Intraoperative radiotherapy in early breast cancer: Observational comparison with whole breast radiotherapy

Abstract

Abstract Introduction In early breast cancer (EBC), a single dose of intraoperative radiotherapy (IORT) might be an option to standard whole breast radiotherapy (WBRT). However, there is no consensus about its use and clinical results. Aim To analyse the morbidity and oncological outcomes of IORT as monotherapy in EBC. Methods A single centre observational analytic study was performed. A prospective IORT cohort (2015−17) and a retrospective WBRT cohort (2012−17) were selected following the same criteria: ≥ 45 y.o., invasive ductal carcinoma or variants, radiological tumour size ≤ 3\xa0cm, positive oestrogenic receptors, negative HER2, cN0; exclusion criteria: lymphovascular invasion, multicentricity/multifocality, BRCA mutation and neoadjuvant therapy. Clinical, histological, surgical, oncological characteristics and complications were collected. Results A total of 425 cases were selected: 217 in IORT cohort and 208 in WBRT cohort. Average age in IORT and WBRT groups was 67\xa0±\xa09.5 and 64.8\xa0±\xa09.9 y.o. respectively (p\xa0=\xa00.01). ASA 3 risk score patients were 17.7% in IORT and 24 cases in WBRT (p\xa0=\xa00.027). There were no differences in histological results or tumoral stage. Average follow up was 24.4\xa0±\xa08 months in IORT and 50.5\xa0±\xa018 months in WBRT (p\xa0 Conclusion IORT as monotherapy in selected patients with EBC stands for an alternative option versus WBRT. It seems especially useful in advanced-age patients with severe comorbidities. IORT associates lesser early severe dermatitis.