Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System-A Systematic Review and First Bulgarian Experience in Breast Cancer Patients.

Autor: Kostova-Lefterova D; Department of Medical Diagnostic Activities, Medical University-Pleven, 1 Saint Kliment Ohridski Str., 5800 Pleven, Bulgaria., Vasileva-Slaveva M; Department of Surgery, University Hospital Acibadem City Clinic Sofia, 66A Tsarigradsko Shose Str., 1784 Sofia, Bulgaria.; Women for Oncology-Bulgaria, 9000 Varna, Bulgaria., Maslyankov S; Department of Surgery, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria., Konsoulova A; Women for Oncology-Bulgaria, 9000 Varna, Bulgaria.; Department of Medical Oncology, Oncology Complex Center-Burgas, 86 Demokracia Str., 8000 Burgas, Bulgaria., Atanasova M; Department of Intensive Care, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria., Paycheva T; Department of Surgery, Military Medical Academy, 3 Georgi Sofiiski Str., 1431 Sofia, Bulgaria., Vlahova A; Department of Pathology, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria., Genadieva-Yordanova M; Department of Pathology, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria., Prodanova G; Department of Surgery, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria., Zahariev Z; Department of Radiotherapy, Uni Hospital, Panagyurishte, 100 Georgi Benkovski Str., 4500 Panagyurishte, Bulgaria., Pavlov V; Department of Surgery, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria., Todorov G; Department of Surgery, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria., Vasilev B; Department of Basic Training, University of Telecommunications and Post, 1 Acad. Stephan Mladenov Str., 1700 Sofia, Bulgaria., Angelov K; Department of Surgery, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria., Deliyski T; Department of Surgery, Medical University-Pleven, 1 Saint Kliment Ohridski Str., 5800 Pleven, Bulgaria.; Department of Surgical Oncology, Dr. Georgi Stranski University Hospital-Pleven, 8a Georgi Kochev Str., 5809 Pleven, Bulgaria., Petrova I; Department of Surgery, Medical University-Pleven, 1 Saint Kliment Ohridski Str., 5800 Pleven, Bulgaria.; Department of Surgical Oncology, Dr. Georgi Stranski University Hospital-Pleven, 8a Georgi Kochev Str., 5809 Pleven, Bulgaria., Hitova D; Department of Radiotherapy, Dr. Georgi Stranski University Hospital-Pleven, 8a Georgi Kochev Str., 5809 Pleven, Bulgaria., Petrov I; Department of Medical Physics, Heart and Brain University Hospital, 2 Pierre Curie Str., 5800 Pleven, Bulgaria.
Jazyk: angličtina
Zdroj: Current oncology (Toronto, Ont.) [Curr Oncol] 2021 Oct 03; Vol. 28 (5), pp. 3932-3944. Date of Electronic Publication: 2021 Oct 03.
DOI: 10.3390/curroncol28050335
Abstrakt: (1) Background: We aimed to analyze currently available studies with intraoperative radiotherapy (IORT) as a choice of treatment where the Xoft Axxent ® electronic brachytherapy (eBx) system was used as a single-dose irradiation and an exclusive radiotherapy approach at the time of surgery in patients with early breast cancer (EBC). We also compared the results of the systematic review to the Bulgarian experience. (2) Methods and Materials: We performed a systematic review of the studies published before February 2021, which investigate the application of a single-fraction 20 Gy radiation treatment, delivered at the time of lumpectomy in EBC patients with the Xoft Axxent ® eBx System. A systematic search in PubMed, Scopus, and ScienceDirect was performed. The results are reported following the PRISMA guidelines. The criteria on patients' selection for IORT (the additional need for EBRT), cosmetic outcomes, and recurrence rate from the eligible studies are compared to the treatment results in Bulgarian patients. (3) Results: We searched through 1032 results to find 17 eligible studies. There are no published outcomes from randomized trials. When reported, the cosmetic outcomes in most of the studies are defined as excellent. The observed recurrence rate is low (1-5.8%). Still, the number of patients additionally referred to postoperative external breast radiotherapy (EBRT) is up to 31%. Amongst the 20 patients treated in Bulgaria, the cosmetic outcomes are also evaluated as excellent, five of which (25%) are referred for EBRT. Within median follow-up of 39 months, there was one local and one distal recurrence. (4) Conclusions: Current evidence demonstrates the Xoft Axxent ® eBx system as a safe and feasible technique for IORT delivery in EBC patients. There are no randomized controlled trials conducted at this time point to prove its long-term effectiveness. Better patient selection and a reimbursement strategy have to be proposed to extend the application of this technique in Bulgaria.
Databáze: MEDLINE
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