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Intraoperative Radiation Therapy: A Large Integrated Health Care System's Approach and Outcomes.

Annie Tang1, Jessica M Dzubnar1, Jason F Kelly2

  • 1Department of Surgery, University of California San Francisco, Oakland, CA, USA.

The Permanente Journal
|March 6, 2023
PubMed
Summary
This summary is machine-generated.

Intraoperative radiation therapy (IORT) showed a 3.7% recurrence rate in community practice, higher than clinical trials. Adherence to endocrine therapy is crucial for improving IORT effectiveness in breast cancer patients.

Keywords:
IORTbreast cancercomplicationsoutcomesrecurrence

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Surgical Oncology

Background:

  • Intraoperative radiation therapy (IORT) is used for breast cancer treatment.
  • Effectiveness of IORT in community settings may differ from clinical trials.

Purpose of the Study:

  • To evaluate the effectiveness and outcomes of IORT in a community healthcare system.
  • To compare real-world IORT outcomes with established clinical trial data.

Main Methods:

  • Retrospective review of electronic health records for 245 patients who received IORT.
  • Analysis of ipsilateral breast tumor recurrence, complication rates, and adherence to adjuvant therapies.
  • Assessment of patient suitability for IORT based on American Society for Radiation Oncology guidelines.

Main Results:

  • The overall ipsilateral breast tumor recurrence rate was 3.7% at a median follow-up of 3.5 years.
  • A higher recurrence rate was observed in patients not completing endocrine treatment (7.4% vs 1.9%).
  • The complication rate was 14.7%, with seroma being the most frequent (8.2%).

Conclusions:

  • The observed IORT recurrence rate of 3.7% is higher than anticipated from clinical trials, potentially linked to lower endocrine therapy compliance.
  • The study led to protocol revisions mandating endocrine treatment with IORT and recommending adjuvant whole breast irradiation for specific patient groups.