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Aristei C, Camilli F, Epifani V, Borghesi S, Palumbo I, Bini V, Poortmans P. A systematic review and meta-analysis of intraoperative electron radiation therapy delivered with a dedicated mobile linac for partial breast irradiation in early breast cancer. Breast 2024; 76:103759. [PMID: 38851057 PMCID: PMC11219955 DOI: 10.1016/j.breast.2024.103759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024] Open
Abstract
•PBI is valid alternative to WBI in patients at low-risk of local relapse. •PBI is delivered by means of various techniques, one of which is IOeRT. •After IOeRT, an unexpectedly high LR rate was observed in the only phase III RCT. •Patient selection impacts on LR rates after IOeRT. •With appropriate patient selection IOeRT outcomes overlap with other RT techniques.
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Affiliation(s)
- Cynthia Aristei
- Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Radiation Oncology Section, Perugia General Hospital, Perugia, Italy.
| | - Federico Camilli
- Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Valeria Epifani
- Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Simona Borghesi
- Radiation Oncology Unit of Arezzo-Valdarno, Azienda USL Toscana Sud Est, Arezzo, Italy
| | - Isabella Palumbo
- Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Radiation Oncology Section, Perugia General Hospital, Perugia, Italy
| | - Vittorio Bini
- Internal Medicine, Endocrine and Metabolic Science Section, University of Perugia, Perugia, Italy
| | - Philip Poortmans
- University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium; Iridium Netwerk, Department of Radiation Oncology, Antwerp, Belgium
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Sun D, Lu G, Liang F, Zhang W, Zeng T, Ling Y, Peng H, Xia T, Hu M, Chen X. Intraoperative radiotherapy: An alternative to whole-breast external beam radiotherapy in the management of highly selective breast cancer: A SEER database analysis. Cancer Med 2024; 13:e7458. [PMID: 39157891 PMCID: PMC11331247 DOI: 10.1002/cam4.7458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 06/13/2024] [Accepted: 06/24/2024] [Indexed: 08/20/2024] Open
Abstract
OBJECTIVE This study aimed to verify if intraoperative radiotherapy (IORT) can achieve the same survival outcome as whole-breast external beam radiotherapy (EBRT) in early breast cancer after breast-conserving surgery (BCS), and to explore the suitable candidates that can safely receive IORT after BCS. METHODS Eligible post-BCS patients who received IORT or EBRT were included in the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2018. Risk factors that affected 5-year overall survival (OS) or breast cancer specific survival (BCSS) were identified by Cox proportional hazards regression analysis. Clinical characteristics, OS, and BCSS were comparatively analyzed between the two treatment modalities. RESULTS The survival analysis after propensity score matching confirmed that patients who received IORT (n = 2200) had a better 5-year OS than those who received EBRT (n = 2200) (p = 0.015). However, the two groups did not differ significantly in 5-year BCSS (p = 0.381). This feature persisted even after multivariate analyses that took into account numerous clinical characteristics. Although there was no significant difference in BCSS between different subgroups of patients treated with IORT or EBRT, patients over 55 years of age, with T1, N0, non-triple negative breast cancers, hormone receptor-positive, and histologic grade II showed a better OS after receiving IORT. CONCLUSION In low-risk, early-stage breast cancer, IORT was not inferior to EBRT considering 5-year BCSS and OS. Considering the equivalent clinical outcome but less radiotoxicity, IORT might be a reasonable alternative to EBRT in highly selective patients undergoing BCS.
