One-step intraoperative radiotherapy optimizes conservative treatment of breast cancer with advantages in quality of life and work resumption

Luca Sorrentino, Susanna Fissi, Ilaria Meaglia, Daniela Bossi, Ottavia Caserini, Serena Mazzucchelli, Marta Truffi, Sara Albasini, Paola Tabarelli, Marco Liotta, Giovanni B Ivaldi, Fabio Corsi

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Intraoperative radiotherapy (IORT) could be not-inferior to external beam radiotherapy (EBRT) in selected patients, but toxicities, self-perception of body image, quality of life, and resumption of work or daily activities have been poorly explored. The aim of the present study was to compare these outcomes between EBRT, IORT full-dose (IORT-f) and IORT boost (IORT-b).

METHODS: 443 consecutive patients, candidates for breast-conserving surgery, were included: EBRT was performed in 220 patients (49.7%), IORT-f in 140 patients (31.6%), and IORT-b in 83 patients (18.7%). Radiotherapy-related toxicities were registered. Patients were evaluated at 6 months for Body Image after Breast Cancer Questionnaire (BIBCQ) to assess possible changes in self-perception of body image and limitations. A second questionnaire explored the impact of EBRT, IORT-f and IORT-b on resumption of work and normal daily activities.

RESULTS: EBRT had a higher risk of breast fibrosis and retraction (OR 3.58, 95% CI 1.024-12.526, p = 0.046) and breast edema (OR 6, 95% CI 2.077-17.335, p = 0.001) compared to IORT-f, but a lower risk of seroma compared to IORT-b (OR 0.36, 95% CI 0.166-0.785, p = 0.01). The BIBCQ scores showed a better outcome in arm concerns with IORT-f (-3.3) vs. IORT-b (-1.3, p = 0.002) and EBRT (-1.7, p = 0.006), although biased by the lower rate in axillary dissections. Return to daily activities occurred after 70.6 days with EBRT vs. 41 days with IORT-f (p < 0.0001) and 53.3 days with IORT-b (p = 0.07), without any effect of age or axillary dissection.

CONCLUSION: IORT could reduce adverse effects, allowing faster resumption of job and houseworks.

Original languageEnglish
Pages (from-to)123-130
Number of pages8
JournalBreast
Volume39
DOIs
Publication statusPublished - Jun 2018

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Radiotherapy
Quality of Life
Breast Neoplasms
Body Image
Conservative Treatment
Self Concept
Dissection
Breast
Seroma
Housekeeping
Segmental Mastectomy

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One-step intraoperative radiotherapy optimizes conservative treatment of breast cancer with advantages in quality of life and work resumption. / Sorrentino, Luca; Fissi, Susanna; Meaglia, Ilaria; Bossi, Daniela; Caserini, Ottavia; Mazzucchelli, Serena; Truffi, Marta; Albasini, Sara; Tabarelli, Paola; Liotta, Marco; Ivaldi, Giovanni B; Corsi, Fabio.

In: Breast, Vol. 39, 06.2018, p. 123-130.

Research output: Contribution to journalArticle

Sorrentino, Luca ; Fissi, Susanna ; Meaglia, Ilaria ; Bossi, Daniela ; Caserini, Ottavia ; Mazzucchelli, Serena ; Truffi, Marta ; Albasini, Sara ; Tabarelli, Paola ; Liotta, Marco ; Ivaldi, Giovanni B ; Corsi, Fabio. / One-step intraoperative radiotherapy optimizes conservative treatment of breast cancer with advantages in quality of life and work resumption. In: Breast. 2018 ; Vol. 39. pp. 123-130.
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title = "One-step intraoperative radiotherapy optimizes conservative treatment of breast cancer with advantages in quality of life and work resumption",
abstract = "BACKGROUND: Intraoperative radiotherapy (IORT) could be not-inferior to external beam radiotherapy (EBRT) in selected patients, but toxicities, self-perception of body image, quality of life, and resumption of work or daily activities have been poorly explored. The aim of the present study was to compare these outcomes between EBRT, IORT full-dose (IORT-f) and IORT boost (IORT-b).METHODS: 443 consecutive patients, candidates for breast-conserving surgery, were included: EBRT was performed in 220 patients (49.7{\%}), IORT-f in 140 patients (31.6{\%}), and IORT-b in 83 patients (18.7{\%}). Radiotherapy-related toxicities were registered. Patients were evaluated at 6 months for Body Image after Breast Cancer Questionnaire (BIBCQ) to assess possible changes in self-perception of body image and limitations. A second questionnaire explored the impact of EBRT, IORT-f and IORT-b on resumption of work and normal daily activities.RESULTS: EBRT had a higher risk of breast fibrosis and retraction (OR 3.58, 95{\%} CI 1.024-12.526, p = 0.046) and breast edema (OR 6, 95{\%} CI 2.077-17.335, p = 0.001) compared to IORT-f, but a lower risk of seroma compared to IORT-b (OR 0.36, 95{\%} CI 0.166-0.785, p = 0.01). The BIBCQ scores showed a better outcome in arm concerns with IORT-f (-3.3) vs. IORT-b (-1.3, p = 0.002) and EBRT (-1.7, p = 0.006), although biased by the lower rate in axillary dissections. Return to daily activities occurred after 70.6 days with EBRT vs. 41 days with IORT-f (p < 0.0001) and 53.3 days with IORT-b (p = 0.07), without any effect of age or axillary dissection.CONCLUSION: IORT could reduce adverse effects, allowing faster resumption of job and houseworks.",
author = "Luca Sorrentino and Susanna Fissi and Ilaria Meaglia and Daniela Bossi and Ottavia Caserini and Serena Mazzucchelli and Marta Truffi and Sara Albasini and Paola Tabarelli and Marco Liotta and Ivaldi, {Giovanni B} and Fabio Corsi",
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year = "2018",
month = "6",
doi = "10.1016/j.breast.2018.04.004",
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T1 - One-step intraoperative radiotherapy optimizes conservative treatment of breast cancer with advantages in quality of life and work resumption

