LC), disease-free survival (DFS), cancer-specific survival (CSS), overall survival (OS), radiation-induced toxicity, and cosmetic outcomes. We also evaluated the prognostic implications of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). RESULTS: Median follow-up was 53 months. Mean patient age was 70 years. The mean duration of radiation delivery was 22.25 min. Two patients developed a recurrence. One death was recorded. Elevated pretreatment NLR levels were a significant risk factor for mortality (p = 0.0026). The most common treatment-related toxicities were breast induration (30%) and seroma (18%). Five-year LC, DFS, CSS, and OS rates were 97.1%, 93.9%, 100%, and 94.4%, respectively. Cosmesis was excellent or good in most cases (94%). CONCLUSION: These findings confirm the effectiveness of a single dose of 20 Gy of IORT with the Intrabeam device as APBI. The toxicity profile was good with excellent cosmesis. These results provide further support for the clinical use of APBI in well-selected patients.
PURPOSE: To evaluate treatment outcomes in patients with early-stage breast cancer (ESBC) treated with targeted intraoperative radiation therapy (IORT) administered as accelerated partial breast irradiation (APBI). METHODS: Between December 2014 and May 2019, 50 patients diagnosed with ESBC were treated with a 50 kilovoltage (kV) X-ray source with a single dose of 20 Gy using the Intrabeam® radiotherapy delivery system. All patients were followed prospectively to assess local control (LC), disease-free survival (DFS), cancer-specific survival (CSS), overall survival (OS), radiation-induced toxicity, and cosmetic outcomes. We also evaluated the prognostic implications of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). RESULTS: Median follow-up was 53 months. Mean patient age was 70 years. The mean duration of radiation delivery was 22.25 min. Two patients developed a recurrence. One death was recorded. Elevated pretreatment NLR levels were a significant risk factor for mortality (p = 0.0026). The most common treatment-related toxicities were breast induration (30%) and seroma (18%). Five-year LC, DFS, CSS, and OS rates were 97.1%, 93.9%, 100%, and 94.4%, respectively. Cosmesis was excellent or good in most cases (94%). CONCLUSION: These findings confirm the effectiveness of a single dose of 20 Gy of IORT with the Intrabeam device as APBI. The toxicity profile was good with excellent cosmesis. These results provide further support for the clinical use of APBI in well-selected patients.
Authors: Frank A Vicini; Reena S Cecchini; Julia R White; Douglas W Arthur; Thomas B Julian; Rachel A Rabinovitch; Robert R Kuske; Patricia A Ganz; David S Parda; Michael F Scheier; Kathryn A Winter; Soonmyung Paik; Henry M Kuerer; Laura A Vallow; Lori J Pierce; Eleftherios P Mamounas; Beryl McCormick; Joseph P Costantino; Harry D Bear; Isabelle Germain; Gregory Gustafson; Linda Grossheim; Ivy A Petersen; Richard S Hudes; Walter J Curran; John L Bryant; Norman Wolmark Journal: Lancet Date: 2019-12-05 Impact factor: 79.321
Authors: Timothy J Whelan; Jim A Julian; Tanya S Berrang; Do-Hoon Kim; Isabelle Germain; Alan M Nichol; Mohamed Akra; Sophie Lavertu; Francois Germain; Anthony Fyles; Theresa Trotter; Francisco E Perera; Susan Balkwill; Susan Chafe; Thomas McGowan; Thierry Muanza; Wayne A Beckham; Boon H Chua; Chu Shu Gu; Mark N Levine; Ivo A Olivotto Journal: Lancet Date: 2019-12-05 Impact factor: 79.321
Authors: Sarah C Darby; Marianne Ewertz; Paul McGale; Anna M Bennet; Ulla Blom-Goldman; Dorthe Brønnum; Candace Correa; David Cutter; Giovanna Gagliardi; Bruna Gigante; Maj-Britt Jensen; Andrew Nisbet; Richard Peto; Kazem Rahimi; Carolyn Taylor; Per Hall Journal: N Engl J Med Date: 2013-03-14 Impact factor: 91.245
Authors: U Veronesi; A Luini; M Del Vecchio; M Greco; V Galimberti; M Merson; F Rilke; V Sacchini; R Saccozzi; T Savio Journal: N Engl J Med Date: 1993-06-03 Impact factor: 91.245
Authors: Vratislav Strnad; Oliver J Ott; Guido Hildebrandt; Daniela Kauer-Dorner; Hellen Knauerhase; Tibor Major; Jaroslaw Lyczek; Jose Luis Guinot; Jürgen Dunst; Cristina Gutierrez Miguelez; Pavel Slampa; Michael Allgäuer; Kristina Lössl; Bülent Polat; György Kovács; Arnt-René Fischedick; Thomas G Wendt; Rainer Fietkau; Marion Hindemith; Alexandra Resch; Anna Kulik; Leo Arribas; Peter Niehoff; Fernando Guedea; Annika Schlamann; Richard Pötter; Christine Gall; Martina Malzer; Wolfgang Uter; Csaba Polgár Journal: Lancet Date: 2015-10-19 Impact factor: 79.321
Authors: S Darby; P McGale; C Correa; C Taylor; R Arriagada; M Clarke; D Cutter; C Davies; M Ewertz; J Godwin; R Gray; L Pierce; T Whelan; Y Wang; R Peto Journal: Lancet Date: 2011-10-19 Impact factor: 79.321