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01-01-2008 | Conference Paper

Concepts and techniques of intraoperative radiotherapy (IORT) for breast cancer

Authors: Roland Reitsamer, Felix Sedlmayer, Michael Kopp, Gerhard Kametriser, Christian Menzel, Silvia Glueck, Olaf Nairz, Heinz Deutschmann, Florian Merz, Florentia Peintinger

Published in: Breast Cancer | Issue 1/2008

Abstract

The standard treatment for early breast cancer comprises wide local excision, sentinel lymph node biopsy or axillary lymph node dissection, adjuvant medical treatment and radiotherapy to the whole breast. Many studies suggest that local control plays a crucial role in overall survival. The local recurrence rate is estimated to be 1% per year and varies between 4 and 7% after 5 years and up to 10 to 20% in the long-term follow up. On the basis of low local recurrence rates the concept of whole breast irradiation comes up for discussion, and partial breast irradiation (PBI) is increasingly under consideration. Intraoperative radiotherapy (IORT) is referred to as the delivery of a single high dose of irradiation directly to the tumor bed (confined target) during surgery. PBI (limited field radiation therapy, accelerated partial breast irradiation APBI) is the irradiation exclusively confined to a breast volume, the tumor surrounding tissue (tumor bed) either during surgery or after surgery without whole breast irradiation. Various methods and techniques for IORT or PBI are under investigation. The advantage of a very short radiation time or the integration of the complete radiation treatment into the surgical procedure convinces at a first glance. The promising short-term results of those studies must not fail to mention that local recurrence rates could probably increase and furthermore give rise to distant metastases and a reduction in overall survival. The combination of IORT in boost modality and whole breast irradiation has the ability to reduce local recurrence rates. The EBCTCG overview approves that differences in local treatment that substantially affect local recurrence rates would avoid about one breast cancer death over the next 15 years for every four local recurrences avoided, and should reduce 15-year overall mortality.

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Title: Concepts and techniques of intraoperative radiotherapy (IORT) for breast cancer
Authors: Roland Reitsamer
Felix Sedlmayer
Michael Kopp
Gerhard Kametriser
Christian Menzel
Silvia Glueck
Olaf Nairz
Heinz Deutschmann
Florian Merz
Florentia Peintinger
Publication date: 01-01-2008
Publisher: Springer Japan
Published in: Breast Cancer / Issue 1/2008
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI: https://doi.org/10.1007/s12282-007-0001-4

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