A New Approach to Treating Breast Cancer Combining Tumor Removal and Intraoperative Radiotherapy: Is it Viable?

Women's Health

Volumn 6, Issue 1, 2010, Pages 9-12

  Keshtgar, Mohammed ^a   Baum, Michael ^a  

^a ROYAL FREE AND UNIVERSITY COLLEGE MEDICAL SCHOOL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

BREAST TUMOR; EDITORIAL; FEMALE; HUMAN; METHODOLOGY; PEROPERATIVE CARE; PHASE 2 CLINICAL TRIAL; RADIATION DOSE; RANDOMIZED CONTROLLED TRIAL; SEGMENTAL MASTECTOMY; TUMOR RECURRENCE;

BREAST NEOPLASMS; CLINICAL TRIALS, PHASE II AS TOPIC; FEMALE; HUMANS; INTRAOPERATIVE CARE; MASTECTOMY, SEGMENTAL; NEOPLASM RECURRENCE, LOCAL; RADIATION DOSAGE; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 77951232413     PISSN: 17455057     EISSN: 17455065     Source Type: Journal    
DOI: 10.2217/WHE.09.74     Document Type: Editorial

References (38)

1. Papers of special note have been highlighted as:
2. of interest
3. of considerable interest
4. Halsted WS: The results of radical operations for the cure of cancer of the breast performed at the Johns Hopkins Hospital from June 1889 to January 1894. Ann. Surg. 20, 455–497 (1898).
5. Keynes G: The radium treatment of carcinoma of the breast. Br. J. Surg. 19, 425 (1931–1932).
6. Landmark paper of historical importance.
7. Fisher B Anderson S Fisher ER et al.: Significance of ipsilateral breast tumour recurrence after lumpectomy. Lancet 338, 327–331 (1991).
8. Landmark paper of historical importance.
9. Early Breast Cancer Trialists Collaborative Group (EBCTCG): Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15 year survival: an overview of the randomized trials. Lancet 366, 2087–2106 (2005).
10. Important reference providing evidence in support of current practice.
11. Overgaard M Hansen PS Overgaard J et al.: Post-operative radiotherapy in high risk pre-menopausal women with breast cancer who receive adjuvant chemotherapy. N. Engl. J. Med. 337, 949–955 (1997).
12. Important reference providing evidence in support of current practice.
13. Athas WF Adams-Cameron M Hunt WC Amir-Fazli A Key CR: Travel distance to radiation therapy and receipt of radiotherapy following breast-conserving surgery. J. Natl Cancer Inst. 92(3), 269–271 (2000).
14. Punglia RS Weeks JC Neville BA Earle CC: Effect of distance to radiation treatment facility on use of radiation therapy after mastectomy in elderly women. Int. J. Radiat. Oncol. Biol. Phys. 66(1), 56–63 (2006).
15. Machtay M Lanciano R Hoffman J Hanks GE: Inaccuracies in using the lumpectomy scar for planning electron boosts in primary breast carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 30(1), 43–48 (1994).
16. Bowden SJ Fernando IN Burton A: Delaying radiotherapy for the delivery of adjuvant chemotherapy in the combined modality treatment of early breast cancer: is it disadvantageous and could combined treatment be the answer? Clin. Oncol. (R. Coll. Radiol.) 18(3), 247–256 (2006).
17. Bartelink H Horiot JC Poortmans P et al.: Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N. Engl. J. Med. 345(19), 1378–1387 (2001).
18. Important reference regarding local recurrence on which the new approach of intraoperative radiotherapy (IORT) is based.
19. Bartelink H Horiot JC Poortmans PM et al.: Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-year results of the randomized boost versus no boost EORTC 22881–10882 trial. J. Clin. Oncol. 25(22), 3259–3265 (2007).
20. Clarke M Collins R Darby S et al.: Effects of radiotherapy and differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomized trials. Lancet 366, 2087–2106 (2005).
