Evidence map›Paper›PMID 33938966›Full record

ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2021

Intraoperative radiotherapy boost as part of breast-conservation therapy for breast cancer: a single-institution retrospective analysis.

Raluca Stoian, Thalia Erbes, Constantinos Zamboglou, Jutta Scholber, Mark Gainey, Ilias Sachpazidis, Erik Haehl, Simon K B Spohn, Vivek Verma, David Krug and 5 more

Open access · hybridAbstract read
In one paragraph

Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
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  5. IORT-photon boost plus hypofractionated whole breast irradiation in patients with breast cancer after primary systemic treatment: feasibility, safety and clinical results.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025
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  6. Major complications after intraoperative radiotherapy with low-energy x-rays in early breast cancer.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 2 countries.

Raluca StoianDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.
Thalia ErbesDepartment of Obstetrics and Gynecology, Medical Center, University of Freiburg, Freiburg, Germany.
Constantinos ZamboglouDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.
Jutta ScholberDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.
Mark GaineyDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.
Ilias SachpazidisDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.
Erik HaehlDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.
Simon K B SpohnDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.
Vivek VermaDepartment of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA, USA.
David KrugDepartment of Radiation Oncology, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
Alexander RühleDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.
Ingolf Juhasz-BössDepartment of Obstetrics and Gynecology, Medical Center, University of Freiburg, Freiburg, Germany.
Anca-Ligia GrosuDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.
Nils H NicolayDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.
Tanja SpraveDepartment of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany. tanja.sprave@uniklinik-freiburg.de.
University Medical Center Freiburg · DEGerman Cancer Research Center · DEHeidelberg University · DEAllegheny General Hospital · USUniversity Hospital Schleswig-Holstein · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are currently no data from randomized controlled trials on the use of intraoperative radiotherapy (IORT) as a tumor bed boost as part of a breast-conservation approach for breast cancer. This study retrospectively reviewed the safety and efficacy of IORT as a boost treatment at a tertiary cancer center.

methodsFrom 2015 to 2019, patients underwent breast-conserving surgery with axillary lymph node staging and a single dose of 20 Gy IORT with 50-kV photons, followed by whole-breast irradiation (WBI) and adjuvant systemic therapy (if applicable). Patients were followed for assessment of acute and late toxicities (using the Common Terminology Criteria for Adverse Events version 5.0) at 3-6-month intervals. Outcomes included ipsilateral (IBTR) and contralateral breast progression-free survival (CBE), distant metastasis-free survival (DMFS), and overall survival (OS).

resultsMedian follow-up for the 214 patients was 28 (range 2-59) months. Most patients had T1 disease (n = 124) and were clinically node negative. Only few patients had high-grade and/or triple-negative disease. The vast majority of patients underwent sentinel node biopsy, and 32 (15%) required re-resection for initially positive margins. Finally, all tumor bed margins were clear. Nine (4.2%) and 48 (22.4%) patients underwent neoadjuvant and adjuvant chemotherapy, respectively. WBI was predominantly performed as conventionally fractionated WBI (n = 187, 87.4%), and the median time from BCS to WBI was 54.5 days. IORT was delivered with a single dose of 20 Gy. The median WBI dose was 50 Gy (range 29.4-50.4 Gy). No patients experienced grade 4 events; acute grade 3 toxicities were limited to 17 (8%) cases of radiation dermatitis. Postoperative toxicities were mild. After WBI only one case of late grade ≥ 2 events was reported. There were two recurrences in the tumor bed and one contralateral breast event.

conclusionThis investigation provides additional preliminary data supporting the using of IORT in the boost setting and corroborates the existing literature. These encouraging results should be prospectively validated by the eventual publication of randomized studies such as TARGIT‑B.

Indexed as

Breast NeoplasmsMastectomy, SegmentalBreastFemaleHumansNeoplasm Recurrence, LocalRadiotherapy, AdjuvantRetrospective StudiesAdjuvant radiation therapyBoostBreast-conservation therapyEarly breast cancerIntraoperative radiotherapy

Identifiers

PMID33938966
PMCPMC8397646
OpenAlexW3158576988

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.