Intraoperative irradiation in breast cancer: Preliminary results in 80 patients as partial breast irradiation or anticipated boost prior to hypo-fractionated whole breast irradiation

• X. Li ^[1] ; J. Sanz ^[2] ; N. Argudo ^[3] ; M. Vernet-Tomas ^[3] ; N. Rodríguez ^[2] ; L. Torrent ^[3] ; E. Fernández-Velilla ^[3] ; O. Pera ^[3] ; Y. Huang ^[1] ; P. Nicolau ^[3] ; M. Jiménez ^[3] ; M. Segura ^[3] ; M. Algara ^[1]
  1. [1] Universitat Autònoma de Barcelona

     Universitat Autònoma de Barcelona

     Barcelona, España

     
  2. [2] Universitat Pompeu Fabra

     Universitat Pompeu Fabra

     Barcelona, España

     
  3. [3] Hospital del Mar

     Hospital del Mar

     Barcelona, España

     

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 24, Nº. 5 (May), 2022, págs. 829-835
• Idioma: inglés
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• Resumen

  • Purpose To present the first results of intraoperative irradiation (IORT) in breast cancer with a low-energy photon system used as partial breast irradiation (PBI) or as an anticipated boost before whole breast hypo-fractionated irradiation (IORT + WBI), concerning tolerance, side effects, quality of life, and patient-reported outcomes.

    Materials and methods Eighty patients treated with an Intrabeam® system of 50 kV X-rays received a 20 Gy dose intraoperatively were included. Moderate daily hypofractionation of 2.7 Gy in 15 fractions up to 40.5 Gy was administered if high-risk factors were present. Acute post-operative toxicity, surgery complications, chronic toxicity, patient-reported cosmesis and Breast-Q questionnaire were performed at follow-up visits.

    Results Thirty-one patients were treated as PBI and the remaining 49 as IORT + WBI. Only the IORT + WBI group presented acute toxicity, mainly mild acute dermatitis (11 patients) and one subacute mastitis. A total of 20 patients presented fibrosis (18 patients grade I, 2 patients grade II), 15 (30.5%) patients in the IORT + WBI group and 3 (9.6%) patients in the group of PBI. The cosmesis evaluation in 73 patients resulted poor, fair, good or excellent in 2, 7, 38 and 26 patients, respectively. In PBI group Breast-Q scored higher, especially in terms of their psychosocial well-being (78 vs 65) and satisfaction with radiation-induced toxicity (77 vs 72, respectively) compared to IORT + WBI group.

    Conclusion IORT is a well-tolerated procedure with low toxicity, good cosmesis and favorable patient-reported outcomes mainly when administered as PBI.