Top

Published in:

01-11-2021 | Literatur kommentiert

Intraoperative Teilbrustbestrahlung mit Elektronen (ELIOT) vs. konventionelle Ganzbrustbestrahlung beim invasiven Mammakarzinom im frühen Stadium nach brusterhaltender Operation: Langzeitdaten einer kontrollierten, randomisierten Studie

Authors: Assoz. Prof. Dr. Gerd Fastner, M.Sc., ao. Univ.-Prof. Dr. Roland Reitsamer, Dipl.-Ing. Dr. Christoph Gaisberger, Dipl.-Ing. Dr. Markus Stana, Univ.-Prof. Dr. Felix Sedlmayer

Published in: Strahlentherapie und Onkologie | Issue 11/2021

Auszug

Nach brusterhaltender Operation invasiver Mammakarzinome im frühen Stadium wurde in der ELIOT-Studie eine konventionelle Ganzbrustbestrahlung (WBI) samt anschließendem perkutanem Tumorbettboost mit einer Teilbrustbestrahlung mit intraoperativ verabreichten Elektronen in einem randomisiert prospektiven Phase-III-Design untersucht. Onkologische Ergebnisse wurden erstmals 2013 veröffentlicht [1]. Die vorliegende Arbeit berichtet über Langzeitresultate nach einer medianen Nachbeobachtung von nunmehr 12,4 Jahren [2]. …

Zeitpunkt der Randomisierung bis zum Rezidivereignis

90 %-Isodose als: a = Radius in der Breite (normal [= 90°] zur Rotationsachse), c = halbe Höhe (gemessen an der Rotationsachse z)

90 %-Isodose als: r = Radius, h = Höhe

Veronesi U, Orecchia R, Maisonneuve P, Viale G, Rotmensz N, Sangalli C, Luini A, Veronesi P, Galimberti V, Zurrida S, Leonardi MC, Lazzari R, Cattani F, Gentilini O, Intra M, Caldarella P, Ballardini B (2013) Intraoperative radiotherapy versus external radiotherapy for early breast cancer (ELIOT): a randomised controlled equivalence trial. Lancet Oncol 14(13):1269–1277. https://doi.org/10.1016/s1470-2045(13)70497-2CrossRefPubMed

Orecchia R, Veronesi U, Maisonneuve P, Galimberti VE, Lazzari R, Veronesi P, Jereczek-Fossa BA, Cattani F, Sangalli C, Luini A, Caldarella P, Venturino M, Sances D, Zurrida S, Viale G, Leonardi MC, Intra M (2021) Intraoperative irradiation for early breast cancer (ELIOT): long-term recurrence and survival outcomes from a single-centre, randomised, phase 3 equivalence trial. Lancet Oncol 22(5):597–608. https://doi.org/10.1016/s1470-2045(21)00080-2CrossRefPubMed

Correa C, Harris EE, Leonardi MC, Smith BD, Taghian AG, Thompson AM, White J, Harris JR (2017) Accelerated partial breast irradiation: executive summary for the update of an ASTRO evidence-based consensus statement. Pract Radiat Oncol 7(2):73–79. https://doi.org/10.1016/j.prro.2016.09.007CrossRefPubMed

Leonardi MC, Maisonneuve P, Mastropasqua MG, Morra A, Lazzari R, Rotmensz N, Sangalli C, Luini A, Veronesi U, Orecchia R (2012) How do the ASTRO consensus statement guidelines for the application of accelerated partial breast irradiation fit intraoperative radiotherapy? A retrospective analysis of patients treated at the European institute of oncology. Int J Radiat Oncol Biol Phys 83(3):806–813. https://doi.org/10.1016/j.ijrobp.2011.08.014CrossRefPubMed

Strnad V, Ott OJ, Hildebrandt G, Kauer-Dorner D, Knauerhase H, Major T, Lyczek J, Guinot JL, Dunst J, Gutierrez Miguelez C, Slampa P, Allgauer M, Lossl K, Polat B, Kovacs G, Fischedick AR, Wendt TG, Fietkau R, Hindemith M, Resch A, Kulik A, Arribas L, Niehoff P, Guedea F, Schlamann A, Potter R, Gall C, Malzer M, Uter W, Polgar C (2016) 5‑year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial. Lancet 387(10015):229–238. https://doi.org/10.1016/s0140-6736(15)00471-7CrossRefPubMed