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Affiliation(s)
- Dexun Sun
- Department of Breast SurgeryThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Guanhua Lu
- Department of Breast SurgeryThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Fenmei Liang
- Department of Breast SurgeryThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Tao Zeng
- Department of Breast SurgeryThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Yun Ling
- Department of Breast SurgeryThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Haojie Peng
- Department of Breast SurgeryThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Ting Xia
- Department of Breast SurgeryThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Meilin Hu
- Department of Breast SurgeryThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Xinxin Chen
- Department of Breast SurgeryThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
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King CA, Shaposhnik G, Sayyed AA, Shoucair S, Farha MJ. Intraoperative Radiation Therapy as a Safe Alternative to Whole Breast Radiation for Treatment of Minimally Invasive Breast Cancers: A Retrospective Cohort Study. Am Surg 2024; 90:190-198. [PMID: 37522359 DOI: 10.1177/00031348231192067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
BACKGROUND Intraoperative radiation therapy (IORT) in select populations is a viable alternative to whole breast radiation therapy (WBRT) in the treatment of biopsy-proven localized invasive and non-invasive breast cancer. We aim to assess recurrence and complication rates following IORT in lumpectomy patients at a community hospital in Baltimore City. METHODS An IRB-approved retrospective cohort study was conducted on consecutive cases of lumpectomy with IORT from 2013 through 2020 by a single surgeon. Patient demographics, tumor and operative characteristics, and complications were retrieved from electronic medical records. Primary outcomes were postoperative complications and local recurrence rates. RESULTS The final cohort included 117 patients with mean follow-up time of 2.60 + 1.78 years. Mean age was 69.84 + 8.77 years. Thirty-three (28.21%) of patients developed a seroma. Odds of seroma formation were mildly significant for skin spacing [OR: 1.18, 95% CI: (1.02-1.37)] and balloon fill volume [1.04 (1.00-1.08)], but not for age, BMI, diabetes, former or current smoking status, history of WBRT, tumor size, or balloon size. Three (2.6%) patients had local recurrence. Odds of local recurrence were mildly significant for increased tumor size [1.14 (1.04-1.24)] and not significant for any other covariates. CONCLUSIONS IORT exposure did not confer higher rates of complications and the local recurrence rate mirrored that of the general population undergoing lumpectomy and WBRT. This study demonstrates the need for equitable treatment options based on individual needs: IORT is a safe alternative to WBRT in certain subpopulations, especially those with physical, social, or personal limitations preventing participation in a 3- to 7-week time commitment of WBRT.
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Affiliation(s)
- Caroline A King
- Georgetown University School of Medicine, Washington, DC, USA
| | - Guy Shaposhnik
- Georgetown University School of Medicine, Washington, DC, USA
| | - Adaah A Sayyed
- Georgetown University School of Medicine, Washington, DC, USA
| | - Sami Shoucair
- Department of Surgery, MedStar Good Samaritan Hospital, Baltimore, MD, USA
| | - Maen J Farha
- Department of Surgery, MedStar Good Samaritan Hospital, Baltimore, MD, USA
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Hosseini SM, Mohammadi MK, Bagheri A, Arvandi S, Shahbazian H, Mohammadian F. The comparison of transforming growth factor beta-1 serum levels in early-stage breast cancer patients treated with external beam whole breast irradiation plus boost versus interstitial brachytherapy accelerated partial breast irradiation. Brachytherapy 2022; 21:748-753. [PMID: 36167654 DOI: 10.1016/j.brachy.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Transforming growth factor beta-1 (TGF-β1) is a profibrotic cytokine used as an early biomarker to develop radiation-induced fibrosis (RIF). This study aimed to compare TGF-β1 serum levels in early-stage breast cancer patients treated with whole-breast radiation therapy (WBRT) plus boost versus accelerated partial breast irradiation (APBI) using multicatheter interstitial brachytherapy. METHODS AND MATERIALS This clinical trial study was conducted on 20 women with early-stage breast cancer after breast-conserving surgery candidate for adjuvant radiotherapy in Golestan hospital, Ahvaz, in 2021. In one group APBI with high-dose-rate brachytherapy (n = 10), the other group WBRT with external beam radiation plus boost (n = 10) was performed. Serum level of TGF-β1 was evaluated before radiotherapy, immediately after the end of radiotherapy and three months after the end of radiotherapy by Enzyme-linked immunosorbent assay technique (ELISA). RESULTS Median serum TGF-β1 level before radiotherapy was not significantly different between the two groups (p = 0.971). In both APBI and WBRT groups, serum TGF-β1 levels significantly decreased immediately after radiotherapy compared to before treatment (p = 0.005 and p = 0.007, respectively); But three months after radiotherapy, serum TGF-β1 levels increased significantly in the WBRT group (40.50 to 77.41 pg/mL; p = 0.017), while no significant change was observed in the APBI group (24.75 to 30.50 pg/mL; p = 0.332). CONCLUSIONS Higher TGF-β1 values in the WBRT group after radiotherapy can be used as an early and vital biomarker in this treatment, and this data may corroborate links between TGF-beta1 and fibrosis and fibrosis rates between APBI and WBRT; It also shows the preference for using the brachytherapy technique in this group of patients. However, due to the small number of samples, definitive conclusions require further prospective studies.
