Intraoperative Radiation Allows Lumpectomy Patients to Skip Boost

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

With this technique, "you can eliminate the boost dose at the endof radiation therapy, thus shortening the course of external beam radiationby eight days," Joyce A. Battle, MD, assistant professor of radiationtherapy, 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 onthe first 21 patients, all with stage I and II disease, and ranging inage from 33 to 75 years. "There have been no local recurrences withthis treatment, with follow-up of 11 years," Dr. Battle said. Twopatients 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 radiationat a dose of 10 or 15 Gy. Said Dr. Battle: "Our center and a centerin Montpellier, France, are the only two that I know of that are doingintraoperative boost radiation to the tumor bed for early-stage conservativetreatment."

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