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IOERT delivered safely in early, low-risk disease
SAN FRANCISCO — Accelerated partial-breast irradiation using a single dose of intraoperative electron radiotherapy can be performed safely in patients with early, low-risk breast cancer, according to results of a phase 2 study.
However, longer follow-up is needed to determine the efficacy of the treatment compared with the current standard of whole-breast irradiation, researchers said.
Stefano Dall’Oglio, MD, and colleagues of the department of radiation oncology at University Hospital in Verona, Italy, enrolled 226 patients with low-risk, early-stage breast cancer who underwent intraoperative electron radiotherapy (IOERT) immediately after surgical resection.
All patients had biopsy-proven cancer. After surgeons temporarily re-approximated the excision cavity, they used IOERT to deliver a dose of 21 Gy to the tumor bed with a margin of 2 cm laterally.
No acute reactions were reported after irradiation, the researchers said.
Three patients experienced a transient edema, and seven others experienced hematomas. No cases of liponecrosis were reported.
After a mean follow-up of 49 months (range, 31-66 months), only one case of local recurrence had been reported.
Researchers also calculated cosmetic results for patients. Six months after the completion of IOERT, 31.4% of patients exhibited a score of 2 for symmetry and contour (asymmetry exhibited by one-third or less of breast volume), and 8.4% exhibited a score of 3 (asymmetry exhibited by greater than one-third of breast volume). These findings remained unchanged in subsequent examinations.
The researchers observed no breast edema, discoloration or scar prominence.
“A single dose of intraoperative electron radiation therapy in early-stage breast cancer can be delivered safely and with excellent results — and here is the caveat — in properly selected patients,” said Jay K. Harness, MD, FACS, president of Breast Surgery International and former president of The American Society of Breast Surgeons.
“Patients who are at a very low risk of local recurrence, such as ASTRO- and ESTRO-guideline patients deemed suitable for accelerated partial-breast irradiation represent an excellent group to receive a one-dose procedure and avoid 5 to 6 weeks of postoperative treatment,” Harness said. “Despite these encouraging results, clearly a longer follow-up is needed in order to compare IOERT [accelerated partial-breast irradiation] efficiency to that of whole-breast irradiation.”
For more information:
Dall’Oglio S. Abstract #143. Presented at: 2012 Breast Cancer Symposium; Sept. 13-15, 2012; San Francisco.
Disclosure: The researchers report no relevant financial disclosures.