Advertisement

Breast Cancer Research and Treatment

, Volume 93, Issue 1, pp 55–59 | Cite as

The Pilot Trial on Intraoperative Radiotherapy with Electrons (ELIOT): Update on the Results

  • Alberto Luini
  • Roberto Orecchia
  • Giovanna Gatti
  • Mattia Intra
  • Mario Ciocca
  • Viviana Galimberti
  • Paolo Veronesi
  • Gabriela Rosali dos Santos
  • Daniela Gilardi
  • Umberto Veronesi
Report

Summary

Background: Intraoperative radiotherapy with electrons (ELIOT) is under evaluation in the conservative treatment of breast carcinoma. At the European Institute of Oncology we started our study on ELIOT in 1999; the first step has been a phase I–II trial to test feasibility and tolerance of ELIOT in patients candidate to breast conserving surgery.

Patients and methods. From July 1999 to September 2000, 101 patients affected by unifocal breast carcinoma up to a diameter of 2.5 cm received wide resection of the breast followed by ELIOT. The trial was based on a dose-escalation starting from 10 Gy: we tested the dose-levels of 10, 15, 17, 19 and 21 Gy. The dose-levels of 10 and 15 Gy were followed by a reduced course of external fractionated radiotherapy. Most patients received 21 Gy intraoperatively. Patients were evaluated 1, 3, 6 and 12 months after surgery, and thereafter every 6 months, to look for early, intermediate, late complications, and other events.

Results. After a mean follow-up of 42 months, 16 patients (16%) developed breast fibrosis, mild in 15, severe in one, which resolved within 24 months. Two patients suffered of postoperative infection, and four developed a lyponecrosis in the treated area.

Conclusion. The first group of patients treated with ELIOT in the phase I–II trial are confirming the good impact of the procedure in terms of tolerance and quality of life.

Keywords

breast carcinoma conservative surgery intraoperative radiotherapy local control treatment toxicity 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Veronesi, U, Orecchia, R, Luini, A,  et al. 2001A preliminary report of intraoperative radiotherapy (IORT) in limited-stage breast cancers that are conservatively treatedEur J Cancer3721782183CrossRefPubMedGoogle Scholar
  2. 2.
    Intra, M, Gatti, G, Luini, A,  et al. 2002Surgical technique of intraoperative radiotherapy in conservative treatment of limited-stage breast cancerArch Surg137737740CrossRefPubMedGoogle Scholar
  3. 3.
    Veronesi, U, Marubini, E, Mariani, L,  et al. 2001Radiotherapy after breast-conserving surgery in small breast carcinoma: long-term results of a randomized trialAnn Oncol129971003CrossRefPubMedGoogle Scholar
  4. 4.
    Baglan, KL, Martinez, AA, Frazier, RC,  et al. 2001The use of high-dose-rate brachytherapy alone after lumpectomy in patients with early-stage breast cancer treated with breast-conserving therapyInt J Radiat Oncol Biol Phys5010031011CrossRefPubMedGoogle Scholar
  5. 5.
    Polgar C, Sulyok Z, Orosz Z, et al. (2002): Sole brachytherapy of the tumour bed after conservative surgery for T1 breast cancer: five-year results of a phase I–II study and initial findings of a randomized phase III trial. J Surg Oncol 80: 121–128; discussion 129Google Scholar
  6. 6.
    Ribeiro, GG, Magee, B, Swindell, R,  et al. 1993The Christie Hospital breast conservation trial: an update at 8 years from inceptionClin Oncol5278283CrossRefGoogle Scholar
  7. 7.
    Magee, B, Swindell, R, Harris, M,  et al. 1996Prognostic factors for breast recurrence after conservative breast surgery and radiotherapy: results from a randomised trialRadiother Oncol39223227CrossRefPubMedGoogle Scholar
  8. 8.
    McBain, CA, Young, EA, Swindell, R,  et al. 2003Local recurrence of breast cancer following surgery and radiotherapy: incidence and outcomeClin Oncol (R Coll Radiol)152531Google Scholar
  9. 9.
    Vicini, F, Baglan, K, Kestin, L,  et al. 2002The emerging role of brachytherapy in the management of patients with breast cancerSemin Radiat Oncol123139CrossRefPubMedGoogle Scholar
  10. 10.
    Vaidya, JS, Baum, M, Tobias, JS,  et al. 2001Targeted intra-operative radiotherapy (Targit): an innovative method of treatment for early breast cancerAnn Oncol1210751080CrossRefPubMedGoogle Scholar
  11. 11.
    Kuerer, HM, Julian, TB, Strom, EA,  et al. 2004Accelerated partial breast irradiation after conservative surgery for breast cancerAnn Surg239338351CrossRefPubMedGoogle Scholar
  12. 12.
    Orecchia, R, Ciocca, M, Lazzari, R,  et al. 2003Intraoperative radiation therapy with electrons (ELIOT) in early-stage breast cancerBreast12483490CrossRefPubMedGoogle Scholar
  13. 13.
    Veronesi, U, Gatti, G, Luini, A,  et al. 2003Full dose intraoperative radiotherapy with electrons during breast-conserving surgeryArch Surg13812631266CrossRefGoogle Scholar
  14. 14.
    Wallner, P, Arthur, D, Bartelink, H,  et al. 2004Workshop on partial breast irradiation: state of the art and the science, Bethesda, MD, December 8–10, 2002J Natl Cancer Inst.96175184PubMedGoogle Scholar
  15. 15.
    Mariani, L, Salvadori, B, Marubini, E,  et al. 1998Ten year results of a randomised trial comparing two conservative treatment strategies for small size breast cancerEur J Cancer3411561162CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Alberto Luini
    • 1
    • 2
    • 6
  • Roberto Orecchia
    • 2
    • 3
  • Giovanna Gatti
    • 1
    • 4
  • Mattia Intra
    • 1
  • Mario Ciocca
    • 5
  • Viviana Galimberti
    • 1
  • Paolo Veronesi
    • 1
    • 2
  • Gabriela Rosali dos Santos
    • 1
  • Daniela Gilardi
    • 1
  • Umberto Veronesi
    • 1
  1. 1.Division of Breast SurgeryUniversity of MilanMilanItaly
  2. 2.University of MilanMilanItaly
  3. 3.Division of RadiotherapyEuropean Institute of OncologyMilanItaly
  4. 4.Postgraduate School of General SurgeryUniversity of PerugiaPerugiaItaly
  5. 5.Unit of Medical PhysicsEuropean Institute of OncologyMilanItaly
  6. 6.Division of Breast SurgeryEuropean Institute of OncologyMilanItaly

Personalised recommendations