Topics:
Breast Cancer • Radiation Oncology
What early stage breast cancer patients would you give IOeRT?
With newly published long-term data of single fraction IOeRT (Intraoperative electron Radiation Therapy) for breast cancer on the ELIOT trial, does this change your thoughts/approach for your patients who were in ASTRO's "suitable" category being considered for IOeRT?
Especially in light of the favorable data in recent years about short [5 fx] APBI courses.
This seems to further narrow the role of IOeRT for breast cancer patients. Should this give someone pause in thinking of initiating or continuing their IOeRT program?
Answer from: Radiation Oncologist at Academic Institution
I think given data from ELIOT update (11% LR with electron IORT vs. 2% WBI) and the TARGIT-A update, there is a limited role for IORT as monotherapy at this time, particularly when options like 5 fx PBI and 5 fx WBI are now possible. The ABS guidelines do not recommend either IORT technique whi...
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Answer from: Radiation Oncologist at Academic Institution
I completely agree with Dr. @Chirag S. Shah. The data from RAPID and RTOG 0413 strongly suggest that external beam partial breast irradiation confers long-term control of disease in the breast that is equivalent to whole breast irradiation. In contrast, the long-term data suggest that IORT, with eit...
Answer from: Radiation Oncologist at Community Practice
Have been using the 5 fx approach in the OPAL II Study that @Benjamin D. Smith mentions above. There is a "boost" option that is a SIB with 30/5 and it creates excellent plans with 26/5 to seroma+clips+2cm CTV margin, 30/5 to seroma+clips+1cm CTV margin. The acute toxicity is very, very low. Li...
Answer from: Radiation Oncologist at Community Practice
I personally started to use the UK FAST FORWARD regimen (26 Gy in 5 fractions QD) in 3D conformal APBI. I think we know from the randomized trials that patients receiving APBI usually present with a low risk cancer, a T1N0 ER+, post-menopausal, and very possibly, they don't need a higher PBI dose. I...
Answer from: Radiation Oncologist at Community Practice
I do not use electron IORT since the data from the ELIOT trial is inferior to EBRT.
I use definitive TARGIT-IORT in many of my early stage patients with outcomes as per the TARGIT-A pre-path trial. See BMJ 8-19-2020 publication. It is much easier and more convenient for the patient than exter...
Comments
Radiation Oncologist at Cleveland Clinic
I agree with your comment on electron IORT given E...
I agree with your comment on electron IORT given E...