Single-fraction intraoperative radiotherapy for breast cancer: Early cosmetic results Journal Article
| Authors: | Beal, K.; McCormick, B.; Zelefsky, M. J.; Borgen, P.; Fey, J.; Goldberg, J.; Sacchini, V. |
| Article Title: | Single-fraction intraoperative radiotherapy for breast cancer: Early cosmetic results |
| Abstract: | 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 cm3 (range, 20-97 cm3). Patients with ≤47 cm3 of treated tissue had better cosmetic outcomes than did the women who had >47 cm3 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. © 2007 Elsevier Inc. All rights reserved. |
| Keywords: | adult; clinical article; treatment outcome; aged; aged, 80 and over; middle aged; cancer surgery; cancer patient; cancer radiotherapy; combined modality therapy; follow up; cancer grading; tumor localization; edema; breast cancer; breast; radiotherapy dosage; radiotherapy; patient monitoring; tumor biopsy; breast neoplasms; oncology; feasibility study; medical imaging; tumors; feasibility studies; pilot projects; tumor burden; intraoperative period; lymph node; brachytherapy; esthetics; photography; intraoperative radiotherapy; cosmetic outcome |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 69 |
| Issue: | 1 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2007-09-01 |
| Start Page: | 19 |
| End Page: | 24 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2007.02.010 |
| PUBMED: | 17446003 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 11" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus" |
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