AU - Sorrentino, Luca

AU - Fissi, Susanna

AU - Meaglia, Ilaria

AU - Bossi, Daniela

AU - Caserini, Ottavia

AU - Mazzucchelli, Serena

AU - Truffi, Marta

AU - Albasini, Sara

AU - Tabarelli, Paola

AU - Liotta, Marco

AU - Ivaldi, Giovanni B

AU - Corsi, Fabio

N1 - Copyright © 2018 Elsevier Ltd. All rights reserved.

PY - 2018/6

Y1 - 2018/6

N2 - BACKGROUND: Intraoperative radiotherapy (IORT) could be not-inferior to external beam radiotherapy (EBRT) in selected patients, but toxicities, self-perception of body image, quality of life, and resumption of work or daily activities have been poorly explored. The aim of the present study was to compare these outcomes between EBRT, IORT full-dose (IORT-f) and IORT boost (IORT-b).METHODS: 443 consecutive patients, candidates for breast-conserving surgery, were included: EBRT was performed in 220 patients (49.7%), IORT-f in 140 patients (31.6%), and IORT-b in 83 patients (18.7%). Radiotherapy-related toxicities were registered. Patients were evaluated at 6 months for Body Image after Breast Cancer Questionnaire (BIBCQ) to assess possible changes in self-perception of body image and limitations. A second questionnaire explored the impact of EBRT, IORT-f and IORT-b on resumption of work and normal daily activities.RESULTS: EBRT had a higher risk of breast fibrosis and retraction (OR 3.58, 95% CI 1.024-12.526, p = 0.046) and breast edema (OR 6, 95% CI 2.077-17.335, p = 0.001) compared to IORT-f, but a lower risk of seroma compared to IORT-b (OR 0.36, 95% CI 0.166-0.785, p = 0.01). The BIBCQ scores showed a better outcome in arm concerns with IORT-f (-3.3) vs. IORT-b (-1.3, p = 0.002) and EBRT (-1.7, p = 0.006), although biased by the lower rate in axillary dissections. Return to daily activities occurred after 70.6 days with EBRT vs. 41 days with IORT-f (p < 0.0001) and 53.3 days with IORT-b (p = 0.07), without any effect of age or axillary dissection.CONCLUSION: IORT could reduce adverse effects, allowing faster resumption of job and houseworks.

AB - BACKGROUND: Intraoperative radiotherapy (IORT) could be not-inferior to external beam radiotherapy (EBRT) in selected patients, but toxicities, self-perception of body image, quality of life, and resumption of work or daily activities have been poorly explored. The aim of the present study was to compare these outcomes between EBRT, IORT full-dose (IORT-f) and IORT boost (IORT-b).METHODS: 443 consecutive patients, candidates for breast-conserving surgery, were included: EBRT was performed in 220 patients (49.7%), IORT-f in 140 patients (31.6%), and IORT-b in 83 patients (18.7%). Radiotherapy-related toxicities were registered. Patients were evaluated at 6 months for Body Image after Breast Cancer Questionnaire (BIBCQ) to assess possible changes in self-perception of body image and limitations. A second questionnaire explored the impact of EBRT, IORT-f and IORT-b on resumption of work and normal daily activities.RESULTS: EBRT had a higher risk of breast fibrosis and retraction (OR 3.58, 95% CI 1.024-12.526, p = 0.046) and breast edema (OR 6, 95% CI 2.077-17.335, p = 0.001) compared to IORT-f, but a lower risk of seroma compared to IORT-b (OR 0.36, 95% CI 0.166-0.785, p = 0.01). The BIBCQ scores showed a better outcome in arm concerns with IORT-f (-3.3) vs. IORT-b (-1.3, p = 0.002) and EBRT (-1.7, p = 0.006), although biased by the lower rate in axillary dissections. Return to daily activities occurred after 70.6 days with EBRT vs. 41 days with IORT-f (p < 0.0001) and 53.3 days with IORT-b (p = 0.07), without any effect of age or axillary dissection.CONCLUSION: IORT could reduce adverse effects, allowing faster resumption of job and houseworks.

U2 - 10.1016/j.breast.2018.04.004

DO - 10.1016/j.breast.2018.04.004

M3 - Article

C2 - 29674010

VL - 39

SP - 123

EP - 130

JO - Breast

JF - Breast

SN - 0960-9776

ER -