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Obi E, Tom MC, Manyam BV, Grobmyer SR, Al‐Hilli Z, Valente S, Fanning A, Radford DM, Cherian S, Tendulkar RD, Shah C. Outcomes with intraoperative radiation therapy for early‐stage breast cancer. Breast J 2020; 26:454-457. [DOI: 10.1111/tbj.13574] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/05/2019] [Accepted: 08/16/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Elizabeth Obi
- Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland Ohio
| | - Martin C. Tom
- Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland Ohio
| | - Bindu V. Manyam
- Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland Ohio
| | - Stephen R. Grobmyer
- Section of Breast Surgery Department of Surgery Cleveland Clinic Cleveland Ohio
| | - Zahraa Al‐Hilli
- Section of Breast Surgery Department of Surgery Cleveland Clinic Cleveland Ohio
| | - Stephanie Valente
- Section of Breast Surgery Department of Surgery Cleveland Clinic Cleveland Ohio
| | - Alicia Fanning
- Section of Breast Surgery Department of Surgery Cleveland Clinic Cleveland Ohio
| | - Diane M. Radford
- Section of Breast Surgery Department of Surgery Cleveland Clinic Cleveland Ohio
| | - Sheen Cherian
- Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland Ohio
| | - Rahul D. Tendulkar
- Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland Ohio
| | - Chirag Shah
- Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland Ohio
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Sorrentino L, Fissi S, Meaglia I, Bossi D, Caserini O, Mazzucchelli S, Truffi M, Albasini S, Tabarelli P, Liotta M, Ivaldi GB, Corsi F. One-step intraoperative radiotherapy optimizes conservative treatment of breast cancer with advantages in quality of life and work resumption. Breast 2018; 39:123-130. [PMID: 29674010 DOI: 10.1016/j.breast.2018.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/21/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Intraoperative radiotherapy (IORT) could be not-inferior to external beam radiotherapy (EBRT) in selected patients, but toxicities, self-perception of body image, quality of life, and resumption of work or daily activities have been poorly explored. The aim of the present study was to compare these outcomes between EBRT, IORT full-dose (IORT-f) and IORT boost (IORT-b). METHODS 443 consecutive patients, candidates for breast-conserving surgery, were included: EBRT was performed in 220 patients (49.7%), IORT-f in 140 patients (31.6%), and IORT-b in 83 patients (18.7%). Radiotherapy-related toxicities were registered. Patients were evaluated at 6 months for Body Image after Breast Cancer Questionnaire (BIBCQ) to assess possible changes in self-perception of body image and limitations. A second questionnaire explored the impact of EBRT, IORT-f and IORT-b on resumption of work and normal daily activities. RESULTS EBRT had a higher risk of breast fibrosis and retraction (OR 3.58, 95% CI 1.024-12.526, p = 0.046) and breast edema (OR 6, 95% CI 2.077-17.335, p = 0.001) compared to IORT-f, but a lower risk of seroma compared to IORT-b (OR 0.36, 95% CI 0.166-0.785, p = 0.01). The BIBCQ scores showed a better outcome in arm concerns with IORT-f (-3.3) vs. IORT-b (-1.3, p = 0.002) and EBRT (-1.7, p = 0.006), although biased by the lower rate in axillary dissections. Return to daily activities occurred after 70.6 days with EBRT vs. 41 days with IORT-f (p < 0.0001) and 53.3 days with IORT-b (p = 0.07), without any effect of age or axillary dissection. CONCLUSION IORT could reduce adverse effects, allowing faster resumption of job and houseworks.
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Affiliation(s)
- Luca Sorrentino
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Via G. B. Grassi 74, 20157 Milan, Italy
| | - Susanna Fissi
- Surgery Department, Breast Unit, ICS Maugeri S.p.A. SB, Via Maugeri 10, 27100 Pavia, Italy
| | - Ilaria Meaglia
- Department of Radiation Oncology, ICS Maugeri S.p.A. SB, Via Maugeri 10, 27100 Pavia, Italy
| | - Daniela Bossi
- Surgery Department, Breast Unit, ICS Maugeri S.p.A. SB, Via Maugeri 10, 27100 Pavia, Italy
| | - Ottavia Caserini
- Surgery Department, Breast Unit, ICS Maugeri S.p.A. SB, Via Maugeri 10, 27100 Pavia, Italy
| | - Serena Mazzucchelli
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Via G. B. Grassi 74, 20157 Milan, Italy
| | - Marta Truffi
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Via G. B. Grassi 74, 20157 Milan, Italy
| | - Sara Albasini
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Via G. B. Grassi 74, 20157 Milan, Italy
| | - Paola Tabarelli
- Division of Medical Physics, ICS Maugeri S.p.A. SB, Via Maugeri 10, 27100 Pavia, Italy
| | - Marco Liotta
- Division of Medical Physics, ICS Maugeri S.p.A. SB, Via Maugeri 10, 27100 Pavia, Italy
| | - Giovanni B Ivaldi
- Department of Radiation Oncology, ICS Maugeri S.p.A. SB, Via Maugeri 10, 27100 Pavia, Italy
| | - Fabio Corsi
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Via G. B. Grassi 74, 20157 Milan, Italy; Surgery Department, Breast Unit, ICS Maugeri S.p.A. SB, Via Maugeri 10, 27100 Pavia, Italy.
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