Doctors investigating one stop shop radiotherapy at time of surgery

A new radiotherapy technique that can be carried out at the time of surgery and avoids long drawn out sessions of treatment may prove better at preventing the cancer returning in the breast and also bring breast conservation surgery within the reach of women in developing countries.

But, although intraoperative radiotherapy appears promising enough to be tested against traditional external beam radiotherapy in some cases, it is still far too early to be advised as standard treatment, Dr Emiel Rutgers told a news briefing at the 3rd European Breast Cancer Conference in Barcelona.

Reports on 3 studies - from the European Institute of Oncology in Milan (101 patients), the Institute of Oncology in Madrid (21 patients) and University College, London (26 patients) are being presented to delegates at the conference. They describe how specially designed portable radiotherapy equipment delivers a concentrated electron beam to the area of the breast from which the tumour has been removed. The Milan Institute and University College now have randomised trials under way comparing introperative radiotherapy with conventional radiotherapy.

Dr. Rutgers, surgical oncologist at the Netherlands Cancer Institute in Amsterdam, said that traditional breast conserving surgery involved excision of the tumour followed by external beam radiotherapy of the whole breast. This can involve 20 to 25 separate visits to the radiotherapy department. It was usual now to give an extra boost to the site of the tumour either by external beam over 4 to 6 sessions or by implants. If implants were given after the course of radiotherapy that meant an extra hospital admission and anaesthesia for placing the needles (although this method had become less popular because of the problem of scar tissue after treatment). A major international trial comparing external radiation with or without a boost dose recently showed that a boost dose reduced the risk of recurrence in the affected

Contact: Margaret Willson
Federation of European Cancer Societies

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