Copenhagen, Denmark
Onsite/Online

ESTRO 2022

Session Item

Breast
6006
Poster (digital)
Clinical
Partial breast irradiation with IORT using Xoft®. Experience at Catalan Institute of Oncology
Sílvia Antón, Spain
PO-1207

Abstract

Partial breast irradiation with IORT using Xoft®. Experience at Catalan Institute of Oncology
Authors:

Silvia Comas Antón1, Sara Moreno1, Guadalupe Molina1, Rosa Ballester2, Elisa Montes3, Miguel Angel Luna4, Maria Iciar Pascual5, Makarena Villalobos6, Gerard Meca1, Salvador Villà1

1Catalan Institute of Oncology. ICO Badalona, Radiation Oncology, Badalona (Barcelona), Spain; 2Catalan Institute of Oncology. ICO Badalona, Radiation Oncology, Badalona (Barcelona), Spain; 3Catalan Institute of Oncology. ICO Badalona, Radiation Oncology. Medical Physics, Radiation Oncology, Spain; 4Hospital Universitari Germans Trias i Pujol, Gynecology, Badalona (Barcelona), Spain; 5Hospital Universitari Germans Trias i Pujol, General Surgery, Badalona (Barcelona), Spain; 6Catalan Institute of Oncology. ICO Badalona, , Radiation Oncology, Badalona (Barcelona), Spain

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Purpose or Objective

Partial breast irradiation (PBI) with intraoperative radiotherapy (IORT) has been implemented as a safe alternative to classic external beam whole breast irradiation (WBI) for low-risk early-stage breast cancer patients after breast conserving surgery. We present the experience at our center treating patients with PBI using an IORT technic with Xoft® Axxent® Electronic Brachytherapy (eBx®) System®.

Material and Methods

Between April 2019 and August 2021, 44 patients diagnosed with low-risk early-stage breast cancer who met international criteria for PBI, received IORT in a single fraction of 20 Gy to the tumor bed after lumpectomy. Toxicities and follow up were prospectively registered.

Results

3 of the 44 initial patients were discarded for IORT due to non-compliance with the minimum safety distance (<1 cm) between the applicator and the skin. Of the remaining patients, 32/41 patients (78%) received a PBI, while 9/41 (22%) required adjuvant WBI due to adverse prognostic factors identified on the definitive biopsy. The most frequent risk factor was close resection margins (<2mm), present in 8/9 patients (88,8%). Two patients additionally presented sentinel node involvement and in 1 case no axillary sample was obtained. The most used IORT applicator was the 3-4 cm balloon, with most likely filling volumes between 30cc and 40 cc. For all treatments, the mean filling volume of the applicator was 45 cc and there were no complications during the irradiation procedure.

Surgical bed seroma was the most common acute effect, observed in 29/41 patients (70,7%), although only 8/29 (27,5%) required drainage. We observed wound dehiscence in 7/41 cases (17%), inflammatory complications requiring antibiotics in 9/41 cases (19,5%), and 4/41 cases of hematoma (9,7%). Regarding late toxicity, at the time of the analysis it was only assessable for 37 patients. We observed low rates of local grade I fibrosis (21,6%) and only 1 case of tumor bed G2 fibrosis. Hyperpigmentation G1 was observed in 8,1% of patients and 10,8% presented occasional mild local discomfort. With median follow-up of 17.14 months (range 4-29 months), no relapses were observed, but 1 patient died from covid-19 pneumonia.

Conclusion

Intra operative PBI with Xoft® Axxent® Electronic Brachytherapy (eBx®) System® is a feasible approach to treat low-risk early-stage breast cancer patients.  Our preliminary results show that it presents advantages over conventional WBI allowing for less toxic and shortened treatment courses while maintaining good local tumor control.