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Breast Care (Basel). 2014 May;9(2):102-6. doi: 10.1159/000362392.

Intraoperative Electron Radiotherapy (IOERT) as an Alternative to Standard Whole Breast Irradiation: Only for Low-Risk Subgroups?

Author information

1
Dept. of Radiotherapy, University Hospital, Verona, Italy.
2
Intraop Medical Corporation, Sunnyvale, CA, USA.
3
Dept. of Radiotherapy, Azienda Ospedaliera, Verona, Italy.

Abstract

BACKGROUND:

Intraoperative radiotherapy during breast-conserving surgery is being studied as an alternative to 6 weeks of external beam radiotherapy (EBRT) for low-risk women; it can be delivered using electrons (intraoperative electron radiotherapy, IOERT) or 50-kV X-rays.

MATERIALS AND METHODS:

We analyzed both single institutional and randomized studies involving single-fraction IOERT treatments. Rates for ipsilateral breast tumor recurrences, disease-specific survival, and overall survival were obtained.

RESULTS:

IOERT had true 5-year recurrence rates of > 1.5% for ASTRO (American Society for Radiation Oncology) and ESTRO (European Society for Therapeutic Radiology and Oncology) suitable women, or for low-risk women as defined by the ELIOT trial. Women with ductal carcinoma in situ eligible for breast-conserving therapy, older women that currently receive no EBRT, and younger women with favorable biology are additional potential candidates.

CONCLUSION:

ASTRO suitable and ESTRO good women for accelerated partial breast irradiation are low-risk groups. Higher-risk women with favorable biology might also be suitable candidates for IOERT, providing the tumor biology can be determined prior to surgery. For intraoperative radiotherapy using 50-kV X-rays, follow-up was too short to assess the effectiveness of the treatment.

KEYWORDS:

Academic Review; Breast cancer; Radiotherapy

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