Long-term toxicity of an intraoperative radiotherapy boost using low energy X-rays during breast-conserving surgery

Journal Article · Sun Oct 01 04:00:00 EDT 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.05.042· OSTI ID:20850110

Kraus-Tiefenbacher, Uta ^[1]; Bauer, Lelia ^[2]; Scheda, Antonella ^[1]; Fleckenstein, Katharina ^[1]; Keller, Anke ^[1]; Herskind, Carsten ^[1]; Steil, Volker ^[1]; Melchert, Frank ^[2]; Wenz, Frederik ^[1]

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1. Department of Radiation Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim (Germany)
2. Department of Gynecology and Obstetrics, Mannheim Medical Center, University of Heidelberg, Mannheim (Germany)

Purpose: Intraoperative radiotherapy (IORT) as a boost for breast cancer delivers a high single dose of radiation to a late-reacting tissue; therefore late toxicity is of particular interest, and long-term follow-up is warranted. To date there are only limited data available on breast cancer patients treated with IORT using low energy X-rays. We analyzed toxicity and cosmesis after IORT as a boost with a minimum follow-up of 18 months. Methods and Materials: A total of 73 patients treated with IORT (20 Gy/50 kV X-rays; INTRABEAM [Carl Zeiss Surgical, Oberkochen, Germany]) to the tumor bed during breast-conserving surgery as a boost followed by whole-breast radiotherapy (WBRT, 46 Gy) underwent a prospective, predefined follow-up (median, 25 months; range 18-44 months), including clinical examination and breast ultrasound at 6-months and mammographies at 1-year intervals. Toxicities were documented using the common toxicity criteria (CTC)/European Organization for Research and Treatment of Cancer and the LENT-SOMA score. Cosmesis was evaluated with a score from 1 to 4. Results: The IORT in combination with WBRT was well tolerated, with no Grade 3 or 4 skin toxicities and no telangiectasias. Fibrosis of the entire breast was observed in 5% of the patients. A circumscribed fibrosis around the tumor bed was palpable in up to 27% with a peak around 18 months after therapy and a decline thereafter. The observed toxicitiy rates were not influenced by age, tumor stage, or systemic therapy. The cosmetic outcome was good to excellent in {>=}90% of cases. Conclusions: After IORT of the breast using low-energy X-rays, no unexpected toxicity rates were observed during long-term-follow-up.

• OSTI ID: 20850110
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 66; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
CARCINOMAS
FIBROSIS
MAMMARY GLANDS
PATIENTS
RADIATION DOSES
RADIOTHERAPY
SKIN
SURGERY
TOXICITY
X RADIATION