Intraoperative Radiation Therapy for Breast Cancer Not Associated with Pulmonary Complications

David R Kalos

doi:10.4172/2155-9619.1000198

Abstract

Radiation pneumonitis and radiation-induced cryptogenic organizing pneumonia are common complications after external beam radiation therapy following breast conserving surgery for patients with early stage breast cancer. Intraoperative radiation therapy (IORT) is designed to decrease radiation exposure to the lung, skin, soft tissue, and contralateral breast. A single-center, retrospective cohort of all patients receiving IORT between 2009 and 2013 was analyzed, and 122 cases of IORT were found. There were no instances of pulmonary complication in patients receiving IORT without whole breast irradiation. The only instance of radiation pneumonitis identified was in a patient who received subsequent external beam radiation after boost IORT. As there are no previous systemic evaluations of pulmonary complications of IORT, this study supports its reported safety.

Highlights

Breast conserving surgery with breast irradiation has been the standard surgical treatment for early stage breast cancer for decades
106 patients received Intraoperative radiation therapy (IORT) alone without additional radiation therapy. 88 had no pulmonary complications after one year, and 18 (16.7% of IORT and bilateral IORT) did not complete 12 month follow-up at the center
In a single center retrospective cohort, IORT alone was not associated with pulmonary complications like radiation pneumonitis (RP) and cryptogenic organizing pneumonia (COP)

Summary

Introduction

Breast conserving surgery with breast irradiation has been the standard surgical treatment for early stage breast cancer for decades. Breast conserving therapy alone leads to increased risk or recurrence [3]. Radiation therapy is associated with a variety of effects, including vascular damage, immunologic effects, and secondary malignancies. The reported incidence of RP varies, but is typically 5-20 percent. It presents with usual symptoms of cough, dyspnea, and chest tightness 3-8 weeks after radiation (but occasionally up to 6 months). But some rapidly progress to pulmonary fibrosis and death in 6-12 months. Factors associated with of RP include prior radiation, concomitant chemotherapy, endocrine therapy, and withdrawal of steroids [4]

Methods

Results

Conclusion