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The case against IORT in the management of early stage breast cancer

  • Chirag Shah
    Correspondence
    Corresponding author. 9500 Euclid Avenue, CA 5-162, Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, 44195.
    Affiliations
    Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
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Published:October 11, 2022DOI:https://doi.org/10.1016/j.brachy.2022.08.010
      Since the development of breast conserving therapy (BCT) that incorporated standard fractionation whole breast irradiation (WBI) delivered daily over 5–7 weeks, there has been a concerted effort to shorten the duration of adjuvant radiation therapy as a way to improve convenience and compliance, reduce costs, and potentially reduce toxicities. Over the past decade, an unprecedent shift in breast radiation techniques and regimens has led to the emergence of shorter courses of WBI (5–15 fractions) as well as partial breast approaches which also reduce treatment duration to 1–3 weeks. However, the ultimate short course radiation therapy approach would be a single fraction of treatment; intraoperative radiation therapy (IORT) offers this potential. However, at this time, the data available supports that IORT is not an appropriate option for patients with early stage breast cancer.

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      Linked Article

      • The case for risk-stratified IORT for early breast cancer
        BrachytherapyVol. 21Issue 6
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          Despite the significant advancement in local and systemic therapies, breast cancer remains the second leading cause of women cancer deaths (1). While adjuvant radiation therapy remains an integral part of breast cancer management (2), de-escalation strategies are increasingly being investigated. Radiation therapy de-escalation approaches entails fewer treatment days (hypofractionation), smaller target volume (partial breast irradiation -PBI-), or both (accelerated partial breast irradiation -APBI-).
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