Intraoperative Radiotherapy for Breast Cancer

Early results of three studies show promise for a new technique in which a tumor is removed from the breast and is immediately followed by the delivery of a concentrated electron beam directly to the tumor site. The studies were presented at the 3rd European Breast Cancer Conference in Barcelona (Spain).

The studies were conducted by researchers at the European Institute of Oncology in Milan (Italy, 101 patients), the Institute of Oncology in Madrid (Spain, 21 patients), and
University College in London (UK, 26 patients). The Milan Institute and University College now have randomized trials under way comparing intraoperative radiotherapy with conventional radiotherapy.

The Milan Institute reports that the cosmetic effect was very good and there have been no relapses within the one-to-two year follow-up period. At the Madrid Institute, a median follow-up of three years found that of the 81% of patients who were still alive, none had suffered recurrence in the breast although three had developed lung or bone metastases. University College reports no local recurrences, although median follow-up was still only 29 months.

A major international trial comparing external radiation with or without a boost dose at the tumor site found that a boost dose reduced the risk of recurrence in the affected breast. However, when relapses do occur, they often occur at the site of the original tumor. This led doctors to investigate whether it would be better to irradiate only the tumor site.

"In addition to its ability to target the tissue that is most at risk of relapse, patients would not need long radiotherapy courses—one treatment and it's over,” said Dr. Rutgers, a surgical oncologist at the Netherlands Cancer Institute (Amsterdam). "Also, it may be cheaper and easier. These factors could be especially important for developing countries.”




Related Links:
Netherlands Cancer Institute