Cosmetic Outcomes for Accelerated Partial Breast Irradiation Before Surgical Excision of Early-Stage Breast Cancer Using Single-Dose Intraoperative Radiotherapy
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC (United States)
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC (United States)
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC (United States)
- Department of Pathology, University of North Carolina at Chapel Hill, Chapel Hill, NC (United States)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC (United States)
Purpose: Determine cosmetic outcome and toxicity profile of intraoperative radiation delivered before tumor excision for patients with early-stage breast cancer. Methods and Materials: Patients age 48 or older with ultrasound-visible invasive ductal cancers <3 cm and clinically negative lymph nodes were eligible for treatment on this institutional review board-approved Phase II clinical trial. Treatment planning ultrasound was used to select an electron energy and cone size sufficient to cover the tumor plus a 1.5- to 2.0-cm circumferential margin laterally and a 1-cm-deep margin with the 90% isodose line. The dose was prescribed to a nominal 15 Gy and delivered using a Mobetron electron irradiator before tumor excision by segmental mastectomy. Physician- and patient-assessed cosmetic outcome and patient satisfaction were determined by questionnaire. Results: From March 2003 to July 2007, 71 patients were treated with intraoperative radiation therapy. Of those, 56 patients were evaluable, with a median follow-up of 3.1 years (minimum 1 year). Physician and patient assessment of cosmesis was 'good or excellent' (Radiation Therapy Oncology Group cosmesis scale) in 45/56 (80%) and 32/42 (76%) of all patients, respectively. Eleven patients who received additional whole breast radiation had similar rates of good or excellent cosmesis: 40/48 (83%) and 29/36 (81%), respectively). Grade 1 or 2 acute toxicities were seen in 4/71 (6%) patients. No Grade 3 or 4 toxicities or serious adverse events have been seen. Conclusion: Intraoperative radiotherapy delivered to an in situ tumor is feasible with acceptable acute tolerance. Patient and physician assessment of the cosmetic outcome is good to excellent.
- OSTI ID:
- 21491577
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 79, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2009.10.032; PII: S0360-3016(09)03424-5; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
Similar Records
Accelerated Partial Breast Irradiation Is Safe and Effective Using Intensity-Modulated Radiation Therapy in Selected Early-Stage Breast Cancer
Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes