J Plast Surg | Volume 2, Issue 1 | Research Article | Open Access
Matteo Ghilli1*, 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 GhilliFulltext PDF
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.
APBI, Intraoperative electron beam; RT; IOERT; Local relapses; Long-term followup
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..