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Feasibility of Intraoperative Radiotherapy Tumor Bed Boost in Patients with Breast Cancer after Neoadjuvant Chemotherapy

Authors
 Gowoon Yang  ;  Jun Won Kim  ;  Ik Jae Lee  ;  Joon Jeong  ;  Sung Gwe Ahn  ;  Soong June Bae  ;  Jee Hung Kim  ;  Yeona Cho 
Citation
 YONSEI MEDICAL JOURNAL, Vol.65(3) : 129-136, 2024-03 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2024-03
MeSH
Breast Neoplasms* / drug therapy ; Breast Neoplasms* / radiotherapy ; Breast Neoplasms* / surgery ; Combined Modality Therapy ; Feasibility Studies ; Female ; Humans ; Mastectomy, Segmental ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local / pathology ; Neoplasm Staging ; Radiotherapy Dosage
Keywords
Breast neoplasms ; intraoperative ; neoadjuvant therapy ; radiotherapy ; safety
Abstract
Purpose: This study aimed to assess the feasibility and safety of administering intraoperative radiotherapy (IORT) as a boost dur ing breast-conserving surgery (BCS) following neoadjuvant chemotherapy for patients at high risk of breast cancer recurrence.

Materials and Methods: Patients who underwent neoadjuvant chemotherapy received a single 20-Gy dose of IORT during BCS, followed by external beam radiotherapy 4–6 weeks after surgery.

Results: The median follow-up duration was 31.0 months (range, 18.0–59.0 months). Initial tumor sizes had a median of 2.6 cm (range: 0.8–5.3 cm), reducing to 0.3 cm (range: 0–4.0 cm) after neoadjuvant chemotherapy. The most common neoadjuvant che motherapy regimen was doxorubicin and cyclophosphamide, followed by paclitaxel (n=42, 73.7%). Among 57 patients who re ceived neoadjuvant chemotherapy before BCS and IORT, 2 patients (3.5%) required secondary surgery to achieve negative resec tion margins due to initially positive margins. Regional lymph node irradiation was performed in 37 (64.9%) patients. There was no grade 3 or higher adverse events, with 4 patients (7.0%) experiencing grade 2 acute radiation dermatitis and 3 (5.3%) having less than grade 2 breast edema. Binary correlation analysis did not reveal statistically significant associations between applicator size or radiation therapy modality and the risk of treatment-related toxicity. Furthermore, chi-square analysis showed that the grade of treatment-related toxicity was not associated with the fractionated regimen (p=0.375).

Conclusion: Most patients successfully received IORT as a tumor bed boost after neoadjuvant chemotherapy. Thus, IORT may be a safe and feasible option for patients with advanced-stage breast cancer receiving neoadjuvant chemotherapy.
Files in This Item:
T202401722.pdf Download
DOI
10.3349/ymj.2023.0229
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Kim, Jee Hung(김지형) ORCID logo https://orcid.org/0000-0002-9044-8540
Bae, Soong June(배숭준) ORCID logo https://orcid.org/0000-0002-0012-9694
Ahn, Sung Gwe(안성귀) ORCID logo https://orcid.org/0000-0002-8778-9686
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Jeong, Joon(정준) ORCID logo https://orcid.org/0000-0003-0397-0005
Cho, Yeona(조연아) ORCID logo https://orcid.org/0000-0002-1202-0880
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198808
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