Coles CE, Griffin CL, Kirby AM, Titley J, Agrawal RK, Alhasso A, Bhattacharya IS, Brunt AM, Ciurlionis L, Chan C, Donovan EM, Emson MA, Harnett AN, Haviland JS, Hopwood P, Jefford ML, Kaggwa R, Sawyer EJ, Syndikus I, Tsang YM, Wheatley DA, Wilcox M, Yarnold JR, Bliss JM (2017) Partial-breast radiotherapy after breast conservation surgery for patients with early breast cancer (UK IMPORT LOW trial): 5‑year results from a multicentre, randomised, controlled, phase 3, non-inferiority trial. Lancet 390(10099):1048–1060. https://doi.org/10.1016/s0140-6736(17)31145-5CrossRefPubMedPubMedCentral

Livi L, Meattini I, Marrazzo L, Simontacchi G, Pallotta S, Saieva C, Paiar F, Scotti V, De Luca Cardillo C, Bastiani P, Orzalesi L, Casella D, Sanchez L, Nori J, Fambrini M, Bianchi S (2015) Accelerated partial breast irradiation using intensity-modulated radiotherapy versus whole breast irradiation: 5‑year survival analysis of a phase 3 randomised controlled trial. Eur J Cancer 51(4):451–463. https://doi.org/10.1016/j.ejca.2014.12.013CrossRefPubMed

Whelan TJ, Julian JA, Berrang TS, Kim DH, Germain I, Nichol AM, Akra M, Lavertu S, Germain F, Fyles A, Trotter T, Perera FE, Balkwill S, Chafe S, McGowan T, Muanza T, Beckham WA, Chua BH, Gu CS, Levine MN, Olivotto IA (2019) External beam accelerated partial breast irradiation versus whole breast irradiation after breast conserving surgery in women with ductal carcinoma in situ and node-negative breast cancer (RAPID): a randomised controlled trial. Lancet 394(10215):2165–2172. https://doi.org/10.1016/s0140-6736(19)32515-2CrossRefPubMed

Meattini I, Marrazzo L, Saieva C, Desideri I, Scotti V, Simontacchi G, Bonomo P, Greto D, Mangoni M, Scoccianti S, Lucidi S, Paoletti L, Fambrini M, Bernini M, Sanchez L, Orzalesi L, Nori J, Bianchi S, Pallotta S, Livi L (2020) Accelerated partial-breast irradiation compared with whole-breast irradiation for early breast cancer: long-term results of the randomized phase III APBI-IMRT-florence trial. J Clin Oncol 38(35):4175–4183. https://doi.org/10.1200/jco.20.00650CrossRefPubMed

10.

Polgár C, Fodor J, Major T, Sulyok Z, Kásler M (2013) Breast-conserving therapy with partial or whole breast irradiation: ten-year results of the Budapest randomized trial. Radiother Oncol 108(2):197–202. https://doi.org/10.1016/j.radonc.2013.05.008CrossRefPubMed

11.

Fastner G, Gaisberger C, Kaiser J, Scherer P, Ciabattoni A, Petoukhova A, Sperk E, Poortmans P, Calvo FA, Sedlmayer F, Leonardi MC (2020) ESTRO IORT task force/ACROP recommendations for intraoperative radiation therapy with electrons (IOERT) in breast cancer. Radiother Oncol 149:150–157. https://doi.org/10.1016/j.radonc.2020.04.059CrossRefPubMed

12.

Fastner G, Reitsamer R, Sedlmayer F (2014) Partial breast irradiation with intraoperative electrons versus conventional external whole breast irradiation for early breast cancer. Results of the ELIOT trial. Strahlenther Onkol 190(4):422–424. https://doi.org/10.1007/s00066-014-0556-xCrossRefPubMed

13.

Brenner DJ (1993) Dose, volume, and tumor-control predictions in radiotherapy. Int J Radiat Oncol Biol Phys 26(1):171–179. https://doi.org/10.1016/0360-3016(93)90189-3CrossRefPubMed

14.

Leonardi MC, Maisonneuve P, Mastropasqua MG, Cattani F, Fanetti G, Morra A, Lazzari R, Bazzani F, Caputo M, Rotmensz N, Gerardi MA, Ricotti R, Galimberti VE, Veronesi P, Dicuonzo S, Viale G, Jereczek-Fossa BA, Orecchia R (2017) Comparison of treatment outcome between invasive lobular and ductal carcinomas in patients receiving partial breast irradiation with intraoperative electrons. Int J Radiat Oncol Biol Phys 99(1):173–181. https://doi.org/10.1016/j.ijrobp.2017.04.033CrossRefPubMed

15.

