open access

Ahead of print
Research paper (original)
Published online: 2021-03-12
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Efficacy of IORT (Intraoperative Radiotherapy (for early advanced breast cancer depending on time delay of external beam irradiation (EXRT) post conservative breast surgery (CBS)

Agata Celejewska, Bogusław Maciejewski, Jerzy Wydmański, Krzysztof Składowski
DOI: 10.5603/NJO.a2021.0019

open access

Ahead of print
Original article
Published online: 2021-03-12

Abstract

Present study concentrates on efficacy of the IORT (14.4 izoGy2.0) as a part of conservative surgery with adjuvant EXRT (50 Gy in 25 fractions) for low risk 109 early breast cancer patients and 106 intermediate or nonlinear high risk patients with adjuvant chemoradiation or chemotherapy followed by the EXRT. Accumulation of local recurrences (LR) and distant metastases (DM) rates are characterized by nonlinear but two-phase curves. During the first 5 years 67% of all LR, and only 43% of all DM have occurred, and between 8th and 10th years the LR curve steeply increases by 25% and the DM by 48%. It suggest that 5-year follow-up is too short and it should be extended to 10 years. Among analysed prognostic factors, time interval (TI) between IORT and adjuvant EXRT has occurred the major prognostic risk factor. If the TI is extended over 60 days (delayed EXRT) the LR and the DM risks increases by 3-10 folds. Concurrent CH-EXRT significantly lowers local and distant failures, compared with delayed EXRT after completing CHT. Therefore, delayed EXRT completely ruins expected efficacy of the IORT.

Abstract

Present study concentrates on efficacy of the IORT (14.4 izoGy2.0) as a part of conservative surgery with adjuvant EXRT (50 Gy in 25 fractions) for low risk 109 early breast cancer patients and 106 intermediate or nonlinear high risk patients with adjuvant chemoradiation or chemotherapy followed by the EXRT. Accumulation of local recurrences (LR) and distant metastases (DM) rates are characterized by nonlinear but two-phase curves. During the first 5 years 67% of all LR, and only 43% of all DM have occurred, and between 8th and 10th years the LR curve steeply increases by 25% and the DM by 48%. It suggest that 5-year follow-up is too short and it should be extended to 10 years. Among analysed prognostic factors, time interval (TI) between IORT and adjuvant EXRT has occurred the major prognostic risk factor. If the TI is extended over 60 days (delayed EXRT) the LR and the DM risks increases by 3-10 folds. Concurrent CH-EXRT significantly lowers local and distant failures, compared with delayed EXRT after completing CHT. Therefore, delayed EXRT completely ruins expected efficacy of the IORT.

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Keywords

IORT, early breast cancer, delayed adjuvant EXRT

About this article
Title

Efficacy of IORT (Intraoperative Radiotherapy (for early advanced breast cancer depending on time delay of external beam irradiation (EXRT) post conservative breast surgery (CBS)

Journal

Nowotwory. Journal of Oncology

Issue

Ahead of print

Article type

Research paper (original)

Published online

2021-03-12

DOI

10.5603/NJO.a2021.0019

Keywords

IORT
early breast cancer
delayed adjuvant EXRT

Authors

Agata Celejewska
Bogusław Maciejewski
Jerzy Wydmański
Krzysztof Składowski

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