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A Good Alternative after Breast-Conserving Surgery

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Intra-operative radiotherapy (IORT) has been given positive recognition as Austrian Researchers report it to be a good alternative to standard postoperative radiation for breast conserving surgery.

Conventional radiotherapy, according to Dr. R. Reitsamer from the Landesklinken Salzburg, consists of 50 Gy to 55Gy of external beam radiation to the whole breast followed by 10 Gy to 16Gy electron boost radiation (also known as Brachyltherapy) to the tumor bed. This may partially miss the tumor bed resulting in local recurrence of cancer.

Dr Reitsamer’s team performed IORT on 156 patients with stage I and II breast cancer to investigate the benefit of IORT and external beam radiation. The wound was sutured, and then the patients received a single dose of 9 Gy directly to the tumor bed.

After the surgical wound healed, the patients were given 51 Gy to 56 Gy of external beam radiation therapy to the whole breast.

Dr Reitsamer’s team reported that there were no acute complications with IORT. Of the 156 patients, five had to undergo a secondary mastectomy due to tumor multicentricity seen in the final pathological report or excessive intraductal component. Other issues that evolved include two patients who developed rib necrosis and seven patients who experienced healing difficulties.

There were no local recurrences during an average of 18 months of follow-up treatment and in addition, ‘the cosmetic result was excellent except for the patients with wound healing problems and/or secondary surgery’ according to the report.

‘IROT is a new alternative for boost application in breast cancer patients’, Dr Reitsamer and colleagues conclude. ‘The advantage of IORT is the high precision of the boost application directly to the tumor bed and complete sparing of the skin’.

‘High homogeneity of the dose application and the small treatment volumes are further advantages compared with external boost application’, the researchers found. ‘In a dedicated unit, the surgical procedure is prolonged by IORT for 15 to 20 minutes, but the postoperative radiation period is shortened by 7 to 14 days’.

Source: Reuters News sited on American Society for Clinical Oncology

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Posted On: 25 September, 2002
Modified On: 3 December, 2013


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