Intraoperative radiation therapy during breast-conserving surgery; The Memorial Sloan-Kettering Cancer Center technique Book Section
| Authors: | Beal, K.; Cohen, G. N.; McCormick, B.; Sacchini, V.; Zelefsky, M. |
| Editors: | Wazer, D. E.; Arthur, D. W.; Vicini, F. A. |
| Article/Chapter Title: | Intraoperative radiation therapy during breast-conserving surgery; The Memorial Sloan-Kettering Cancer Center technique |
| Abstract: | Intraoperative radiation therapy (IORT) for breast cancer has been studied in various centers but has been developed most extensively at the Institute of Milan, where electrons are used. Dose-escalation studies from the Institute of Milan show that intraoperative electrons are safe when used either as a boost or as definitive adjuvant treatment for early-stage breast cancer. Descriptions of their technique and outcomes have been widely published. More recently, the Memorial-Sloan Kettering Cancer Center (MSKCC) in New York has developed a brachytherapy high dose rate (HDR) IORT technique using a breast applicator. Drawing on MSKCC experience with HDR IORT, this applicator was modeled after the HAM applicator and consists of catheters embedded in Silastic material and a matching tungsten shield to protect the skin at the incision area. The breast applicator is placed in the surgical cavity and the catheters are attached to a machine that houses the 192Ir HDR radiation source. The source steps through each catheter to deliver radiation to the target as determined by a custom treatment plan. 20 Gy is prescribed to a depth of 1 cm from the surface of the applicator, and care is taken to keep the skin dose under 10 Gy. To date, disease and cosmetic outcomes have been excellent. Cosmetic outcomes are improving with treating physician experience, and patient satisfaction is high. © 2009 Springer Berlin Heidelberg. |
| Book Title: | Accelerated Partial Breast Irradiation. 2nd ed |
| ISBN: | 978-3-540-88005-9 |
| Publisher: | Springer |
| Publication Place: | New York, NY |
| Date Published: | 2009-01-01 |
| Start Page: | 367 |
| End Page: | 376 |
| Language: | English |
| DOI: | 10.1007/978-3-540-88006-6_21 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Book Chapter 21 -- 9783540880059 (ISBN) -- Export Date: 3 March 2014 -- Source: Scopus |
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