Abstract
Intraoperative radiotherapy (IORT) for breast cancer has challenged the standard external beam radiotherapy (EBRT) and has been shown to be non-inferior for treating early breast cancer in the past decade. Several technologies have been tested for IORT and various randomised controlled trials are still ongoing. Different methods of application of IORT have also been evaluated, from early breast cancer to tumour bed boost radiotherapy amongst high risk women. TARGIT-A and ELIOT trials have reported a low incidence of local recurrence and good survival in both arms. Moreover, mortality has been found to be lower amongst women who underwent partial breast radiotherapy compared to those treated with EBRT in a recent meta-analysis. Despite this, IORT has not been introduced in the current clinical practice as yet, and many clinicians do not mention this treatment option to patients awaiting breast cancer surgery. The scientific community does not unanimously support the effectiveness of IORT and still raises concerns about introducing IORT as a standard treatment option for breast cancer. Current evidence demonstrates that IORT is ready for roll-out; it is time to let well-selected and informed patients be offered this treatment option in the current clinical practice.
Highlights
Intraoperative radiotherapy (IORT) is the administration of radiation therapy at the time of surgery, accurately defining the target volume of the breast
This study proposes to investigate the efficacy and toxicity of IORT after breast conserving surgery (BCS), with or without external beam radiation treatment (EBRT) as indicated by pathologic risk factors, in women with early stage breast cancer (ClinicalTrials.gov Identifier: NCT01570998)
The use of IORT as an alternative to EBRT in selected groups of patients has been a fundamental change in approaching breast cancer therapy
Summary
Intraoperative radiotherapy (IORT) is the administration of radiation therapy at the time of surgery, accurately defining the target volume of the breast. TARGIT-A and ELIOT, have shown, in selected patients, encouraging results in terms of local recurrence and survival. After five years’ follow-up, the ELIOT trial showed a 4.4% of local recurrence rate (LRR) amongst patients who underwent BCS and IORT.
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