Single dose IOERT versus whole breast irradiation

Struikmans, H.; Snijders, Malou L H; Mast, M.; Fisscher, U.; Franssen, J.H.; Immink, Marcelle; Marinelli, A.; Merkus, J. W. S.; Petoukhova, A.; Speijer, G.; Koper, P.

doi:10.1007/s00066-016-1029-1

Cited by 7 publications

(9 citation statements)

References 32 publications

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“…Excellent or good cosmesis was scored by patients in 77% and by physicians in 84%. The Netherlands group compared institutional data for women treated with IOERT ( n = 26) or conventional WBRT ( n = 45) based on seven asymmetry features ( 24 ). Features favoring IOERT with smaller differences between treated and untreated breast included breast contour, relative breast area, and breast overlap.…”

Section: Io(e)rt As Sole Partial Breast Radiationmentioning

confidence: 99%

Intraoperative Radiotherapy for Breast Cancer

Harris

Small

2017

Front. Oncol.

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Intraoperative radiotherapy (IORT) for early stage breast cancer is a technique for partial breast irradiation. There are several technologies in clinical use to perform breast IORT. Regardless of technique, IORT generally refers to the delivery of a single dose of radiation to the periphery of the tumor bed in the immediate intraoperative time frame, although some protocols have performed IORT as a second procedure. There are two large prospective randomized trials establishing the safety and efficacy of breast IORT in early stage breast cancer patients with sufficient follow-up time on thousands of women. The advantages of IORT for partial breast irradiation include: direct visualization of the target tissue ensuring treatment of the high-risk tissue and eliminating the risk of marginal miss; the use of a single dose coordinated with the necessary surgical excision thereby reducing omission of radiation and the selection of mastectomy for women without access to a radiotherapy facility or unable to undergo several weeks of daily radiation; favorable toxicity profiles; patient convenience and cost savings; radiobiological and tumor microenvironment conditions which lead to enhanced tumor control. The main disadvantage of IORT is the lack of final pathologic information on the tumor size, histology, margins, and nodal status. When unexpected findings on final pathology such as positive margins or positive sentinel nodes predict a higher risk of local or regional recurrence, additional whole breast radiation may be indicated, thereby reducing some of the convenience and low-toxicity advantages of sole IORT. However, IORT as a tumor bed boost has also been studied and appears to be safe with acceptable toxicity. IORT has potential efficacy advantages related to overall survival related to reduced cardiopulmonary radiation doses. It may also be very useful in specific situations, such as prior to oncoplastic reconstruction to improve accuracy of adjuvant radiation delivery, or when used as a boost in higher risk patients to improve tumor control. Ongoing international clinical trials are studying these uses and follow-up data are accumulating on completed studies.

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Section: Io(e)rt As Sole Partial Breast Radiationmentioning

confidence: 99%

Intraoperative Radiotherapy for Breast Cancer

Harris

Small

2017

Front. Oncol.

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“…After eliminating duplicates, 1659 articles remained but 1575 did not meet the selection criteria; 66/84 remaining papers were excluded for not meeting clinical and outcome criteria. Consequently, only 18 articles that were published in the period 2010–2023 were suitable for inclusion in this meta-analysis and systematic review [ [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] ]. Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies [ 6 , 8 , 13 , 14 , 20 , 21 , 23 , 24 , 26 , 27 ] reported lowest and highest ages (median lowest age 50 years, range 33–59; median highest age 82.5 years, range 62–91). Five studies [ 14 , 20 , 22 , 25 , 26 ] reported mean ages (65.1 years, range 56.4–69.3).…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of intraoperative electron radiation therapy delivered with a dedicated mobile linac for partial breast irradiation in early breast cancer

Aristei,

Camilli,

Epifani

et al. 2024

The Breast

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“…Twenty studies concerned breast cancer and 12 studies concerned prostate cancer 22 – 33 . Among the 7 APBI 34 – 40 studies, 6 were designed as non-inferiority trials and one did not specify the design of the trial. In the 13 HWBI 41 – 53 , 2 were designed as non-inferiority trials, 2 as superiority trials andin 9 studies did mention the design of the trial.…”

Section: Resultsmentioning

confidence: 99%

Assessment of non-inferiority with meta-analysis: example of hypofractionated radiation therapy in breast and prostate cancer

Trone

Ollier

Chapelle

et al. 2020

Sci Rep

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The aim of this study was to propose a methodology for the assessment of non-inferiority with meta-analysis. Assessment of hypofractionated RT in prostate and breast cancers is used as an illustrative example. Non-inferiority assessment of an experimental treatment versus an active comparator should rely on two elements: (1) an estimation of experimental treatment’s effect versus the active comparator based on a meta-analysis of randomized controlled trials and (2) the value of an objective non-inferiority margin. This margin can be defined using the reported effect of active comparator and the percentage of the active comparator’s effect that is desired to be preserved. Non-inferiority can then be assessed by comparing the upper bound of the 95% confidence interval of experimental treatment’s effect to the value of the objective non-inferiority margin. Application to hypofractionated RT in breast cancer showed that hypofractionated whole breast irradiation (HWBI) appeared to be non-inferior to conventionally fractionated RT for local recurrence. This was not the case for accelerated partial breast irradiation (APBI). Concerning overall survival, non-inferiority could not be claimed for either HWBI or APBI. For prostate cancer, the lack of demonstrated significant superiority of conventional RT versus no RT precluded any conclusion regarding non-inferiority of hypofractionated RT.

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Single dose IOERT versus whole breast irradiation

Cited by 7 publications

References 32 publications

Intraoperative Radiotherapy for Breast Cancer

Intraoperative Radiotherapy for Breast Cancer

A systematic review and meta-analysis of intraoperative electron radiation therapy delivered with a dedicated mobile linac for partial breast irradiation in early breast cancer

Assessment of non-inferiority with meta-analysis: example of hypofractionated radiation therapy in breast and prostate cancer

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