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Intraoperative Radiation Allows Lumpectomy Patients to Skip Boost

Intraoperative Radiation Allows Lumpectomy Patients to Skip Boost

TOLEDO, Ohio—Researchers at the Medical College of Ohio have treated a series of breast-conservation patients with intraoperative electron beam radiation to the tumor bed, in conjunction with a course of 45 to 50 Gy of external beam radiation.

With this technique, "you can eliminate the boost dose at the end of radiation therapy, thus shortening the course of external beam radiation by eight days," Joyce A. Battle, MD, assistant professor of radiation therapy, said in her poster presentation.

The study began in 1984 under the auspices of Ralph R. Dobelbower, MD, PhD, chairman, Department of Radiation Therapy. Dr. Battle reported on the first 21 patients, all with stage I and II disease, and ranging in age from 33 to 75 years. "There have been no local recurrences with this treatment, with follow-up of 11 years," Dr. Battle said. Two patients have died of distant disease, including the youngest patient, whose disease was very virulent, and one patient has been lost to follow-up.

The Ohio team has now treated 25 patients with intraoperative radiation at a dose of 10 or 15 Gy. Said Dr. Battle: "Our center and a center in Montpellier, France, are the only two that I know of that are doing intraoperative boost radiation to the tumor bed for early-stage conservative treatment."

The technique requires a surgeon who is willing to work in the intraoperative radiotherapy suite. "Dr. H. W. Merrick has performed all but two of these procedures," she said, "but with the recent addition of another surgical oncologist, we may do more."

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