Top

World Journal of Surgical Oncology

Published in:

Open Access 01-12-2009 | Technical innovations

Intraoperative radiation therapy in the treatment of early-stage breast cancer utilizing xoft axxent electronic brachytherapy

Authors: Adam Dickler, Olga Ivanov, Darius Francescatti

Published in: World Journal of Surgical Oncology | Issue 1/2009

Abstract

Background

In an effort to overcome the barriers to BCT, alternative methods of delivering radiation therapy have been explored. APBI allows the radiation treatment to be accomplished in one week or less. XB is a form of balloon-based APBI that uses an electronic source generated by a mobile controller unit. Investigators have also explored IORT treatment that delivers a single fraction of radiation in the operating suite at the time of surgery.

Methods

We report on the first patient treated with XB to deliver IORT.

Results

IORT treatment utilizing XB is feasible and can be accomplished with a total procedure time of approximately 2 hours.

Conclusion

Further research on XB and other methods of IORT is needed to establish clinical efficacy and safety for patients with early-stage breast cancer.

Available only for authorised users

Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, Aguilar M, Marubini E: Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002, 347: 1227-1232. 10.1056/NEJMoa020989.CrossRefPubMed

Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N: Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002, 341: 1233-1241. 10.1056/NEJMoa022152.CrossRef

Farrow DC, Hunt WC, Samet JM: Geographic variation the treatment of localized breast cancer. N Engl J Med. 1992, 326: 1097-1101.CrossRefPubMed

Dolan JT, Granchi TS, Miller CC, Brunicardi FC: Low use of breast conservation surgery medically indigent populations. Am J Surg. 1999, 178: 470-474. 10.1016/S0002-9610(99)00226-3.CrossRefPubMed

Athas WF, Adams-Cameron M, Hunt WC, Amir-Fazli A, Key CR: Travel distance to radiation therapy and receipt of radiotherapy following breast-conserving surgery. J Natl Cancer Inst. 2000, 92: 269-271. 10.1093/jnci/92.3.269.CrossRefPubMed

Hahn CA, Marks LB, Chen DY, Lind PA, Lind HM, Prosnitz LR: Breast conservation rates-barriers between tertiary care and community practice. Int J Radiat Oncol Biol Phys. 2003, 55 (5): 1196-1199.CrossRefPubMed

Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans E, Godwin J, Gray R, Hicks C, James S, MacKinnon E, McGale P, McHugh T: Effects of radiotherapy and differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomized trials. Lancet. 2005, 366: 287-2106. 10.1016/S0140-6736(05)66973-5.CrossRef

Vicini F, Kestin L, Chen P, Benitez P, Goldstein NS, Martinez A: Limited-field radiation therapy in the management of early stage breast cancer. J Natl Cancer Inst. 2003, 95: 1205-1210.CrossRefPubMed

King TA, Bolton JS, Kuske RR, Fuhrman GM, Scroggins TG, Jiang XZ: Long-term results of wide-field brachytherapy as the sole method of radiation therapy after segmental mastectomy for T(is,1,2) breast cancer. Am J Surg. 2000, 180: 299-304. 10.1016/S0002-9610(00)00454-2.CrossRefPubMed

10.

Vicini FA, Beitsch P, Quiet C, Keleher AJ, Garcia D, Snider HC, Gittleman MA, Zannis VJ, Kuerer HM, Lyden M: Three-year analysis of treatment efficacy, cosmesis and toxicity by the American Society of Breast Surgeons (ASBS) MammoSite breast brachytherapy registry trial in patients treated with accelerated partial breast irradiation (APBI). IJROBP. 2007, 69: S207-

11.

Benitez PR, Keisch ME, Vicini F, Stolier A, Scroggins T, Walker A, White J, Hedberg P, Hebert M, Arthur D: Five-year results: the initial clinical trial of MammoSite balloon brachytherapy for partial breast irradiation in early-stage breast cancer. Am J Surg. 2007, 194: 456-462. 10.1016/j.amjsurg.2007.06.010.CrossRefPubMed

12.