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Affiliation(s)
- Seyed Mohammad Hosseini
- Department of Radiotherapy, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marjan Kouhzad Mohammadi
- Department of Radiotherapy, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Interventional Radiotherapy Ward, Department of Radiation Oncology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran..
| | - Ali Bagheri
- Interventional Radiotherapy Ward, Department of Radiation Oncology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shole Arvandi
- Department of Radiotherapy, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hojattollah Shahbazian
- Department of Radiotherapy, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Mohammadian
- Department of Radiotherapy, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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He L, Zhou J, Qi Y, He D, Yuan C, Chang H, Wang Q, Li G, Shao Q. Comparison of the Oncological Efficacy Between Intraoperative Radiotherapy With Whole-Breast Irradiation for Early Breast Cancer: A Meta-Analysis. Front Oncol 2022; 11:759903. [PMID: 34976808 PMCID: PMC8718609 DOI: 10.3389/fonc.2021.759903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/29/2021] [Indexed: 01/09/2023] Open
Abstract
Background Intraoperative radiotherapy (IORT) and whole-breast irradiation (WBI) are both effective radiotherapeutic interventions for early breast cancer patients undergoing breast-conserving surgery; however, an issue on whether which one can entail the better prognosis is still controversial. Our study aimed to investigate the 5-year oncological efficacy of the IORT cohort and the WBI cohort, respectively, and compare the oncological efficacy between the cohorts. Materials and Methods We conducted a computerized retrieval to identify English published articles between 2000 and 2021 in the PubMed, the Web of Science, the Cochrane Library, and APA PsycInfo databases. Screening, data extraction, and quality assessment were performed in duplicate. Results A total of 38 studies were eligible, with 30,225 analyzed participants. A non-comparative binary meta-analysis was performed to calculate the weighted average 5-year local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) in the two cohorts, respectively. The LRFS, DMFS, and OS (without restriction on the 5-year outcomes) between the two cohorts were further investigated by a comparative binary meta-analysis. The weighted average 5-year LRFS, DMFS, and OS in the IORT cohort were 96.3, 96.6, and 94.1%, respectively, and in the WBI cohort were 98.0, 94.9, and 94.9%, respectively. Our pooled results indicated that the LRFS in the IORT cohort was significantly lower than that in the WBI cohort (pooled odds ratio [OR] = 2.36; 95% confidential interval [CI], 1.66–3.36). Nevertheless, the comparisons of DMFS (pooled OR = 1.00; 95% CI, 0.76–1.31), and OS (pooled OR = 0.95; 95% CI, 0.79–1.14) between the IORT cohort with the WBI cohort were both not statistically significant. Conclusions Despite the drastically high 5-year oncological efficacy in both cohorts, the LRFS in the IORT cohort is significantly poorer than that in the WBI cohort, and DMFS and OS do not differ between cohorts.
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Affiliation(s)
- Lin He
- Department of Radiotherapy, Tangdu Hospital, Air Force Military Medical University, Xi'an, China.,Cancer Center, Faculty of Health Sciences, University of Macau, Macau, Macau SAR, China
| | - Jiejing Zhou
- Department of Radiotherapy, Tangdu Hospital, Air Force Military Medical University, Xi'an, China
| | - Yuhong Qi
- Department of Radiotherapy, Tangdu Hospital, Air Force Military Medical University, Xi'an, China
| | - Dongjie He
- Department of Radiotherapy, Tangdu Hospital, Air Force Military Medical University, Xi'an, China
| | - Canliang Yuan
- Department of Radiotherapy, Tangdu Hospital, Air Force Military Medical University, Xi'an, China
| | - Hao Chang
- Department of Radiotherapy, Tangdu Hospital, Air Force Military Medical University, Xi'an, China
| | - Qiming Wang
- Department of Radiotherapy, Tangdu Hospital, Air Force Military Medical University, Xi'an, China
| | - Gaiyan Li
- Department of Radiotherapy, Tangdu Hospital, Air Force Military Medical University, Xi'an, China
| | - Qiuju Shao
- Department of Radiotherapy, Tangdu Hospital, Air Force Military Medical University, Xi'an, China
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Belgioia L, Fozza A, Trapani L, Carmisciano L, Cavagnetto F, Agostinelli S, Guenzi M, Friedman D, Fregatti P, Corvò R. Ten Daily Fractions for Whole Breast Cancer Irradiation: Long Term Results. In Vivo 2021; 35:2875-2880. [PMID: 34410981 PMCID: PMC8408691 DOI: 10.21873/invivo.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM To report the feasibility and oncological outcomes in breast cancer patients treated with a short hypofractionated radiotherapy schedule. PATIENTS AND METHODS We evaluated 380 breast cancer patients treated with ten daily fractions of radiotherapy up to 39 Gy on tumor bed. Primary endpoint was local relapse rate (LRR). Secondary endpoints were overall survival (OS) and metastasis-free survival (MFS). RESULTS The median follow up was 5.0 years. Two- and 5-year LRR rates were 0.2 and 2%, respectively. Two- and 5-year MFS rates were 96.1% and 90.5%, respectively. Two and 5-year OS rates were 97.4% and 95%, respectively. CONCLUSION This short schedule may represent an alternative option to standard mild hypofractionated radiotherapy in breast cancer patients due to its excellent feasibility and very low recurrence rate.
