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Annals of Surgical Oncology

, Volume 24, Issue 10, pp 3082–3087 | Cite as

Intraoperative Radiation Using Low-Kilovoltage X-Rays for Early Breast Cancer: A Single Site Trial

  • Melvin J. SilversteinEmail author
  • Melinda S. EpsteinEmail author
  • Kevin Lin
  • Peter Chen
  • Sadia Khan
  • Lincoln Snyder
  • Lisa E. Guerra
  • Cristina De Leon
  • Ralph Mackintosh
  • Colleen Coleman
  • January Lopez
  • Brian Kim
Breast Oncology

Abstract

Introduction

Two prospective, randomized trials, TARGIT-A and ELIOT, have shown intraoperative radiation therapy (IORT) to be a safe alternative to whole breast radiation therapy following breast-conserving surgery for selected low-risk patients. However, minimal data are available about the clinical effectiveness of this modality of treatment using the Xoft® Axxent® Electronic Brachytherapy (eBx®) System®.

Methods

A total of 201 patients with 204 early-stage breast cancers were enrolled in a prospective X-ray IORT trial from June 2010 to September 2013. All tumors were treated with breast-conserving surgery and IORT. Data were collected at 1 week, 1 month, 6 months, 1 year, and yearly thereafter.

Results

With a median follow-up of 50 months, there have been seven ipsilateral breast tumor events (IBTE), no regional or distant recurrences, and no breast cancer-related deaths. One IBTE was within the IORT field, four outside of the IORT field but within the same quadrant as the index cancer, and two were new biologically different cancers in different quadrants. Three events were in patients who deviated from the protocol criteria. Kaplan–Meier analysis projects that 2.9% of patients will recur locally at 4 years.

Conclusions

Recurrence rates observed in this trial were comparable to those of the TARGIT-A and ELIOT trials as well as the retrospective TARGIT-R trial. The low complication rates previously reported by our group as well as the low recurrence rates reported in this study support the cautious use and continued study of IORT in selected women with low-risk breast cancer.

Notes

Disclosure

The authors have no commercial interest or financial support relevant to this research.

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Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Melvin J. Silverstein
    • 1
    • 2
    Email author
  • Melinda S. Epstein
    • 3
    Email author
  • Kevin Lin
    • 4
  • Peter Chen
    • 4
  • Sadia Khan
    • 1
    • 2
  • Lincoln Snyder
    • 1
  • Lisa E. Guerra
    • 5
    • 1
  • Cristina De Leon
    • 3
  • Ralph Mackintosh
    • 4
  • Colleen Coleman
    • 1
  • January Lopez
    • 6
  • Brian Kim
    • 4
  1. 1.Department of SurgeryHoag Memorial Hospital PresbyterianNewport BeachUSA
  2. 2.Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  3. 3.Hoag Institute for Research and EducationHoag Memorial Hospital PresbyterianNewport BeachUSA
  4. 4.Department of Radiation OncologyHoag Memorial Hospital PresbyterianNewport BeachUSA
  5. 5.BreastlinkNewport BeachUSA
  6. 6.Department of RadiologyHoag Memorial Hospital PresbyterianNewport BeachUSA

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