Long-Term Outcomes of an International Cooperative Study of Intraoperative Radiotherapy Upfront Boost With Low Energy X-Rays in Breast Cancer

Frontiers in Oncology

Jose A. Galarreta¹  Maria L. Ramos¹  Jose M. Cotrina¹  Gonzalo Ziegler¹  Elena Sperk²  David A. Martinez³  Ruben Del Castillo³  Kevin Colqui³  Luis V. Pinillos³  Leonard Christopher Schmeel⁴  Frank A. Giordano⁴  Gustavo R. Sarria⁴  Amalia Palacios⁵  Angel Calvo⁵  Adela Heredia⁶  Gustavo J. Sarria⁶  Alicia Avalos⁶  Paola Fuentes-Rivera⁶  Felipe Castro⁶  Frederik Wenz⁷ 

[1] Department of Mastology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru;Department of Radiation Oncology, Mannheim Cancer Center, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany;Department of Radiation Oncology, Oncosalud-Auna, Lima, Peru;Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany;Department of Radiation Oncology, University Hospital Reina Sofia, Cordoba, Spain;Department of Radiotherapy, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru;University Hospital Freiburg, University of Freiburg, Freiburg, Germany;

关键词: breast cancer;    boost;    intraoperative radiotherapy;    IORT;    whole-breast radiotherapy;   

DOI  :  10.3389/fonc.2022.850351

来源: DOAJ

【 摘 要 】

PurposeThe purpose of this study was to assess the effectivity of upfront kilovoltage intraoperative radiotherapy (IORT) as a boost in high-risk early-stage breast cancer patients from an international pooled cohort.Materials/MethodsPatients from four centers in three different countries were retrospectively screened. Those with a minimum 1-year follow-up were included. Cumulative local (LR), regional (RR), and distant metastasis rates (DM) were analyzed. Additionally, the estimated overall survival (OS) was assessed. The Cox regression analysis was performed to identify failure predicting factors.ResultsA total of 653 patients from centers in Peru, Spain, and Germany were included. The median follow-up was 55 (12–180) months, and age was 58 (27–86) years. Clinical tumor (T) staging was T1 65.85%, T2 30.17%, and T3 3.98%. Positive margins were found in 7.9% and in-situ component in 20.06%. The median IORT dose was 20 (6–20). The median time from IORT to EBRT was 74.5 (13-364) days. An overall 3.4% (n = 22) of patients developed local recurrence at some point during follow-up. The 12-, 60-, and 120-month cumulative LR were 0.3%, 2.3%, and 7.9%, respectively. After multivariate analysis, only age <50 remained to be a significant prognostic factor for local recurrence (HR 0.19, 95% CI 0.08–0.47; p < 0.05). The 10-year estimated OS was 81.2%.ConclusionUpfront boost with IORT yields similar local control outcomes to those EBRT-based reports. Results from prospective trials, regarding toxicity, cosmesis, and effectivity are awaited to confirm these findings.

【 授权许可】

Unknown