कैंसर विज्ञान एवं चिकित्सा

Comparing Outcome of Radical Dose Intraoperative Radiotherapy with Electron (IOERT) According to IRIORT Consensus and External Beam Radiotherapy in Early Breast Cancer

Abstract

Azam Salati, Mohammad Esmaeil Akbari, Nahid Nafissi, Sajad Noorian, HamidReza Mirzaei, Seyed Rabei Mahdavi and Hassan Moaiery

Introduction and Hypothesis: The current standard treatment for early breast cancer includes conservative surgery followed by whole breast radiotherapy (WBRT). Recent study findings show that most local recurrences are in the scar tissue area suggesting that whole-breast radiotherapy may not always be necessary. If the volume of breast tissue to be irradiated is limited, radiotherapy may be performed as intraoperative. Intraoperative radiotherapy could in principle substitute the currently used radiation course of external radiotherapy after breast-conserving surgery in selected cases.
Patients and Methods: Patients were enrolled at two center. Khatam Hospital (related to CRC1, SBMU2) patients were delivered intraoperative electron beam during surgery and Azar Clinic (related to CRC) patients received external beam radiotherapy after surgery. Suitable criteria was age>45 y, tumor size ≤ 3 cm, lymphnode negative. Though we included some patients 40-44 y and T=3-4 cm, N=0 and favorable biomarkers as Possible Group.
Results: We applied full dose electron beam intraoperative radiotherapy to 216 patients with early breast cancer and suitable for breast conserving surgery. Afterwards, we compared results with 323 patients with early breast cancer and external beam radiotherapy. Within 4 years for the invasive breast cancer patients, local recurrence was 2 (1.06%) and 1 (0.36%) and also, systemic recurrence was 1and 4 patients in the intraoperative and external radiotherapy groups, respectively. Mortality was 3 cancer related death and the other one, none cancer related death in the external radiotherapy patients. There was not any cancer related death for intraoperative radiotherapy patients.
Conclusion: Comparison of local recurrence in two groups (p-value: 0.335), via demonstrated that IOERT in contrast with EBRT had not inferiority however, it had superiority about systemic recurrence and death. In addition, we can transcend the boundaries of the definition, such as age, tumor size, histology. Invasive lobular carcinoma and DCIS with special characters could be one of these.