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Affiliation(s)
- Liliana Belgioia
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy;
- Radiation Oncology Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alessandra Fozza
- Radiation Oncology Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luca Trapani
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | - Luca Carmisciano
- Department of Health Science (DISSAL), Biostatistics Unit, University of Genoa, Genoa, Italy
| | - Francesca Cavagnetto
- Medical Physics Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Stefano Agostinelli
- Medical Physics Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Marina Guenzi
- Radiation Oncology Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Daniele Friedman
- Department of Surgical Science and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy
- Department of Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Piero Fregatti
- Department of Surgical Science and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy
- Department of Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Renzo Corvò
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
- Radiation Oncology Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Feng JY, Li G, Guo Y, Gao YH, Ma SY. Effectiveness of intraoperative radiotherapy vs hypofractionated postmastectomy radiotherapy for early stage breast cancer: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24098. [PMID: 33466176 PMCID: PMC7808461 DOI: 10.1097/md.0000000000024098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 12/08/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Radiotherapy is one of the essential components of breast cancer treatment. It destroys the remaining cells in the chest area after breast cancer surgery and is useful for reducing the necessity of mastectomies. As a single dose of radiation at the time of breast conserving surgery, intraoperative radiotherapy delivers radiotherapy directly and accurately to the tumor itself or the tumor bed whilst delivering minimal dose to the surrounding normal tissues. Hypofractionated postmastectomy radiotherapy with shorter and more convenient hypofractionated dose schedules might help to treat more patients and reduce cost. We will conduct a comprehensive systematic review and meta-analysis to compare the effectiveness of these 2 therapies in the management of early stage breast cancer. METHODS Four English databases (PubMed, Embase, Cochrane Library, and Web of Science) and 3 Chinese databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, and Chinese Biomedical Literature Database) will be searched from inception of databases to December 2020 without language limitation. Two reviewers will independently conduct selection of studies, data extraction and management, and assessment of risk of bias. Any disagreement will be resolved by the third reviewer. Review Manager 5.3 (The Cochrane Collaboration, Software Update, Oxford, UK) will be used for data synthesis. Cochrane risk of bias assessment tool will be used to assess the risk of bias. RESULTS This study will provide a systematic synthesis of current published data to compare the effectiveness of intraoperative radiotherapy vs hypofractionated postmastectomy radiotherapy for early stage breast cancer. CONCLUSIONS This systematic review and meta-analysis will provide clinical evidence for the effectiveness of intraoperative radiotherapy vs hypofractionated postmastectomy radiotherapy for early stage breast cancer, and inform our understanding of the value of intraoperative radiotherapy and hypofractionated postmastectomy radiotherapy for early stage breast cancer. STUDY REGISTRATION NUMBER INPLASY2020110115.
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Sun MS, Liu HJ, Liu YH, Xu L, Ye JM. Intraoperative radiotherapy versus whole-breast external beam radiotherapy, and other factors associated with the prognosis of early breast cancer treated with breast-conserving surgery and radiotherapy: a retrospective study from SEER database. Transl Cancer Res 2020; 9:7125-7139. [PMID: 35117317 PMCID: PMC8798017 DOI: 10.21037/tcr-20-2441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/14/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study was aimed to investigate the prognostic factors of early breast cancer treated with breast-conserving surgery (BCS) and radiotherapy. Besides, we focused our attention exclusively on the comparison of the impact on prognosis between intraoperative radiotherapy (IORT) and whole-breast external beam radiotherapy (EBRT). METHODS An observational cohort study was performed on patients with Tis-2 N0-1 M0 breast cancer from the Surveillance, Epidemiology, and End Results (SEER) database who treated with BCS and radiotherapy. Cox regression analysis, Kaplan-Meier analysis, and propensity score matching (PSM) were used to estimate risk factors for overall survival (OS) and breast cancer-specific survival (BCSS). RESULTS Of the 98,614 early breast cancer patients treated with BCS and radiotherapy, 97,164 (98.5%) patients underwent EBRT and 1,450 (1.5%) underwent IORT. Multivariable Cox regression analysis showed that early breast cancer patients with age ≥65, poor marital status, lack of medical insurance, histological grade III/IV (SEER 4 grades), high T stage, high N stage, and TNBC were associated with a decreased OS/BCSS, whereas ER-positive and PR-positive were associated with an improved OS/BCSS. No significant difference was observed in survival between IORT and EBRT groups (P=0.213 for OS, P=0.180 for BCSS), or between intraoperative beam radiation and intraoperative radioactive implants groups (P=0.319 for OS, P=0.972 for BCSS). CONCLUSIONS Our study can help clinicians identify patients with poor prognosis after breast-conserving therapy. IORT may be an alternative to EBRT for early breast cancer patients who are unable to complete the long-term postoperative radiation treatment. Beam radiation and radioactive implants are both ideal alternatives for patients who choose IORT.
