ESTRO 36 Abstract Book

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S621 ESTRO 36 2017
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EP-1152 Intraoperative radiotherapy for early breast
cancer: a monocentric experience
A. Baldissera 1, L. Giaccherini2, I. Marinelli3, A. Parisi4, G.
Siepe2, O. Martelli1, F. Salvi1, D. Balestrini1, C. Degli
Esposti 1, I. Ammendolia2, G. Tolento2, V. Panni2, G.
Macchia 5, F. Deodato5, S. Cilla6, A.G. Morganti2, G.P.
Frezza 1
1 Ospedale Bellaria, Radiotherapy Department, Bologna,
Italy
2 University of Bologna, Radiation Oncology Center-
Department of Experimental- Diagnostic and Specialty
Medicine - DIMES, Bologna, Italy
3 Sapienza University, Radiation Oncology Department,
Rome, Italy
4 Istituto Oncologico Veneto IRCCSS, Radiation Oncology
Department, Padua, Italy
5 Fondazione di Ricerca e Cura “Giovanni Paolo II”,
Radiotherapy Unit, Campobasso, Italy
6 Fondazione di Ricerca e Cura “Giovanni Paolo II”,
Medical Physics Unit, Campobasso, Italy
Purpose or Objective
Single-dose intraoperative radiotherapy (IORT) is an
alternative treatment for selected cases of early stage
breast cancer. The purpose of this study is to present
preliminary results of patients treated with IORT at
Bellaria Hospital, Bologna, Italy
Material and Methods
We analysed data of 108 women who underwent
lumpectomy and IORT with primary intent. IORT
treatment was performed with a dedicated mobile
electron accelerator (21 Gy were prescribed at 90%
isodose). Data collected were histopathology, adjuvant
treatment, clinical tolerability, local recurrences and
outcomes.
Results
From December 2011 to December 2015, 108 women
(median age 72 years) were treated with IORT. 75% of
patients were treated with adjuvant ormonotherapy and
11.1% with combined chemotherapy plus hormonotherapy.
The median follow-up was 26 months (range 2-52). 82.4%
of patients had disease that was <2 cm in size, 65.7% of
patients had an infiltrative duct carcinoma. At the end of
follow-up 89.9% had a G0-G2 grade of late parenchymal
fibrosis and 69.4% of patients a good cosmetic result. One
patient underwent a mastectomy after five months
because of chronic fistula in the irradiated area. One
patient had a local relapse in a different quadrant and one
patient had an axillary lymph node recurrence. Only one
patient developed systemic metastasis. One patient died
from breast progressive disease.
Conclusion
IORT represents a safe and effective alternative treatment
option in selected patients with early breast cancer. Low
complication rate with good clinical and cosmetic
outcomes support IORT as a treatment option for selected
women.
EP-1153 Post-Mastectomy Hypofractionated
Radiotherapy for Breast Cancer Treatment
C.S. Ortiz Arce1, A. Chagoya González2, E.N. Barrientos
Luna2
1 Hospital Regional de Alta Especialidad Bajío,
Radiotherapy, León, Mexico
2 Centro Médico Nacional Siglo XXI- IMSS, Radiotherapy,
Mexico City, Mexico
Purpose or Objective
Radiotherapy (RT) for Breast Cancer improves local
control and provides benefit in overall survival; this is
given mainly in daily fractions (Fx) over a period of 5-6
weeks.
Hypofractionated schedules reduce the number of
sessions, shortening the treatment time.
Many studies reported local recurrence in patients treated
with breast-conserving surgery (BCS) with less than 5% in
a lapse of 5 years.
However, the indication of a hypofractionated scheme
after a Modified Radical Mastectomy (MRM) is not clearly
established, since there is only one study with a 7-year
follow-up which reported 3 patients with local recurrence.
Due to the high number of patients requiring RT, we
initiated this transversal and comparative study, at the
Centro Médico Nacional Siglo XXI, IMSS.
We compared hypofractionated and conventional
schedules in order to evaluate acute toxicity and local
control, including patients treated with BCS and MRM,
between November 2012 and March 2016.
Material and Methods
We included 560 patients: 394 were treated with MRM and
166 with BCS.
According to the radiotherapy schedule received, they
were divided in 3 groups: 40Gy/15Fx, 42Gy/16Fx, and
50Gy/25Fx.
Results
At the end of the treatment, acute skin morbidity grade 1
was found in 57, 72 and 32% of the cases; grade 2 in 42,
27 and 64% for treatments with 40, 42 and 50 Gy,
respectively, and grade 3 in 3% for a dose of 50 Gy in
patients treated with MRM.
Regarding BCS, skin morbidity grade 1 was found in 48, 66
and 23% of the cases, while grade 2 in 51, 33 and 73% for
treatments with 40, 42 and 50 Gy, respectively, and grade
3 in 3% of patients treated with 50 Gy (Figure 1).
After the first month, morbidity was reported in 489
patients (341 MRM and 148 BCS); mainly xerosis and
hyperpigmentation; subacute morbidity (at third month)
was reported in 346 patients (247 of MRM group and 99 of
BCS group), mainly xerosis (Table 1).
In follow-up studies, radiation pneumonitis was found in
seven patients treated with MRM (2.8% of the total),
regardless of the schedule received; they were still
asymptomatic in the last follow-up.
So far, we have an average 6-month follow-up after ending
RT treatment with 226 patients (136 of them were treated
with MRM, and 90 with BCS), with a maximum 3-year
follow-up.
In total, nine locoregional recurrences (LR) are reported,
either on the chest wall, breast or the lymph node regions,
while we found 14 systemic recurrences which are
reported in one or more sites. Most LR were observed
among patients treated with MRM, which may be
associated with the patients undergoing radical
treatments that generally have a more advanced clinical
stage.
Conclusion
With these results we can conclude that it is safe to use
hypofractionated treatments for patients with breast
cancer treated either with MRM , with acute and subacute
morbidity similar to that found in patients treated with
conventional schedules, at least with a similar local
control between the different schedules.
It is required, however, to complete the long-term
monitoring.
EP-1154 Changes in skin microcirculation during
radiation therapy for breast cancer
E. Tesselaar1, A.M. Flejmer2, S. Farnebo3, A. Dasu4
1Linköping University, Department of Radiation Physics
and Department of Medical and Health Sciences,
Linköping, Sweden
2Linköping University, Department of Oncology and
Department of Clinical and Experimental Medicine,
Linköping, Sweden
3Linköping University, Department of Hand and Plastic
Surgery and Burns and Department of Clinical and
Experimental Medicine, Linköping, Sweden
4Skandionkliniken, ----, Uppsala, Sweden