The current status of intraoperative radiation therapy in breast cancer: Challenges and promises

Bradley, Julie A.

doi:10.1111/tbj.13071

Cited by 2 publications

(2 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Radiotherapy and chemotherapy, along with surgery, are the key modalities used in cancer treatment. Radiotherapy is an efficacious treatment for cancers of the breast, thyroid gland, prostate gland, head, and neck [143][144][145]. Radiotherapy causes DNA damage mainly by ionizing molecules in irradiated tissue, blocking DNA replication, and killing tumor cells [146].…”

Section: Radiotherapymentioning

confidence: 99%

Cardio-Oncology: Mechanisms, Drug Combinations, and Reverse Cardio-Oncology

Liang

2022

IJMS

View full text Add to dashboard Cite

Chemotherapy, radiotherapy, targeted therapy, and immunotherapy have brought hope to cancer patients. With the prolongation of survival of cancer patients and increased clinical experience, cancer-therapy-induced cardiovascular toxicity has attracted attention. The adverse effects of cancer therapy that can lead to life-threatening or induce long-term morbidity require rational approaches to prevention and treatment, which requires deeper understanding of the molecular biology underpinning the disease. In addition to the drugs used widely for cardio-protection, traditional Chinese medicine (TCM) formulations are also efficacious and can be expected to achieve “personalized treatment” from multiple perspectives. Moreover, the increased prevalence of cancer in patients with cardiovascular disease has spurred the development of “reverse cardio-oncology”, which underscores the urgency of collaboration between cardiologists and oncologists. This review summarizes the mechanisms by which cancer therapy induces cardiovascular toxicity, the combination of antineoplastic and cardioprotective drugs, and recent advances in reverse cardio-oncology.

show abstract

Section: Radiotherapymentioning

confidence: 99%

Cardio-Oncology: Mechanisms, Drug Combinations, and Reverse Cardio-Oncology

Liang

2022

IJMS

View full text Add to dashboard Cite

show abstract

“…Currently, the standard of care for EBC is breast-conserving surgery (BCS), followed by adjuvant whole-breast external beam radiotherapy (EBRT) or mastectomy alone [ 6 , 7 ]. The adjuvant EBRT to the whole breast, including the cavity, is administered over five weeks, followed by a lumpectomy cavity boost to an additional one-week course of radiation therapy (RT) depending upon the risk criteria/factors to suppress local recurrence [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Real World and Public Health Perspectives of Intraoperative Radiotherapy in Early-Stage Breast Cancer: A Multidisciplinary Analysis Beyond the Statistical Facts

Vijayakumar¹,

Nittala²,

Buddala³

et al. 2023

Cureus

View full text Add to dashboard Cite

Breast conservation therapy (BCT) (usually a lumpectomy plus radiotherapy (RT)) has become a standard alternative to radical mastectomy in early-stage breast cancers with equal, if not higher, survival rates. The established standard of the RT component of the BCT had been about six weeks of Monday through Friday external beam RT to the whole breast (WBRT). Recent clinical trials have shown that partial breast radiation therapy (PBRT) to the region surrounding the lumpectomy cavity with shorter courses can result in equal local control, survival, and slightly improved cosmetic outcomes. Intraoperative RT (IORT) wherein RT is administered at the time of operation for BCT to the lumpectomy cavity as a single-fraction RT is also considered PBRT. The advantage of IORT is that weeks of RT are avoided. However, the role of IORT as part of BCT has been controversial. The extreme views go from “I will not recommend to anyone” to “I can recommend to all early-stage favorable patients.” These divergent views are due to difficulty in interpreting the clinical trial results. There are two modalities of delivering IORT, namely, the use of low-energy 50 kV beams or electron beams. There are several retrospective, prospective, and two randomized clinical trials comparing IORT versus WBRT. Yet, the opinions are divided. In this paper, we try to bring clarity and consensus from a highly broad-based multidisciplinary team approach. The multidisciplinary team included breast surgeons, radiation oncologists, medical physicists, biostatisticians, public health experts, nurse practitioners, and medical oncologists. We show that there is a need to more carefully interpret and differentiate the data based on electron versus low-dose X-ray modalities; the randomized study results have to be extremely carefully dissected from biostatistical points of view; the importance of the involvement of patients and families in the decision making in a very transparent and informed manner needs to be emphasized; and the compromise some women may be willing to accept between 2-4% potential increase in local recurrence (as interpreted by some of the investigators in IORT randomized studies) versus mastectomy. We conclude that, ultimately, the choice should be that of women with detailed facts of the pros and cons of all options being presented to them from the angle of patient/family-focused care. Although the guidelines of various professional societies can be helpful, they are only guidelines. The participation of women in IORT clinical trials is still needed, and as genome-based and omics -based fine-tuning of prognostic fingerprints evolve, the current guidelines need to be revisited. Finally, the use of IORT can help rural, socioeconomically, and infrastructure-deprived populations and geographic regions as the convenience of single-fraction RT and the possibility of breast preservation are likely to encourage more women to choose BCT than mastectomy. This option can also likely lead to more wom...

show abstract

The current status of intraoperative radiation therapy in breast cancer: Challenges and promises

Cited by 2 publications

References 23 publications

Cardio-Oncology: Mechanisms, Drug Combinations, and Reverse Cardio-Oncology

Cardio-Oncology: Mechanisms, Drug Combinations, and Reverse Cardio-Oncology

Real World and Public Health Perspectives of Intraoperative Radiotherapy in Early-Stage Breast Cancer: A Multidisciplinary Analysis Beyond the Statistical Facts

Contact Info

Product

Resources

About