Targeted intraoperative radiotherapy tumour bed boost during breast-conserving surgery after neoadjuvant chemotherapy
Kolberg HC, Loevey G, Akpolat-Basci L, Stephanou M, Fasching P, Untch M, Liedtke C, Bulsara M, Vaidya JS (2017)
Publication Type: Journal article
Publication year: 2017
Journal
Book Volume: 193
Pages Range: 62-69
Journal Issue: 1
DOI: 10.1007/s00066-016-1072-y
Abstract
INTRODUCTION: The use of targeted intraoperative radiotherapy (TARGIT-IORT) as a tumour bed boost during breast-conserving surgery (BCS) for breast cancer has been reported since 1998. We present its use in patients undergoing breast conservation following neoadjuvant therapy (NACT). METHOD: In this retrospective study involving 116 patients after NACT we compared outcomes of 61 patients who received a tumour bed boost with IORT during lumpectomy versus 55 patients treated in the previous 13 months with external (EBRT) boost. All patients received whole breast radiotherapy. Local recurrence-free survival (LRFS), disease-free survival (DFS), distant disease-free survival (DDFS), breast cancer mortality (BCM), non-breast cancer mortality (NBCM) and overall mortality (OS) were compared. RESULTS: Median follow up was 49 months. The differences in LRFS, DFS and BCM were not statistically significant. The 5‑year Kaplan-Meier estimate of OS was significantly better by 15% with IORT: IORT 2 events (96.7%, 95%CI 87.5-99.2), EBRT 9 events (81.7%, 95%CI 67.6-90.1), hazard ratio (HR) 0.19 (0.04-0.87), log rank p = 0.016, mainly due to a reduction of 10.1% in NBCM: IORT 100%, EBRT 89.9% (77.3-95.7), HR (not calculable), log rank p = 0.015. The DDFS was as follows: IORT 3 events (95.1%, 85.5-98.4), EBRT 12 events (69.0%, 49.1-82.4), HR 0.23 (0.06-0.80), log rank p = 0.012. CONCLUSION: IORT during lumpectomy after neoadjuvant chemotherapy as a tumour bed boost appears to give results that are not worse than external beam radiotherapy boost. These data give further support to the inclusion of such patients in the TARGIT-B (boost) randomised trial that is testing whether IORT boost is superior to EBRT boost.
Authors with CRIS profile
Involved external institutions
University College London (UCL)
United Kingdom (GB)
Marienhospital Bottrop
Germany (DE)
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
HELIOS Kliniken
Germany (DE)
Borad Gemeinschaftspraxis
Germany (DE)
United Kingdom (GB)
Marienhospital Bottrop
Germany (DE)
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
HELIOS Kliniken
Germany (DE)
Borad Gemeinschaftspraxis
Germany (DE)
How to cite
APA:
Kolberg, H.-C., Loevey, G., Akpolat-Basci, L., Stephanou, M., Fasching, P., Untch, M.,... Vaidya, J.S. (2017). Targeted intraoperative radiotherapy tumour bed boost during breast-conserving surgery after neoadjuvant chemotherapy. Strahlentherapie und Onkologie, 193(1), 62-69. https://doi.org/10.1007/s00066-016-1072-y
MLA:
Kolberg, Hans-Christian, et al. "Targeted intraoperative radiotherapy tumour bed boost during breast-conserving surgery after neoadjuvant chemotherapy." Strahlentherapie und Onkologie 193.1 (2017): 62-69.
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