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22-09-2023 | Breast Cancer | Review

Comparison of partial-breast irradiation and intraoperative radiation to whole-breast irradiation in early-stage breast cancer patients: a Kaplan-Meier-derived patient data meta-analysis

Authors: Lis Victoria Ravani, Pedro Calomeni, Ming Wang, Daxuan Deng, Corey Speers, Nicholas G Zaorsky, Chirag Shah

Published in: Breast Cancer Research and Treatment

Abstract

Purpose

Partial breast irradiation (PBI) and intraoperative radiation (IORT) represent alternatives to whole breast irradiation (WBI) following breast conserving surgery. However, data is mixed regarding outcomes. We therefore performed a pooled analysis of Kaplan-Meier-derived patient data from randomized trials to evaluate the hypothesis that PBI and IORT have comparable long-term rates of ipsilateral breast tumor recurrence as WBI.

Methods

In February, 2023, PubMed, EMBASE and Cochrane Central were systematically searched for randomized phase 3 trials of early-stage breast cancer patients undergoing breast-conserving surgery with PBI or IORT as compared to WBI. Time-to-event outcomes of interest included ipsilateral breast tumor recurrence (IBTR), overall survival (OS) and distant disease-free survival (DDFS). Statistical analysis was performed with R Statistical Software.

Results

Eleven randomized trials comprising 15,460 patients were included; 7,675 (49.6%) patients were treated with standard or moderately hypofractionated WBI, 5,413 (35%) with PBI and 2,372 (15.3%) with IORT. Median follow-up was 9 years. PBI demonstrated comparable IBTR risk compared with WBI (HR 1.20; 95% CI 0.95–1.52; p = 0.12) with no differences in OS (HR 1.02; 95% CI 0.90–1.16; p = 0.70) or DDFS (HR 1.15; 95% CI 0.81–1.64; p = 0.43). In contrast, patients treated with IORT had a higher IBTR risk (HR 1.46; 95% CI 1.23–1.72; p < 0.01) compared with WBI with no difference in OS (HR 0.98; 95% CI 0.84–1.14; p = 0.81) or DDFS (HR 0.91; 95% CI 0.76–1.09; p = 0.31).

Conclusion

For patients with early-stage breast cancer following breast-conserving surgery, PBI demonstrated no difference in IBTR as compared to WBI while IORT was inferior to WBI with respect to IBTR.

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Title: Comparison of partial-breast irradiation and intraoperative radiation to whole-breast irradiation in early-stage breast cancer patients: a Kaplan-Meier-derived patient data meta-analysis
Authors: Lis Victoria Ravani
Pedro Calomeni
Ming Wang
Daxuan Deng
Corey Speers
Nicholas G Zaorsky
Chirag Shah
Publication date: 22-09-2023
Publisher: Springer US
Keywords: Breast Cancer
Breast Cancer
Brachytherapy
Published in: Breast Cancer Research and Treatment
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-023-07112-w

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Comparison of partial-breast irradiation and intraoperative radiation to whole-breast irradiation in early-stage breast cancer patients: a Kaplan-Meier-derived patient data meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

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» View more highlights on the ESMO 2023 hub page

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45/♀ with increasing weakness, loss of appetite, diarrhoea and oedema – Case 29

48/♀ with increasing spontaneous haematomas all over her body – Case 37

49/♀ with lymphoedema of the arm in condition of metastasised triple-negative breast carcinoma – Case 43

53/♂ with movement-dependent pain in the left anterior pelvis and bloody urine – Case 39

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Abstract

Purpose

Methods

Results

Conclusion

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European Society for Medical Oncology Congress 2023

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Oncology and Hematology Cases