Early toxicity outcomes: A single 15Gy fraction HDR brachytherapy as pre-treatment EBRT boost in prostate cancer

Abstract

Purpose/Objectivel: Targeted intraoperative radiation therapy (IORT) as an alternative to whole breast irradiation has been described for patients with early-stage breast cancer. The randomized phase III TARGiT trial demonstrated similar recurrence rates to WBI and a lower overall toxicity profile on short-term follow-up. We report on our early Latin American surgical experience using the Intrabeam radiotherapy delivery system. Materials and Methods: Prospectively gathered estrogen receptor-positive, clinically node-negative patients with invasive breast cancer < 2.5 cm receiving using the Intrabeam system were reviewed. IORT-related effects and early postoperative outcome were assessed. Results: Seventy eight patients (median age 67 years) underwent lumpectomy, sentinel lymph node biopsy, and concurrent IORT from march 2013 to march 2014. Ninety-five percent of patients had invasive ductal histology with a median tumor size of 1.5 cm. Conclusions: While a variety of APBI techniques are currently available for clinical use, our early Latin American operative experience with IORT shows it is well tolerated with low morbidity. The addition of WBI may be necessary in situations for positive residual margins or microscopic nodal disease in patients who do not undergo additional surgery. Implementation of IB impacts treatment planning and operating room use in a multidisciplinary breast cancer program. The safety profile, ease of administration, and reduced costs of IB favor its more widespread use in selected patients with early-stage breast cancer.