Intraoperative radiotherapy in the conventional linear accelerator room for early breast cancer treatment: an alternative choice in developing countries.

摘要

Intraoperative radiotherapy with a single dose of electrons (ELIOT) in the conservative treatment of breast cancer is a possibility under evaluation in clinical trials. The costs of the mobile linear accelerator with a robotic arm, used in intraoperative radiotherapy, are prohibitive for poor countries. The aim of this study was to evaluate the feasibility of ELIOT in the accelerator room of the Radiotherapy Service for early breast cancer treatment. We analyzed 40 patients submitted to breast conservative surgery and ELIOT, in the accelerator room of the Radiotherapy Service at the Hospital of Pontificia Universidade Catolica do Rio Grande do Sul in Brazil from January 2004 to July 2005. Patients with unifocal breast carcinoma smaller than 25 mm, aged over 45 years, who were candidates for conservative surgery were selected and a total dose of 21Gy was delivered, without further radiotherapy. In the short-term follow-up (median 18 months), six patients (15%) presented with some grade of fibrosis underthe scar. One case (2.5%) of local recurrence was reported. There are no cases of contralateral carcinoma or distant metastases so far. Our data show that intraoperative radiotherapy with electrons can be safely performed in an accelerator room with a conventional machine.