Partial breast irradiation with intraoperative radiotherapy in the ELIOT trial.

Abstract

We congratulate Roberto Orecchia and colleagues 1 Orecchia R Veronesi U Maisonneuve P et al. Intraoperative irradiation for early breast cancer (ELIOT): long-term recurrence and survival outcomes from a single-centre, randomised, phase 3 equivalence trial. Lancet Oncol. 2021; 22: 597-608 Summary Full Text Full Text PDF PubMed Scopus (25) Google Scholar for publishing the long-term results of the single-centre, phase 3, randomised, equivalence ELIOT trial, in which 1305 women (aged 48–75 years, with a unicentric tumour ≤2·5 cm in diameter, and node-negative) were randomly assigned to receive a single 21 Gy fraction of electron intraoperative radiotherapy, or whole-breast irradiation over 6 weeks. Higher 15-year rates of local relapse were found in the electron intraoperative radiotherapy group (12·6% vs 2·4%; p<0·0001). No differences in either overall survival or breast cancer-specific survival were observed. 1 Orecchia R Veronesi U Maisonneuve P et al. Intraoperative irradiation for early breast cancer (ELIOT): long-term recurrence and survival outcomes from a single-centre, randomised, phase 3 equivalence trial. Lancet Oncol. 2021; 22: 597-608 Summary Full Text Full Text PDF PubMed Scopus (25) Google Scholar Intraoperative irradiation for early breast cancer (ELIOT): long-term recurrence and survival outcomes from a single-centre, randomised, phase 3 equivalence trialThe long-term results of this trial confirmed the higher rate of IBTR in the ELIOT group than in the WBI group, without any differences in overall survival. ELIOT should be offered to selected patients at low-risk of IBTR. Full-Text PDF Partial breast irradiation with intraoperative radiotherapy in the ELIOT trialWe congratulate Roberto Orecchia and colleagues1 for presenting long-term results of partial breast irradiation with electron intraoperative radiotherapy for patients with early breast cancer (the ELIOT trial) in The Lancet Oncology. In this single-centre, randomised phase 3 trial, 1305 women were randomly allocated into two groups to receive a single electron intraoperative radiotherapy dose of 21 Gy or whole-breast irradiation. Higher rates of ipsilateral breast tumour relapse were found in the electron intraoperative radiotherapy group than in the whole-breast irradiation group (15 year recurrence rate: 12·6% vs 2·4%; p<0·0001), without differences in overall survival. Full-Text PDF Partial breast irradiation with intraoperative radiotherapy in the ELIOT trialWe congratulate Roberto Orecchia and colleagues1 for their Article reporting the long-term outcomes of the ELIOT trial, for which the first publication (with 5-year data) took place in 2013.2 Reported risk-stratified cumulative incidences of breast cancer recurrence rates were now based on the renewed American Society for Radiation Oncology criteria for partial breast irradiation.3 For patients defined as cautionary under the American Society for Radiation Oncology criteria (n=182), Orecchia and colleagues1 (table 3) report a 15-year breast cancer recurrence rate of 10% (95% CI 6·3–14·7)—surprisingly lower than the 15-year breast cancer recurrence rate in 223 patients defined as suitable (13·1% [95% CI 8·3–19·1]), which was, in turn, unexpectedly high. Full-Text PDF Partial breast irradiation with intraoperative radiotherapy in the ELIOT trial – Authors' replyWe would like to thank our colleagues for their interest in the updated ELIOT trial.1 By showing a higher local relapse rate in the accelerated partial breast irradiation group, we do not intend to discourage the use of electron intraoperative radiotherapy (ELIOT)—let alone of accelerated partial breast irradiation in general—but rather to underscore the importance of appropriate patient selection. The ELIOT trial has identified a subgroup of patients with a notably low rate of local recurrence after either accelerated partial breast irradiation or whole-breast irradiation. Full-Text PDF Partial breast irradiation with intraoperative radiotherapy in the ELIOT trialDescribing the long-term outcomes of the ELIOT trial,1 the authors point out “the possible local side-effects of the [ELIOT] technique (immediate fat necrosis, skin flap-temporary suffering, or late parenchymal fibrosis)”, which is an important detail. Full-Text PDF