%0 Journal Article
%T Intraoperative radiotherapy (IORT) is an option for patients with localized breast recurrences after previous external-beam radiotherapy
%A Uta Kraus-Tiefenbacher
%A Lelia Bauer
%A Antonella Scheda
%A Carola Schoeber
%A Joerg Schaefer
%A Volker Steil
%A Frederik Wenz
%J BMC Cancer
%D 2007
%I BioMed Central
%R 10.1186/1471-2407-7-178
%X Between 4/02 and 11/06, 15 patients were treated for in-breast recurrences at a median of 10 years (3¨C25) after previous EBRT (10 recurrences in the initial tumor bed, 3 elsewhere in-breast failures, 2 invasive recurrences after previous DCIS). Additional 2 patients were selected for IORT with new primary breast cancer after previous partial breast EBRT for treatment of Hodgkin's disease. IORT with a single dose of 14.7 ¨C 20 Gy 50 kV X-rays at the applicator surface was delivered with the Intrabeam£¿-device (Carl Zeiss, Oberkochen, Germany).After a median follow-up of 26 months (1¨C60), no local recurrence occurred. 14 out of 17 patients are alive and free of disease progression. Two patients are alive with distant metastases. One patient died 26 months after BCS/IORT due to pulmonary metastases diagnosed 19 months after BCS/IORT. Acute toxicity after IORT was mild with no Grade 3/4 toxicities and cosmetic outcome showed excellent/good/fair results in 7/7/3 cases.IORT for recurrent breast cancer using low energy X-rays is a valuable option for patients with recurrent breast cancer after previous radiotherapy.External-beam radiotherapy (EBRT) of the breast after breast conserving surgery (BCS) reduces the local breast tumour recurrence rate from 25 ¨C 30% to less than 10% at 10 years [1-6]. However, it is still a problem to find the optimal therapy modality for the remaining 10% of breast cancer patients presenting with a tumour recurrence years after BCS and EBRT. The normal tissue tolerance does not allow, even after years, a second full-dose course of radiotherapy to the entire breast after a second BCS. Especially for patients with small, localized recurrences, in whom a local excision would technically be possible, mastectomy is generally preferred over BCS for fear of worse outcome due to omission of radiotherapy. This is particularly unsatisfying, because recurrent breast tumours, with increasing advances in diagnostic modalities and regular follow-up visits, are
%U http://www.biomedcentral.com/1471-2407/7/178