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@ARTICLE{Stoian:168703,
author = {R. Stoian$^*$ and T. Erbes and C. Zamboglou$^*$ and J.
Scholber$^*$ and M. Gainey$^*$ and I. Sachpazidis$^*$ and E.
Haehl$^*$ and S. K. B. Spohn$^*$ and V. Verma and D. Krug
and A. Rühle$^*$ and I. Juhasz-Böss and A.-L. Grosu$^*$
and N. H. Nicolay$^*$ and T. Sprave$^*$},
title = {{I}ntraoperative radiotherapy boost as part of
breast-conservation therapy for breast cancer: a
single-institution retrospective analysis.},
journal = {Strahlentherapie und Onkologie},
volume = {197},
number = {9},
issn = {1439-099X},
address = {Heidelberg},
publisher = {Springer Medizin},
reportid = {DKFZ-2021-01011},
pages = {812-819},
year = {2021},
note = {2021 Sep;197(9):812-819},
abstract = {There are currently no data from randomized controlled
trials on the use of intraoperative radiotherapy (IORT) as
a tumor bed boost as part of a breast-conservation
approach for breast cancer. This study retrospectively
reviewed the safety and efficacy of IORT as a boost
treatment at a tertiary cancer center.From 2015 to 2019,
patients underwent breast-conserving surgery with axillary
lymph node staging and a single dose of 20 Gy IORT with
50-kV photons, followed by whole-breast irradiation (WBI)
and adjuvant systemic therapy (if applicable). Patients were
followed for assessment of acute and late toxicities (using
the Common Terminology Criteria for Adverse Events version
5.0) at 3-6-month intervals. Outcomes included ipsilateral
(IBTR) and contralateral breast progression-free survival
(CBE), distant metastasis-free survival (DMFS), and overall
survival (OS).Median follow-up for the 214 patients was 28
(range 2-59) months. Most patients had T1 disease (n = 124)
and were clinically node negative. Only few patients had
high-grade and/or triple-negative disease. The vast majority
of patients underwent sentinel node biopsy, and 32 $(15\%)$
required re-resection for initially positive margins.
Finally, all tumor bed margins were clear. Nine $(4.2\%)$
and 48 $(22.4\%)$ patients underwent neoadjuvant and
adjuvant chemotherapy, respectively. WBI was predominantly
performed as conventionally fractionated WBI (n = 187,
$87.4\%),$ and the median time from BCS to WBI was
54.5 days. IORT was delivered with a single dose of 20 Gy.
The median WBI dose was 50 Gy (range 29.4-50.4 Gy). No
patients experienced grade 4 events; acute grade 3
toxicities were limited to 17 $(8\%)$ cases of radiation
dermatitis. Postoperative toxicities were mild. After WBI
only one case of late grade ≥ 2 events was reported. There
were two recurrences in the tumor bed and one contralateral
breast event.This investigation provides additional
preliminary data supporting the using of IORT in the boost
setting and corroborates the existing literature. These
encouraging results should be prospectively validated by the
eventual publication of randomized studies such as
TARGIT‑B.},
keywords = {Adjuvant radiation therapy (Other) / Boost (Other) /
Breast-conservation therapy (Other) / Early breast cancer
(Other) / Intraoperative radiotherapy (Other)},
cin = {FR01 / E055},
ddc = {610},
cid = {I:(DE-He78)FR01-20160331 / I:(DE-He78)E055-20160331},
pnm = {315 - Bildgebung und Radioonkologie (POF4-315)},
pid = {G:(DE-HGF)POF4-315},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:33938966},
doi = {10.1007/s00066-021-01785-2},
url = {https://inrepo02.dkfz.de/record/168703},
}