Mehta VK, Dooley W, Griem KL, Dickler A, Haile K, Wazer DE, Kurtzman S, Chadha M, Steven RE, Modin SD, Elliott K: Early experience with an electronic brachytherapy technique for intracavitary accelerated partial breast irradiation. Proceedings of the 2008 ASCO Breast Cancer Symposium. 2008, http://www.asco.org/ASCO/Abstracts+%26+Virtual+Meeting/Abstracts?%26vmview=abst_detail_view%26confID=58%26abstractID=40414

13.

Vaidya JS, Walton L, Dewar J: Single dose targeted intraoperative radiotherapy (TARGIT) for breast cancer can be delivered as a second procedure under local anaesthetic. World J Surg Oncol. 2006, 4: 2-10.1186/1477-7819-4-2.PubMedCentralCrossRefPubMed

14.

Vaidya JS, Baum M, Tobias JS, Massarut S, Wenz F, Murphy O, Hilaris B, Houghton J, Saunders C, Corica T: Targeted intraoperative radiotherapy (TARGIT) yields very low recurrence rates when given as a boost. Int J Radiat Oncol Biol Phys. 2006, 66: 1335-8.CrossRefPubMed

15.

Intra M, Gatti G, Luini A, Galimberti V, Veronesi P, Zurrida S, Frasson A, Ciocca M, Orecchia R, Veronesi U: Surgical technique of intraoperative radiotherapy in conservative treatment of limited-stage breast cancer. Arch Surg. 2002, 137: 737-40. 10.1001/archsurg.137.6.737.CrossRefPubMed

16.

Dickler A, Kirk MC, Seif N, Griem K, Dowlatshahi K, Francescatti D, Abrams RA: A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy. Brachytherapy. 2007, 6: 164-8. 10.1016/j.brachy.2007.01.005.CrossRefPubMed

17.

Veronesi U, Orecchia R, Luini A, Gatti G, Intra M, Zurrida S, Ivaldi G, Tosi G, Ciocca M, Tosoni A: A preliminary report of intraoperative radiotherapy (IORT) in limited-stage breast cancers that are conservatively treated. Eur J Cancer. 2001, 37 (17): 2178-2183. 10.1016/S0959-8049(01)00285-4.CrossRefPubMed

18.

Holmes DR, Baum M, Joseph D: The targit trial: targeted intraoperative radiation therapy versus conventional postoperative whole-breast radiotherapy after breast-conserving surgery for the management of early-stage invasive breast cancer (a trial update). Amer J Surg. 2007, 194: 507-510. 10.1016/j.amjsurg.2007.06.018.CrossRefPubMed

19.

Vaidya JS, Tobias JS, Baum M, Wenz F, Kraus-Tiefenbacher U, D'souza D, Keshtgar M, Massarut S, Hilaris B, Saunders C: Targeted intraoperative radiotherapy: an innovative approach to partial breast irradiation. Sem Radiat Oncol. 2005, 15: 84-91. 10.1016/j.semradonc.2004.10.007.CrossRef

Title: Intraoperative radiation therapy in the treatment of early-stage breast cancer utilizing xoft axxent electronic brachytherapy
Authors: Adam Dickler
Olga Ivanov
Darius Francescatti
Publication date: 01-12-2009
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2009
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/1477-7819-7-24

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intraoperative radiation therapy in the treatment of early-stage breast cancer utilizing xoft axxent electronic brachytherapy

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2009

A huge intraductal papillary mucinous carcinoma of the bile duct treated by right trisectionectomy with caudate lobectomy

Taurolidine reduces the tumor stimulating cytokine interleukin-1beta in patients with resectable gastrointestinal cancer: a multicentre prospective randomized trial

Clostridium septicum sepsis and colorectal cancer - a reminder

Dramatic response of a gastrointestinal stromal tumor to neadjuvant imatinib therapy

Synchronous colorectal adenocarcinoma and gastrointestinal stromal tumor in Meckel's diverticulum; an unusual association

Venous obstruction of thyroid malignancy origin: the Antoine Lacassagne Institute experience