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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 4/2020

01-04-2020 | Hyperpigmentation | Original Article

Long-term outcome after intraoperative radiotherapy as a boost in breast cancer

Authors: Matthias Pez, Anke Keller, MSc, Grit Welzel, MSc, Yasser Abo-Madyan, MD, Michael Ehmann, MD, Benjamin Tuschy, MD, Sebastian Berlit, MD, Marc Sütterlin, MD, Frederik Wenz, MD, Frank A. Giordano, MD, Elena Sperk, MD

Published in: Strahlentherapie und Onkologie | Issue 4/2020

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Abstract

Purpose

To investigate long-term oncological outcome and incidence of chronic side effects in patients with breast cancer and intraoperative radiotherapy given as an upfront boost (IORT boost).

Methods

Retrospective analysis of 400 patients with an IORT boost with low-energy X‑rays (20 Gy), subsequent whole-breast irradiation (46–50 Gy), and annual oncological follow-up. Side effects were prospectively evaluated (LENT-SOMA scales) over a period of up to 15 years. Side effects scored ≥grade 2 at least three times during follow-up were judged to be chronic.

Results

The median age was 63 years (30–85) and the median follow-up was 78 months (2–180) after IORT boost. In 15 patients a local recurrence occurred, resulting in a local recurrence rate at 5, 10, and 15 years of 2.0%, 6.6%, and 10.1%, respectively. The overall survival rates at 5, 10, and 15 years were 92.1%, 81.8%, and 80.7%, respectively. The most common high-grade side effects were fibrosis (21%) and pain (8.6%). The majority of side effects occurred within the first 3 years. The actuarial rates of chronic fibrosis were 19.1% and 21.1% at 5 and ≥8 years, of chronic pain 8.6% at ≥4 years, of chronic edema of the breast 2.4% at ≥2 years, of chronic lymphedema 0.0% at 5 and 10 years, and of chronic hyperpigmentation 0.5% at ≥2 years. Side effects were similar or less than expected from an external beam boost.

Conclusion

IORT boost appears to be a highly efficient and safe method for upfront delivery of the tumor bed boost in high-risk breast cancer patients.
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Metadata
Title
Long-term outcome after intraoperative radiotherapy as a boost in breast cancer
Authors
Matthias Pez
Anke Keller, MSc
Grit Welzel, MSc
Yasser Abo-Madyan, MD
Michael Ehmann, MD
Benjamin Tuschy, MD
Sebastian Berlit, MD
Marc Sütterlin, MD
Frederik Wenz, MD
Frank A. Giordano, MD
Elena Sperk, MD
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 4/2020
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-019-01525-7

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