Blamey RW, Bates T, Chetty U, Duffy SW, Ellis IO, George D, Mallon E, Mitchell MJ, Monypenny I, Morgan DA, Macmillan RD, Patnick J, Pinder SE (2013) Radiotherapy or tamoxifen after conserving surgery for breast cancers of excellent prognosis: British association of surgical oncology (BASO) II trial. Eur J Cancer 49(10):2294–2302. https://doi.org/10.1016/j.ejca.2013.02.031CrossRefPubMed

16.

Fastner G, Sedlmayer F, Widder J, Metz M, Geinitz H, Kapp K, Fesl C, Solkner L, Greil R, Jakesz R, Kwasny W, Heck D, Bjelic-Radisic V, Balic M, Stoger H, Wieder U, Zwrtek R, Semmler D, Horvath W, Melbinger-Zeinitzer E, Wiesholzer M, Wette V, Gnant M (2020) Endocrine therapy with or without whole breast irradiation in low-risk breast cancer patients after breast-conserving surgery: 10-year results of the Austrian breast and colorectal cancer study group 8A trial. Eur J Cancer 127:12–20. https://doi.org/10.1016/j.ejca.2019.11.024CrossRefPubMed

17.

Hughes KS, Schnaper LA, Bellon JR, Cirrincione CT, Berry DA, McCormick B, Muss HB, Smith BL, Hudis CA, Winer EP, Wood WC (2013) Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. J Clin Oncol 31(19):2382–2387. https://doi.org/10.1200/jco.2012.45.2615CrossRefPubMedPubMedCentral

18.

Alco G, Igdem SI, Ercan T, Dincer M, Senturk R, Atilla S, Oral Zengin F, Okkan S (2010) Coverage of axillary lymph nodes with high tangential fields in breast radiotherapy. Br J Radiol 83(996):1072–1076. https://doi.org/10.1259/bjr/25788274CrossRefPubMedPubMedCentral

19.

Sautter-Bihl ML, Sedlmayer F, Budach W, Dunst J, Feyer P, Fietkau R, Fussl C, Haase W, Harms W, Piroth MD, Souchon R, Wenz F, Sauer R (2014) DEGRO practical guidelines: radiotherapy of breast cancer III—radiotherapy of the lymphatic pathways. Strahlenther Onkol 190(4):342–351. https://doi.org/10.1007/s00066-013-0543-7CrossRefPubMed

20.

Gentilini O, Botteri E, Leonardi MC, Rotmensz N, Vila J, Peradze N, Thomazini MV, Jereczek BA, Galimberti V, Luini A, Veronesi P, Orecchia R (2017) Ipsilateral axillary recurrence after breast conservative surgery: the protective effect of whole breast radiotherapy. Radiother Oncol 122(1):37–44. https://doi.org/10.1016/j.radonc.2016.12.021CrossRefPubMed

Title: Intraoperative Teilbrustbestrahlung mit Elektronen (ELIOT) vs. konventionelle Ganzbrustbestrahlung beim invasiven Mammakarzinom im frühen Stadium nach brusterhaltender Operation: Langzeitdaten einer kontrollierten, randomisierten Studie
Authors: Assoz. Prof. Dr. Gerd Fastner, M.Sc.
ao. Univ.-Prof. Dr. Roland Reitsamer
Dipl.-Ing. Dr. Christoph Gaisberger
Dipl.-Ing. Dr. Markus Stana
Univ.-Prof. Dr. Felix Sedlmayer
Publication date: 01-11-2021
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 11/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-021-01848-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intraoperative Teilbrustbestrahlung mit Elektronen (ELIOT) vs. konventionelle Ganzbrustbestrahlung beim invasiven Mammakarzinom im frühen Stadium nach brusterhaltender Operation: Langzeitdaten einer kontrollierten, randomisierten Studie

Auszug

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Auszug

Please log in to get access to this content

Other articles of this Issue 11/2021

Moderately hypofractionated radiotherapy as definitive treatment for localized prostate cancer: Pattern of practice in German-speaking countries

Neoadjuvante Radiochemotherapie kombiniert mit regionaler Tiefenhyperthermie beim Rektumkarzinom?

Biochemical control after adjuvant radiation therapy for prostate cancer: a unicentric, retrospective analysis

Trimodal therapy with high-dose-rate brachytherapy and hypofractionated external beam radiation combined with long-term androgen deprivation for unfavorable-risk prostate cancer

Could pulmonary low-dose radiation therapy be an alternative treatment for patients with COVID-19 pneumonia? Preliminary results of a multicenter SEOR-GICOR nonrandomized prospective trial (IPACOVID trial)

Prospective validation of stringent dose constraints for prostatic stereotactic radiation monotherapy: results of a single-arm phase II toxicity-oriented trial