Intraoperative Strahlentherapie (IORT) in der behandlung des mammakarzinoms - Eine neue therapeutische alternative im rahmen der brusterhaltenden therapie? Stellenwert und zukunftsperspektiven. Erfahrungsbericht aus dem European Institute of Oncology (EIO), Mailand

Translated title of the contribution: Intra-Operative Radiation Therapy (IORT) in the treatment of breast cancer - A new therapeutic alternative in the conservative treatment of breast cancer? Its potential role and future perspectives. Experiences from the European Institute of Oncology (EIO), Milan

Wolfgang Gatzemeier, Roberto Orecchia, Giovanna Gatti, Mattia Intra, Umberto Veronesi

Research output: Contribution to journalArticle

Abstract

Background: External beam radiation therapy (EBRT) represents an integra'l component of breast-conserving treatment. In published series it has been demonstrated that the external boost can be replaced by intraoperative radiotherapy (IORT) where irradiation at a single dose from 10 up to 15 Gy was safety delivered directly to the tumor bed. Patients and Methods: At the European Institute of Oncology, Milan, we initiated a dose escalation study to investigate the feasibility of applying single doses of IORT from 10 Gy up to 22 Gy. A portable IORT equipment with different electron energies was used. From July to December 1999, a total of 65 patients with T1-2 (max. 2.5 cm) NO-1 breast cancer, median age 58 years (range 33-80 years) was treated. Ten patients received 10 Gy, eight patients were treated with an IORT of 15 Gy, eight received 17 Gy, six had 19 Gy, and 33 were treated with 21-22 Gy. Patients with 10 and 15 Gy received an additional EBRT of 44 and 40 Gy, respectively. In all other patients IORT was the sole radiation treatment. Results: No acute side effects or intermediate untoward effects after a follow-up from three to nine months related to IORT were observed. Conclusions: Since the applicator can be safely placed under the control of the surgeon and radiotherapist IORT has the potential of accurately treating the tumor bed. Skin and subcutaneous tissue are not irradiated thus decreasing the potential risk of fibrosis and eventually obtaining a better cosmesis. With IORT single doses of 22 Gy being equivalent to a 60 Gy EBRT can safely be delivered. Even so the average time of operation was prolonged by around 20 minutes IORT application ultimately improves the quality of life of the patients in shortening overall treatment. Long-term follow-up is necessary to demonstrate whether large single doses of IORT might have the potential of sufficient local tumor control without major side effects. As a future perspective a randomized trial comparing EBRT with IORT as sole treatment will be performed.

Translated title of the contributionIntra-Operative Radiation Therapy (IORT) in the treatment of breast cancer - A new therapeutic alternative in the conservative treatment of breast cancer? Its potential role and future perspectives. Experiences from the European Institute of Oncology (EIO), Milan
Original languageGerman
Pages (from-to)330-337
Number of pages8
JournalStrahlentherapie und Onkologie
Volume177
Issue number7
Publication statusPublished - 2001

Keywords

  • Breast conservation treatment
  • Intraoperative radiation treatment
  • Radiotherapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cancer Research
  • Radiological and Ultrasound Technology

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