Single-Fraction Intraoperative Radiotherapy for Breast Cancer: Early Cosmetic Results

Journal Article · Sat Sep 01 04:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.02.010· OSTI ID:21036193

Beal, Kathryn ^[1]; McCormick, Beryl; Zelefsky, Michael J ^[1]; Borgen, Patrick; Fey, Jane; Goldberg, Jessica; Sacchini, Virgilio ^[2]

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1. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
2. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

Purpose: To evaluate the cosmetic outcome of patients treated with wide local excision and intraoperative radiotherapy for early-stage breast cancer. Methods and Materials: A total of 50 women were treated on a pilot study to evaluate the feasibility of intraoperative radiotherapy at wide local excision. The eligibility criteria included age >60, tumor size {<=}2.0 cm, clinically negative lymph nodes, and biopsy-established diagnosis. After wide local excision, a custom breast applicator was placed in the excision cavity, and a dose of 20 Gy was prescribed to a depth of 1 cm. After 18 patients were treated, the dose was constrained laterally to 18 Gy. The cosmetic outcome was evaluated by photographs at baseline and at 6 and 12 months postoperatively. Four examiners graded the photographs for symmetry, edema, discoloration, contour, and scarring. The grades were evaluated in relationship to the volume of irradiated tissue, tumor location, and dose at the lateral aspects of the cavity. Results: The median volume of tissue receiving 100% of the prescription dose was 47 cm{sup 3} (range, 20-97 cm{sup 3}). Patients with {<=}47 cm{sup 3} of treated tissue had better cosmetic outcomes than did the women who had >47 cm{sup 3} of treated tissue. Women who had received 18 Gy at the lateral aspects of their cavities had better cosmetic outcomes than did women who had received 20 Gy at the lateral aspects. When comparing the 6- and 12-month results, the scores remained stable for 63%, improved for 17%, and worsened for 20%. Conclusion: Intraoperative radiotherapy appears feasible for selected patients. A favorable cosmetic outcome appears to be related to a smaller treatment volume. The cosmetic outcome is acceptable, although additional follow-up is necessary.

• OSTI ID: 21036193
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 69; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOPSY
BRACHYTHERAPY
CARCINOMAS
DIAGNOSIS
EDEMA
IMAGES
IRRADIATION
LYMPH NODES
MAMMARY GLANDS
PATIENTS
PHOTOGRAPHY
RADIATION DOSES
WOMEN