Tumor Bed Boost Radiotherapy in the Conservative Treatment of Breast Cancer: A Review of Intra-Operative Techniques and Outcomes
Abstract
:Simple Summary
Abstract
1. Introduction
2. Bed Boost in Breast Cancer
3. IORT in Conservative Breast Cancer Treatment
Study | No. Patients | IORT Technique | IORT Dose (Single Fraction, Gy) | Median Follow-Up (Years) | Rate of Local Recurrence with IORT (%) | Rate of Local Recurrence with WBI (%) | Hazard Ratio (95% CI, p Value) |
---|---|---|---|---|---|---|---|
ELIOT [26] | 1305 | Electrons | 21 | 12.4 | 11 | 2 | 4.62 (2.68–7.95, p < 0.0001) |
TARGIT-A [31] | 3451 | 50 kV X-rays | 20 | 8.6 | 2.11 | 0.95 | 1.13 (0.91–1.41, p = 0.28) |
4. BED Boost with IORT
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author/Year | Number of Patients | IORT Dose (Gy) | WBI Total Dose/ Number of Fractions | Follow-Up (Years) | Local Control (%) | Overall Survival (%) | Toxicities |
---|---|---|---|---|---|---|---|
Retrospective | |||||||
Batlle/1997 [36] | 51 | 10 | 45/25 | >2 | 100 | NR | 13.3% grade 2 fibrosis |
Merrick/2003 [37] | 21 | 10–15 | 45–50/25 | 5.9 | 100 | 90.5 | NR |
Lemanski/2006 [34] | 50 | 9–20 | 50/25 | 9 | 96 | 94 | 12% grade 2 fibrosis |
Reitsamer/2006 [35] | 190 (IORT) 118 (EBRT) | 9 (IORT) 12 (EBRT) | 51–56/28 | 4.25 (IORT) 6.75 (EBRT) | 100 (IORT), 95.7 (EBRT) | NR | NR |
Ivaldi/2008 [38] | 204 | 13.3 | 37.05/13 | 8.9 | 100 | 98.2% grade ≤ 2 late skin toxicity | |
Fastner/2013 (ISIORT registry) [39] | 1109 | 6–15 | 50–54/25–28 | 6 | 99.2 | 91.4 | NR |
Fastner/2015 [40] | 83 (IORT) 26 (EBRT) | 9 (IORT) 12 (EBRT) | 51–57/25–28 | 5 (IORT) 5.6 (EBRT) | 98.5 (IORT) 88.1 (EBRT) | 86.4 (IORT) 92 (EBRT) | NR |
Fastner/2016 [41] | 71 | 7–12 | 54/27 | 8 | 89 | 75 | NR |
Kaiser/2018 [42] | 770 | 10 | 54/24–28 | 10 | 97.2 | 85.7 | NR |
Machiels/2020 [43] | 763 | 9 | 40/15 or 50/25 | 5.2 | 98.4 | 97.2 | 3.5% postoperative complications |
Ciabattoni/2022 [44] | 797 | 9–12 | 40.5/15 or 42.56/16 | 5 | 99.25 | 98.6 | 22.5% ≥ grade 2 acute toxicity |
Schumacher/2022 [45] | 76 (IORT) 76 (EBRT) | 9 (IORT) 8.4 (SIB EBRT) | 50.4/28 or 50/25 | 7.92 | 100 (IORT) 98.7 (EBRT) | 92 (IORT) 97.4 (EBRT) | 37% grade 1 acute dermatitis 21% grade 1 chronic fibrosis |
Leonardi/2022 [46] | 481 | 12 | 37.05/13 | 9.6 | 95.9 | 96.5 | <2% acute grade 3 dermatitis 40.8% moderate/severe fibrosis |
Prospective/Randomized | |||||||
Ciabattoni/2021 [47] | 133 (IORT) 112 (EBRT) | 10 | 50/25 | 12 | 95.7 (IORT) 94.7(EBRT) | 91.6 (IORT) 94.3 (EBRT) | No late complications |
Fastner/2022 (HIOB Trial) [48] | 1119 | 11.1 | 40.5/15 | 4.2 | 98.3 | 97.9 | 33% grade 1 fibrosis, 9.9% grade 2 fibrosis |
Author/Year | Number of Patients | IORT Dose (Gy) | WBI Total Dose/Number of Fractions | Follow-Up (Years) | Local Control (%) | Overall Survival (%) | Toxicities |
---|---|---|---|---|---|---|---|
Retrospective | |||||||
Blank/2010 [49] | 197 | 20 | 45–50/25 | 3 | 96.9 | 91.35 | 13.8% chronic dermatitis 34.6% grade 2 fibrosis |
Wenz/2010 [53] | 154 | 20 | 45/25 | 2.83 | 98.5 | 87% | 30% grade 2 fibrosis 22% grade 1 fibrosis |
Vaidja/2011 [51] | 299 | 20 | 50/25 | 5 | 97.4 | NR | NR |
Pez/2020 [52] | 400 | 20 | 46–50/23–25 | 6.5 | 96.25 | 81.8 | 19% and 21.1% chronic fibrosis at 5 and ≥8 years |
Tallet/2020 [54] | 240 | 20 | 46–50/23–25 | 4.5 | 99.6 | NR | 34% grade 1–2 chronic toxicity |
Hochertz/2022 [55] | 68 | 20 | 40.5/15 (16%) 50.4/28 (84%) | 7.6 | 92.6 | 86.7 | 1.4 grade 3 acute dermatitis |
Prospective/Randomized | |||||||
Li/2022 [50] | 49 | 20 | 40.5/15 | 1.5 | 100 | 100 | 36.7% grade 1–2 fibrosis |
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Sanz, J.; Eraso, A.; Ibáñez, R.; Williams, R.; Algara, M. Tumor Bed Boost Radiotherapy in the Conservative Treatment of Breast Cancer: A Review of Intra-Operative Techniques and Outcomes. Cancers 2023, 15, 4025. https://doi.org/10.3390/cancers15164025
Sanz J, Eraso A, Ibáñez R, Williams R, Algara M. Tumor Bed Boost Radiotherapy in the Conservative Treatment of Breast Cancer: A Review of Intra-Operative Techniques and Outcomes. Cancers. 2023; 15(16):4025. https://doi.org/10.3390/cancers15164025
Chicago/Turabian StyleSanz, Javier, Arantxa Eraso, Reyes Ibáñez, Rachel Williams, and Manuel Algara. 2023. "Tumor Bed Boost Radiotherapy in the Conservative Treatment of Breast Cancer: A Review of Intra-Operative Techniques and Outcomes" Cancers 15, no. 16: 4025. https://doi.org/10.3390/cancers15164025
APA StyleSanz, J., Eraso, A., Ibáñez, R., Williams, R., & Algara, M. (2023). Tumor Bed Boost Radiotherapy in the Conservative Treatment of Breast Cancer: A Review of Intra-Operative Techniques and Outcomes. Cancers, 15(16), 4025. https://doi.org/10.3390/cancers15164025