Pre- and Intraoperative Factors Influencing Omission of Planned Intraoperative Radiation Therapy As a Boost for Breast Cancer Patients Undergoing Breast Conserving Treatment

Author(s):  
J.W. Kim ◽  
Y. Cho ◽  
I.J. Lee
2020 ◽  
Vol 62 (1) ◽  
pp. 110-118
Author(s):  
Isabel Linares-Galiana ◽  
Miguel Angel Berenguer-Frances ◽  
Rut Cañas-Cortés ◽  
Monica Pujol-Canadell ◽  
Silvia Comas-Antón ◽  
...  

Abstract A detailed understanding of the interactions and the best dose-fractionation scheme of radiation to maximize antitumor immunity have not been fully established. In this study, the effect on the host immune system of a single dose of 20 Gy through intraoperative radiation therapy (IORT) on the surgical bed in low-risk breast cancer patients undergoing conserving breast cancer has been assessed. Peripheral blood samples from 13 patients were collected preoperatively and at 48 h and 3 and 10 weeks after the administration of radiation. We performed a flow cytometry analysis for lymphocyte subpopulations, natural killer cells (NK), regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSCs). We observed that the subpopulation of NK CD56+high CD16+ increased significantly at 3 weeks after IORT (0.30–0.42%, P < 0.001), while no changes were found in immunosuppressive profile, CD4+CD25+Foxp3+Helios+ Treg cells, granulocytic MDSCs (G-MDSCs) and monocytic MDSCs (Mo-MDSCs). A single dose of IORT may be an effective approach to improve antitumor immunity based on the increase in NK cells and the non-stimulation of immunosuppressive cells involved in immune escape. These findings support future combinations of IORT with immunotherapy, if they are confirmed in a large cohort of breast cancer patients.


2016 ◽  
Vol 23 (10) ◽  
pp. 3304-3309 ◽  
Author(s):  
Melinda Epstein ◽  
Melvin Silverstein ◽  
Kevin Lin ◽  
Brian Kim ◽  
Sadia Khan ◽  
...  

2017 ◽  
Vol Volume 9 ◽  
pp. 257-263 ◽  
Author(s):  
Sunil Dutta ◽  
Shayna Showalter ◽  
Timothy Showalter ◽  
Bruce Libby ◽  
Daniel Trifiletti

2018 ◽  
Vol 17 (4) ◽  
pp. 417-421
Author(s):  
Omid Baziar ◽  
Hamid Gholamhosseinian ◽  
Mohammad Naser Forghani

AbstractPurposeTo assess skin dose and incidence of skin reactions in early breast cancer patients treated via Intrabeam™ intraoperative radiation therapy (IORT) device.Materials and methodsIn total, 250 breast cancer patients treated with a single fraction of 20 Gy using 50 kV photon were recruited. The applicator to skin distance (ASD) was measured before the initiation of the radiation and the skin dose in each patient was accordingly calculated based on the treatment planning system (TPS).ResultsThe average skin doses calculated were equal to 7·91, 5·83, 3·96 and 2·14 Gy for 6–10, 10–15, 15–20 and 20–30 mm ASD values, respectively. It is noticeable that the skin doses could be lower than the TPS measurements up to 45%, mostly due to lack of backscatter radiation in breast tissue compared with the full scatter condition in the Zeiss water phantom. Finally, only three patients showed low-grade skin reactions 1 week after IORT. A review of the related literature also revealed the incidence of lower skin complications among patients treated via Intrabeam™ compared with MammoSite™ machine.ConclusionsThe Intrabeam™ TPS did not seem to be very reliable for accurate skin dosimetry. However, breast cancer treatment using Intrabeam™ could result in fewer incidences of skin reactions than MammoSite™ machine.


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