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TEN-YEAR OUTCOMES AFTER BREAST-CONSERVING SURGERY WITH INTRAOPERATIVE RADIOTHERAPY FOR BREAST CANCER

https://doi.org/10.21294/1814-4861-2017-16-6-11-17

Abstract

The purpose of the study was to analyze the 10-year outcomes after breast-conserving surgery with electronbeam intraoperative radiation therapy (IORT) followed by external beam radiotherapy (EBRT) in patients with breast cancer. Material and methods. The study included 905 patients with stage T1–2N0–1M0 breast cancer, who underwent breast-conserving surgery. Group I consisted of 746 patients who received IORT at a single dose of 10 Gy, biologically equivalent to 24.8 in standard fractionation, followed by EBRT at a total dose of 46 ± 8.1 Gy. A combined IORT and EBRT photon-equivalent dose delivered to the tumor bed was 60 Gy. Group II (control group) comprised 159 who received EBRT at a total dose of 40–44 Gy delivered to the remaining breast tissue and electron therapy delivered to the area of postoperative scar (a single 3–4 Gy fraction, 3 days per week, to the total photon-equivalent dose of 15-18 Gy). The combined photon-equivalent dose was 58 Gy. Results. According to RTOG/EORTC toxicity criteria, grade 1 radiation-induced damage was observed in 413 (55.3 %) patients of Group I and in 71 (44.6 %) patients of Group II (р=0.2); grade 2 radiation-induced damage in 76 (10.1%) and 43 (27 %) patients (p=0.0002) and grade 3 in 18 (2.4 %) and 9 (5.7 %) patients, respectively (р=0.1). Late radiation-induced injuries (grade I and 2) were mostly observed in the control group. Local recurrence was diagnosed in 11 (1.47 %) patients of Group I and in 14 (8.8 %) patients of Group II. The 10-year disease-free survival rates were 97.3 ± 1.08 % and 88.96 ± 2.8 % in Group I and Group II patients, respectively (р<0.05). The metastasis-free survival rates were 94.4 ± 2.7 and 90.46 ± 1.4 %, respectively (р><0.05). Conclusion. In patients with stage T1–2N0–1M0 breast cancer, combination of IORT and EBRT resulted in higher recurrence-free and metastasis-free survival rates than EBRT alone. Key words: breast cancer, combined modality treatment, intraoperative radiation therapy, breast-conserving surgery.><0.05). The metastasis-free survival rates were 94.4 ± 2.7 and 90.46 ± 1.4 %, respectively (р<0.05). Conclusion. In patients with stage T1–2N0–1M0 breast cancer, combination of IORT and EBRT resulted in higher recurrence-free and metastasis-free survival rates than EBRT alone.

 

About the Authors

A. V. Doroshenko
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, PhD, Researcher, General Oncology Department

SPIN-code: 7874-7606



E. M. Slonimskaya
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk; Siberian State Medical University, Tomsk
Russian Federation

MD, DSc, Professor, Head General Oncology Department, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Professor of Head of Oncology Department, Siberian State Medical University (Tomsk, Russia)

SPIN-code: 7763-6417



Zh. A. Startseva
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, DSc, Head of Radiology Department

SPIN-code: 8121-0310



V. A. Lisin
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

PhD, DSc, Professor, Chief Researcher, Department of Radiology

SPIN-code: 1431-3965



Ye. Yu. Garbukov
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, PhD, Senior Researcher, General Oncology Department

SPIN-код: 3630-2324



N. A. Tarabanovskaya
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, PhD, Junior Researcher, General Oncology Department

SPIN-code: 7481- 2159



Yu. L. Kokorina
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation
MD, Physician


N. V. Litviakov
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

PhD, DSc, Head of Oncvirology Laboratory

SPIN-code: 2546-0181



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Review

For citations:


Doroshenko A.V., Slonimskaya E.M., Startseva Zh.A., Lisin V.A., Garbukov Ye.Yu., Tarabanovskaya N.A., Kokorina Yu.L., Litviakov N.V. TEN-YEAR OUTCOMES AFTER BREAST-CONSERVING SURGERY WITH INTRAOPERATIVE RADIOTHERAPY FOR BREAST CANCER. Siberian journal of oncology. 2017;16(6):11-17. (In Russ.) https://doi.org/10.21294/1814-4861-2017-16-6-11-17

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ISSN 1814-4861 (Print)
ISSN 2312-3168 (Online)