J Plast Surg | Volume 2, Issue 1 | Research Article | Open Access

IOERT in Breast Cancer: Results of Ten-Year Follow-Up in an Italian Experience Confirm High Local Recurrence Rate

Matteo Ghilli^1*, Lucia Fatigante², Alessandra Gonnelli², Maria Donatella Mariniello¹, Stefano Spagnesi², Alessandro Molinari², Sabrina Montrone², Fabio Di Martino³, Riccardo Morganti⁴, Maria Cristina Cossu⁵, Cristian Scatena⁶, Enrico Perre¹, Gianpiero Manca⁷, Paola Ferarri⁸, Livio Colizzi¹, Fabiola Paiar² and Manuela Roncella¹

¹Department of Breast Surgery, University Hospital of Pisa, Italy ²Department of Translational Research and New Technologies in Medicine and Surgery, University Hospital of Pisa, Italy ³Department of Physics, University Hospital of Pisa, Italy ⁴Department of Statistics, Pisan University Hospital, University Hospital of Pisa, Italy ⁵Department of Breast Radiology, University Hospital of Pisa, Italy ⁶Department of Translational Research and New Technologies in Medicine and Surgery, Division of Pathology, University Hospital of Pisa, Italy ⁷Department of Nuclear Medicine, University Hospital of Pisa, Italy ⁸Deparment of Breast Oncology, University Hospital of Pisa, Italy

^*Correspondance to: Matteo Ghilli 

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Abstract

Purpose: Accelerated Partial Breast Irradiation (APBI) using Electron-Beam Intraoperative Radiation Therapy (IOERT) in carefully selected breast cancer patients is usually performed as single dose after conserving surgery. IOERT has demonstrated a low incidence of complications without compromising oncological outcomes. In our study we evaluated the rate of LR and progression free survival in a long-term follow-up. Patients and Methods: We performed IOERT with a 21 Gy single total dose referred to iso dose 90% in 322 selected patients for a total of 332 irradiated tumor lesions at the Breast Center of Pisa between January 2004 and May 2015. A close multidisciplinary follow-up was regularly conducted every 6 months. We evaluated the data at the end of 2020. Results: At a median follow-up of 10 years, 27 patients had in-field breast recurrence (8.1%) while considering a 5-year follow-up, we observed 16 LR (4.8%). According to our data, although a 5-year follow-up demonstrates an acceptable relapse rate in patients treated with IOERT, the assessed LR rate over a longer follow-up period reveals the occurrence of a significant number of relapses. Our results are consistent with the more important ones revealed by randomized trials. Conclusion: IOERT remains an acceptable approach to be considered only in carefully selected patients at particularly low risk of relapse (small, well-differentiated, luminal-A tumors, with a low Mib-1) even though the LR rate in a longer follow-up is significantly higher than standard RT.

Keywords:

APBI, Intraoperative electron beam; RT; IOERT; Local relapses; Long-term followup

Citation:

Ghilli M, Fatigante L, Gonnelli A, Mariniello MD, Spagnesi S, Molinari A, et al. IOERT in Breast Cancer: Results of Ten-Year Follow-Up in an Italian Experience Confirm High Local Recurrence Rate. J Plast Surg. 2022; 2(1): 1008..