Intraoperative breast radiotherapy: survival, local control and risk factors for recurrence

Guilherme Rocha Melo Gondim, Fabiana Baroni Alves Makdissi, Ricardo Cesar Fogaroli, Juan Bautista Donoso Collins, Hirofumi Iyeyasu, Douglas Guedes de Castro, Maria Letícia Gobo Silva, Michael Jenwei Chen, Tharcisio Machado Coelho, Henderson Ramos, Antônio

Summary:

Background Whole breast irradiation reduces loco-regional recurrence and risk of death in patients submitted to breast-conserving treatment. Data show that radiation to the index quadrant alone may be enough in selected patients. Aim To report the experience with intra-operative radiotherapy (IORT) with Electron-beam Cone in Linear Accelerator (ELIOT) and the results in overall survival, local control and late toxicity of patients submitted to this treatment. Materials and Methods 147 patients treated with a median follow up of 6.9 years (0.1⿿11.5 years). The actuarial local control and overall survival probabilities were estimated using the Kaplan Meier method. All tests were two-sided and p ⿤ 0.05 was considered statistically significant. Results Overall survival of the cohort in 5 years, in the median follow up and in 10 years was of 98.3%, 95.1% and 95.1%, respectively, whereas local control in 5 years, in the median follow up and in 10 years was of 96%, 94.9% and 89.5%, respectively. Two risk groups were identified for local recurrence depending on the estrogen or progesterone receptors, axillary or margin status and lymphovascular invasion (LVI) (p = 0.016). Conclusions IORT is a safe and effective treatment. Rigorous selection is important to achieve excellent local control results.

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