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  • [Front Oncol .] Radiation dose-event relationship after intraoperative radiotherapy as a boost in patients with breast cancer

    연세의대 / 조연아, 이익재*

  • 출처
    Front Oncol .
  • 등재일
    2023 May 5
  • 저널이슈번호
    13:1182820. doi: 10.3389/fonc.2023.1182820. eCollection 2023.
  • 내용

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    Abstract
    Purpose: Intraoperative radiotherapy (IORT) can be used as a boost in combination with external whole breast irradiation. This study reports the clinical and dosimetric factors associated with IORT-related adverse events (AE).

    Methods and materials: Between 2014 and 2021, 654 patients underwent IORT. A single fraction of 20 Gy was prescribed to the surface of the tumour cavity using the mobile 50-kV X-ray source. For skin dose measurement, at least four optically stimulated luminescent dosimeter (OSLD) chips were annealed and attached to the skin edge in the superior, inferior, medial, and lateral locations during IORT. Logistic regression analyses were conducted to identify factors associated with IORT-related AE.

    Results: With a median follow-up period of 42 months, 7 patients experienced local recurrence, resulting in a 4-year local failure-free survival rate of 97.9%. The median skin dose measured by OSLD was 3.85 Gy (range, 0.67-10.89 Gy), and a skin dose of > 6 Gy was observed in 38 patients (2%). The most common AE was seroma (90 patients, 13.8%). We also found that 25 patients (3.9%) experienced fat necrosis during follow-up, and among them, 8 patients underwent biopsy or excision to exclude local recurrence. IORT-related late skin injury occurred in 14 patients, and a skin dose > 6 Gy was significantly associated with IORT-induced skin injury (odds ratio 4.942, 95% confidence interval 1.294-18.871, p = 0.019).

    Conclusions: IORT was safely administered as a boost to various populations of patients with breast cancer. However, several patients may experience severe skin injuries, and for older patients with diabetes, IORT should be performed with caution.

     

     

    Affiliations

    Yeona Cho 1, Jun Won Kim 1, Jee Suk Chang 1, Ji Young Kim 1, Sung Gwe Ahn 2, Soong June Bae 2, Joon Jeong 2, Ik Jae Lee 3
    1Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
    2Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
    3Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

  • 키워드
    boost radiotherapy; breast cancer; intraoperative radiation therapy (IORT); radiation toxicites; radiotherapy.
  • 편집위원

    IORT boost를 시행환 유방암 환자의 치료성적과 부작용을 분석하고 특히 skin injury의 위험인자를 제시한 논문

    2023-07-04 14:54:52

  • 편집위원2

    국내에서 발표된 유방암 환자에서 IORT 후 EBRT 시행할때 치료 성적 및 발생하는 부작용에 대해서 상세하게 분석한 연구입니다.

    2023-07-04 15:14:24

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