Boost IORT in Breast Cancer: Body of Evidence

Boost IORT in Breast Cancer: Body of Evidence

The term IORT (intraoperative radiotherapy) is currently used for various techniques that show decisive differences in dose delivery. The largest evidence for boost IORT preceding whole breast irradiation (WBI) originates from intraoperative electron treatments with single doses around 10 Gy, provid...

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Main Authors: Sedlmayer, Felix, Reitsamer, Roland, Fussl, Christoph, Ziegler, Ingrid, Zehentmayr, Franz, Deutschmann, Heinz, Kopp, Peter, Fastner, Gerd
Format: Online
Language:English
Published: Hindawi Publishing Corporation 2014
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167210/
id pubmed-4167210
recordtype oai_dc
spelling pubmed-41672102014-09-25 Boost IORT in Breast Cancer: Body of Evidence Sedlmayer, Felix Reitsamer, Roland Fussl, Christoph Ziegler, Ingrid Zehentmayr, Franz Deutschmann, Heinz Kopp, Peter Fastner, Gerd Review Article The term IORT (intraoperative radiotherapy) is currently used for various techniques that show decisive differences in dose delivery. The largest evidence for boost IORT preceding whole breast irradiation (WBI) originates from intraoperative electron treatments with single doses around 10 Gy, providing outstandingly low local recurrence rates in any risk constellation also at long term analyses. Compared to other boost methods, an intraoperative treatment has evident advantages as follows. Precision. Direct visualisation of the tumour bed during surgery guarantees an accurate dose delivery. This fact has additionally gained importance in times of primary reconstruction techniques after lumpectomy to optimise cosmetic outcome. IORT is performed before breast tissue is mobilised for plastic purposes. Cosmesis. As a consequence of direct tissue exposure without distension by hematoma/seroma, IORT allows for small treatment volumes and complete skin sparing, both having a positive effect on late tissue tolerance and, hence, cosmetic appearance. Patient Comfort. Boost IORT marginally prolongs the surgical procedure, while significantly shortening postoperative radiotherapy. Its combination with a 3-week hypofractionated external beam radiotherapy to the whole breast (WBI) is presently tested in the HIOB trial (hypofractionated WBI preceded by IORT electron boost), a prospective multicenter trial of the International Society of Intraoperative Radiotherapy (ISIORT). Hindawi Publishing Corporation 2014 2014-09-02 /pmc/articles/PMC4167210/ /pubmed/25258684 http://dx.doi.org/10.1155/2014/472516 Text en Copyright © 2014 Felix Sedlmayer et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Sedlmayer, Felix
Reitsamer, Roland
Fussl, Christoph
Ziegler, Ingrid
Zehentmayr, Franz
Deutschmann, Heinz
Kopp, Peter
Fastner, Gerd
spellingShingle Sedlmayer, Felix
Reitsamer, Roland
Fussl, Christoph
Ziegler, Ingrid
Zehentmayr, Franz
Deutschmann, Heinz
Kopp, Peter
Fastner, Gerd
Boost IORT in Breast Cancer: Body of Evidence
author_facet Sedlmayer, Felix
Reitsamer, Roland
Fussl, Christoph
Ziegler, Ingrid
Zehentmayr, Franz
Deutschmann, Heinz
Kopp, Peter
Fastner, Gerd
author_sort Sedlmayer, Felix
title Boost IORT in Breast Cancer: Body of Evidence
title_short Boost IORT in Breast Cancer: Body of Evidence
title_full Boost IORT in Breast Cancer: Body of Evidence
title_fullStr Boost IORT in Breast Cancer: Body of Evidence
title_full_unstemmed Boost IORT in Breast Cancer: Body of Evidence
title_sort boost iort in breast cancer: body of evidence
description The term IORT (intraoperative radiotherapy) is currently used for various techniques that show decisive differences in dose delivery. The largest evidence for boost IORT preceding whole breast irradiation (WBI) originates from intraoperative electron treatments with single doses around 10 Gy, providing outstandingly low local recurrence rates in any risk constellation also at long term analyses. Compared to other boost methods, an intraoperative treatment has evident advantages as follows. Precision. Direct visualisation of the tumour bed during surgery guarantees an accurate dose delivery. This fact has additionally gained importance in times of primary reconstruction techniques after lumpectomy to optimise cosmetic outcome. IORT is performed before breast tissue is mobilised for plastic purposes. Cosmesis. As a consequence of direct tissue exposure without distension by hematoma/seroma, IORT allows for small treatment volumes and complete skin sparing, both having a positive effect on late tissue tolerance and, hence, cosmetic appearance. Patient Comfort. Boost IORT marginally prolongs the surgical procedure, while significantly shortening postoperative radiotherapy. Its combination with a 3-week hypofractionated external beam radiotherapy to the whole breast (WBI) is presently tested in the HIOB trial (hypofractionated WBI preceded by IORT electron boost), a prospective multicenter trial of the International Society of Intraoperative Radiotherapy (ISIORT).
publisher Hindawi Publishing Corporation
publishDate 2014
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167210/
_version_ 1613134909670424576

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