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Affiliation(s)
- Ming-Shuai Sun
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Hong-Jin Liu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yin-Hua Liu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Ling Xu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Jing-Ming Ye
- Breast Disease Center, Peking University First Hospital, Beijing, China
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Baghani HR, Robatjazi M, Mahdavi SR. Comparing the performance of some dedicated radioprotection disks in breast intraoperative electron radiotherapy: a Monte Carlo study. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2020; 59:265-281. [PMID: 32253497 DOI: 10.1007/s00411-020-00836-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
Radiation-shielding of healthy tissue is mandatory in breast intraoperative electron radiotherapy (IOERT). In this regard, dedicated radioprotection disks have been introduced. The aim of this study was to evaluate and compare the performance of three radioprotection disks widely used for breast IOERT. A Monte Carlo simulation approach was used for this purpose. The considered disks included Al + Pb, PMMA + Copper, and PTFE + Steel. They were stimulated by means of the MCNPX Monte Carlo code at depths around R100 and R90 of different electron energies in a water phantom, and their impact on the dosimetric properties of the therapeutic beam was evaluated in both correct and upside down disk placements. The electron energy spectrum immediately above and below each disk was calculated and analyzed. Furthermore, performance characteristics of the studied disks such as backscatter factors (BSFs) and transmission factors (TFs) at different electron energies were determined and compared. The results show that the Al + Pb disk most effectively attenuates the beam, while at the same time exhibits maximum BSF values. Employing the PMMA + Copper disk can minimize the BSF value but at the expense of an increased TF. The Al + Pb disk showed the best performance from the radiation protection viewpoint, while its highest BSF values could lead to perturbation of dose homogeneity within the target volume. PTFE + Steel disk showed an intermediate performance regarding the electron backscattering and transmission among the studied disks. The reverse placement of each disk can substantially increase the BSF value as compared to the correct situation but had less impact on the TF value.
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Affiliation(s)
| | - Mostafa Robatjazi
- Medical Physics and Radiological Sciences Department, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Seyed Rabi Mahdavi
- Medical Physics Department, Iran University of Medical Sciences, Tehran, Iran
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Cañas R, Linares I, Guedea F, Berenguer Francés MÁ. Why should radiation oncology do translational research? [corrected]. Rep Pract Oncol Radiother 2019; 24:60-64. [PMID: 30455615 PMCID: PMC6234255 DOI: 10.1016/j.rpor.2018.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/14/2018] [Accepted: 10/25/2018] [Indexed: 11/29/2022] Open
Abstract
Radiological Oncology, like the rest of medical specialties, is beginning to provide can personalized therapies. The ongoing scientific advances enable a great degree of precision in diagnoses and therapies. To fight cancer, from a radiotherapy unit, requires up-to-date equipment, professionals with different specialties working in synchrony (doctors, physicists, biologists, etc.) and a lot of research. Some of the new therapeutic tendencies are immunotherapy, nanoparticles, gene therapy, biomarkers, artificial intelligence, etc. A new clinical paradigm in which new professional networks are inevitable is arising. The mission of translational research is to become a scientific engine in the clinical space.
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Affiliation(s)
- Rut Cañas
- Department of Radiobiology and Cancer, ONCOBELL – IDIBELL, Barcelona, Spain
| | - Isabel Linares
- Department of Radiobiology and Cancer, ONCOBELL – IDIBELL, Barcelona, Spain
- Radiation Oncology Department. Institut Català d’Oncologia, L’Hospitalet de Llobregat, Avinguda Granvia, 199-203, 08908, Barcelona, Spain
| | - Ferran Guedea
- Department of Radiobiology and Cancer, ONCOBELL – IDIBELL, Barcelona, Spain
- Radiation Oncology Department. Institut Català d’Oncologia, L’Hospitalet de Llobregat, Avinguda Granvia, 199-203, 08908, Barcelona, Spain
| | - Miguel Ángel Berenguer Francés
- Department of Radiobiology and Cancer, ONCOBELL – IDIBELL, Barcelona, Spain
- Radiation Oncology Department. Institut Català d’Oncologia, L’Hospitalet de Llobregat, Avinguda Granvia, 199-203, 08908, Barcelona, Spain
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