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- Title
Feasibility of Intraoperative Radiotherapy Tumor Bed Boost in Patients with Breast Cancer after Neoadjuvant Chemotherapy.
- Authors
Gowoon Yang; Jun Won Kim; Ik Jae Lee; Joon Jeong; Sung Gwe Ahn; Soong June Bae; Jee Hung Kim; Yeona Cho
- Abstract
Purpose: This study aimed to assess the feasibility and safety of administering intraoperative radiotherapy (IORT) as a boost during breast-conserving surgery (BCS) following neoadjuvant chemotherapy for patients at high risk of breast cancer recurrence. Materials and Methods: Patients who underwent neoadjuvant chemotherapy received a single 20-Gy dose of IORT during BCS, followed by external beam radiotherapy 4--6 weeks after surgery. Results: The median follow-up duration was 31.0 months (range, 18.0--59.0 months). Initial tumor sizes had a median of 2.6 cm (range: 0.8--5.3 cm), reducing to 0.3 cm (range: 0--4.0 cm) after neoadjuvant chemotherapy. The most common neoadjuvant chemotherapy regimen was doxorubicin and cyclophosphamide, followed by paclitaxel (n=42, 73.7%). Among 57 patients who received neoadjuvant chemotherapy before BCS and IORT, 2 patients (3.5%) required secondary surgery to achieve negative resection margins due to initially positive margins. Regional lymph node irradiation was performed in 37 (64.9%) patients. There was no grade 3 or higher adverse events, with 4 patients (7.0%) experiencing grade 2 acute radiation dermatitis and 3 (5.3%) having less than grade 2 breast edema. Binary correlation analysis did not reveal statistically significant associations between applicator size or radiation therapy modality and the risk of treatment-related toxicity. Furthermore, chi-square analysis showed that the grade of treatment-related toxicity was not associated with the fractionated regimen (p=0.375). Conclusion: Most patients successfully received IORT as a tumor bed boost after neoadjuvant chemotherapy. Thus, IORT may be a safe and feasible option for patients with advanced-stage breast cancer receiving neoadjuvant chemotherapy.
- Subjects
INTRAOPERATIVE radiotherapy; NEOADJUVANT chemotherapy; CANCER patients; BREAST cancer; EXTERNAL beam radiotherapy; RADIODERMATITIS; CANCER relapse; PHYLLODES tumors
- Publication
Yonsei Medical Journal, 2024, Vol 65, Issue 3, p129
- ISSN
0513-5796
- Publication type
Article
- DOI
10.3349/ymj.2023.0229