21. Saphner T Tormey DC Gray R et al.: Annual hazard rates of recurrence for breast cancer after primary therapy. J. Clin. Oncol. 14, 2738–2746 (1996).
22. Demicheli R Terenziani M Valagussa P Moliterni A Zambetti M Bonadonna G: Local recurrences following mastectomy: support for the concept of tumour dormancy. J. Natl Cancer Inst. 86, 45–48 (1994).
23. Baum M Demicheli R Hrushesky W et al.: Does surgery unfavourably perturb the ‘natural history’ of early breast cancer by accelerating the appearance of distant metastases. Eur. J. Cancer 41, 508–515 (2005). Vicini FA Beitsch P Quiet C et al.: Three-year analysis of treatment efficacy, cosmesis and toxicity by the American Society of Breast Surgeons (ASBS) MammoSite breast brachytherapy registry trial in patients treated with accelerated partial breast irradiation (APBI). Int. J. Radiat. Oncol. Biol. Phys. 69, S207 (2007).
24. Benitez PR Keisch ME Vicini F et al.: Five-year results: the initial clinical trial of MammoSite™ balloon brachytherapy for partial breast irradiation in early-stage breast cancer. Am. J. Surg. 194, 456–462 (2007).
25. Outlines the technique of accelerated partial breast irradiation using the MammoSite™ technique with data on 5-year results.
26. Vaidya JS Baum M Tobias JS et al.: Targeted intra-operative radiotherapy (TARGIT): an innovative method of treatment for early breast cancer. Ann. Oncol. 12(8), 1075–1080 (2001).
27. Outlines the novel approach of IORT.
28. Veronesi U Orecchia R Luini A et al.: A preliminary report of intraoperative radiotherapy (IORT) in limited-stage breast cancers that are conservatively treated. Eur. J. Cancer 37, 2178–2183 (2001).
29. Outlines the novel approach of IORT.
30. Vaidya JS Baum M Tobias JS et al.: Targeted intraoperative radiotherapy (TARGIT) yields very low recurrence rates when given as a boost. Int. J. Radiat. Oncol. Biol. Phys. 66(5), 1335–1338 (2006).
31. Vaidya JS Baum M Tobias JS et al.: Efficacy of targeted intraoperative radiotherapy (Targit) boost after breast conserving surgery: updated results. J. Clin. Oncol. 26, 565 (2008) (Abstract).
32. Luini A Orecchia R Gatti G et al.: The pilot trial on intraoperative radiotherapy with electrons (ELIOT): update on the results. Breast Cancer Res. Treat. 93, 55–59 (2005).
33. Vaidya JS Joseph D Hilaris B et al.: Targeted intraoperative radiotherapy (TARGIT) for breast cancer: an international trial. [Abstract]. Breast Cancer Res. Treat. 76(Suppl. 1), S116 (2002).
34. Keshtgar M Williams NR Corica T Hedges R Saunders C Joseph D; on behalf of the TARGIT Trialists' Group: Cosmetic outcome 2 and 3 years after intraoperative radiotherapv compared with external beam radiotherapy for early breast cancer: an objeclive assessment of patients from a randomized controlled trial. The ASCO 2009 Breast Cancer Symposium Proceedings, 135 (2009).
35. Keshtgar M Vaidya JS Keller A et al.: Intra-operative radiotherapy for breast cancer in patients where external beam radiation was not possible – results after 3 years of follow-up. Breast 18(Suppl. 1), S48 (2009).
36. Keshtgar M Tobias JS Vaidya JS et al.: Breast cancer patients treated with intra-operative radiotherapy alone when conventional external beam radiation therapy was not possible. EJC Suppl. 6(7), 146 (2008).
37. Vaidya JS Baum M Tobias JS Houghton J: Targeted Intraoperative Radiothearpy (TARGIT)-trial protocol. Lancet. www.thelancet.com/protocol-reviews/99PRT-47
38. The ASCO 2009 Breast Cancer Symposium Proceedings. https://store.asco.org/public/eCommerce/Orders/product.aspx?categoryId=15&productId=372