A Review of Intraoperative Radiotherapy After Neoadjuvant Chemotherapy in Patients with Locally Advanced Breast Cancer: From Bench to Bedside

Keramati, Alireza; Javadinia, Seyed Alireza; Gholamhosseinian, Hamid; Fanipakdel, Azar; Shandiz, Fatemeh Homaei; Taghizadeh‐Hesary, Farzad

doi:10.1007/s40944-020-00465-w

Cited by 3 publications

(3 citation statements)

References 52 publications

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“…In recent years, several studies have demonstrated the safety and efficacy of administering the boost during WBI using modern techniques such as Intensity Modulated RT (IMRT) or Volumetric Modulated Arc RT (VMAT) with alternative splitting schemes [ 38 , 39 , 40 ]. Moreover, boosts should be administrated as intra-operative RT, reporting similar results in terms of efficacy and toxicity compared to external beam techniques [ 41 , 42 , 43 , 44 , 45 ]. The results of the pilot Breast IRRADIATA showed that the boost was administrated in only 64% of cases, generally as sequential with a 3D conformal RT technique.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Care for Breast Radiotherapy in Italy: Breast IRRadiATA (Italian Repository of Radiotherapy dATA) Feasibility Study

Ciabattoni

Gregucci

D'Ermo

et al. 2022

Cancers

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Aim. Breast IRRADIATA (Italian Repository of RADIotherapy dATA) is a collaborative nationwide project supported by the Italian Society of Radiotherapy and Clinical Oncology (AIRO) and the Italian League Against Cancer (LILT). It focuses on breast cancer (BC) patients treated with radiotherapy (RT) and was developed to create a national registry and define the patterns of care in Italy. A dedicated tool for data collection was created and pilot tested. The results of this feasibility study are reported here. Methods. To validate the applicability of a user-friendly data collection tool, a feasibility study involving 17 Italian Radiation Oncology Centers was conducted from July to October 2021, generating a data repository of 335 BC patients treated between January and March 2020, with a minimum follow-up time of 6 months. A snapshot of the clinical presentation, treatment modalities and radiotherapy toxicity in these patients was obtained. A Data Entry Survey and a Satisfaction Questionnaire were also sent to all participants. Results. All institutions completed the pilot study. Regarding the Data Entry survey, all questions achieved 100% of responses and no participant reported spending more than 10 min time for either the first data entry or for the updating of follow-up. Results from the Satisfaction Questionnaire revealed that the project was described as excellent by 14 centers (82.3%) and good by 3 (17.7%). Conclusion. Current knowledge for the treatment of high-prevalence diseases, such as BC, has evolved toward patient-centered medicine, evidence-based care and real-world evidence (RWE), which means evidence obtained from real-world data (RWD). To this aim, Breast IRRADIATA was developed as a simple tool to probe the current pattern of RT care in Italy. The pilot feasibility of IRRADIATA encourages a larger application of this tool nationwide and opens the way to the assessment of the pattern of care radiotherapy directed to other cancers.

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Section: Discussionmentioning

confidence: 99%

Patterns of Care for Breast Radiotherapy in Italy: Breast IRRadiATA (Italian Repository of Radiotherapy dATA) Feasibility Study

Ciabattoni

Gregucci

D'Ermo

et al. 2022

Cancers

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“…Early diagnosis of BC could be so helpful in the overall survival (OS) of the patients 4 . Different guidelines of therapies were recommended for BC due to its stage, and phenotypes ranged from surgery to chemotherapy and radiotherapy 5‐9 . If the BC cases were a candidate for surgery as the first step of therapy (non‐neoadjuvant cases), breast‐conserving surgery (BCS) or mastectomy could be performed due to the stage of the disease.…”

Section: Introductionmentioning

confidence: 99%

“… 4 Different guidelines of therapies were recommended for BC due to its stage, and phenotypes ranged from surgery to chemotherapy and radiotherapy. 5 , 6 , 7 , 8 , 9 If the BC cases were a candidate for surgery as the first step of therapy (non‐neoadjuvant cases), breast‐conserving surgery (BCS) or mastectomy could be performed due to the stage of the disease. For example, a single invasive ductal carcinoma (IDC) tumor with a size smaller than 2 cm could be a candidate for BCS, 10 while multifocal scattered ductal carcinoma in situ (DCIS) would be referred to mastectomy.…”

Section: Introductionmentioning

confidence: 99%

Human study on cancer diagnostic probe (CDP) for real‐time excising of breast positive cavity side margins based on tracing hypoxia glycolysis; checking diagnostic accuracy in non‐neoadjuvant cases

et al. 2022

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Factors Associated with Late Local Radiation Toxicity after Post-Operative Breast Irradiation

et al. 2022

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Purpose. To assess determinants associated with late local radiation toxicity in patients treated for breast cancer. Methods. A systematic review was performed. All studies reporting ≥2 variables associated with late local radiation toxicity after treatment with postoperative whole breast irradiation were included. Cohort studies, randomized controlled trials, and cross-sectional studies were eligible designs. Study characteristics and definitions of determinants and outcome measures were extracted. If possible, the measure of association was extracted. Results. Twenty-one studies were included in this review. Six out of seven studies focused on the association between radiotherapy (boost) dose or irradiated breast volume and late radiation toxicity found significant results. Tumor bed boost was associated with late radiation toxicity, fibrosis, and/or edema in six out of twelve studies. Lower age was associated with late breast toxicity in one study, while in another study, higher age was significantly associated with breast fibrosis. Also, no association between age and late radiation toxicity was found in eight out of twelve studies. Similar inconsistent results were found in the association between late radiation toxicity and other patient-related factors (i.e., breast size, diabetes mellitus) and surgical and systemic treatment-related factors (i.e., complications after surgery, chemotherapy, and time between surgery and radiotherapy). Conclusion. In modern 3D radiotherapy, radiotherapy (boost) dose and volume are—like in 2D radiotherapy—associated with late local radiation toxicity, such as breast fibrosis and edema. Treatment de-escalation, for example, partial breast irradiation in selected patients might be important to decrease late local toxicity without compromising locoregional control and survival.

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A Review of Intraoperative Radiotherapy After Neoadjuvant Chemotherapy in Patients with Locally Advanced Breast Cancer: From Bench to Bedside

Cited by 3 publications

References 52 publications

Patterns of Care for Breast Radiotherapy in Italy: Breast IRRadiATA (Italian Repository of Radiotherapy dATA) Feasibility Study

Patterns of Care for Breast Radiotherapy in Italy: Breast IRRadiATA (Italian Repository of Radiotherapy dATA) Feasibility Study

Human study on cancer diagnostic probe (CDP) for real‐time excising of breast positive cavity side margins based on tracing hypoxia glycolysis; checking diagnostic accuracy in non‐neoadjuvant cases

Factors Associated with Late Local Radiation Toxicity after Post-Operative Breast Irradiation

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