Affiliation:
1. Surgical Oncology Division, General Surgery Department Shiraz University of Medical Sciences Shiraz Iran
2. Breast Diseases Research Center Shiraz University of Medical Sciences Shiraz Iran
3. Student Research Committee Shiraz University of Medical Sciences Shiraz Iran
4. Poostchi Ophthalmology Research Center Shiraz University of Medical Sciences Shiraz Iran
5. Radiation Oncology, Radio‐Oncology Department, School of Medicine Shiraz University of Medical Sciences Shiraz Iran
Abstract
AbstractBackgroundIntraoperative radiotherapy (IORT) is an alternative for external beam radiotherapy (EBRT) for early stage breast cancer (BC). Herein, we compared outcomes, postoperative and post‐radiation complications of IORT and EBRT.MethodsWe conducted a cohort study to compare complications of IORT and EBRT in patients. A checklist of the complications of IORT and EBRT, was used to assess and post‐radiation complications and outcomes.ResultsOverall, 264 women (121 in IORT and 143 in EBRT group) with a mean (SD) age of 55 ± 8.6 years analyzed in this study. The IORT group (quadrantectomy + SLNB + IORT) had more severe post‐operative pain compared to the EBRT group (quadrantectomy + SLNB) (OR = 1.929, 95% CI: 1.116–3.332). Other postoperative complications, including edema, erythema, seroma, hematoma, and wound complications were not significantly different between the IORT and EBRT groups.EBRT was associated with higher rates post‐radiation complications, including erythema (95.8% vs. 21.5%), skin dryness (30.8% vs. 12.4%), pruritus (26.6% vs. 17.4%), hyperpigmentation (48.3% vs. 9.9%), and telangiectasia (1.4% vs. 0.8%). Multivariate analysis showed that erythema, skin dryness and pruritus, and hyperpigmentation were more severe in the EBRT group, while breast induration was higher in the IORT group (OR = 4.109, 95% CI: 2.242–7.531). Excellent, good, and fair cosmetic outcome was seen in 11.2%, 72%, and 16.8% of the patients in the EBRT group and 29.8%, 63.6%, and 6.6% in the IORT group, respectively, suggesting that the cosmetic outcome was significantly better in the IORT group (P < .001). There wasn't statistically significant difference in recurrence‐free survival and overall survival rates between two groups of patients who received either IORT or EBRT (P = .953, P = .56).ConclusionIORT is considered to have lower post‐radiation complications and better cosmetic outcomes in breast cancer patients. Therefore, IORT might be used as the treatment of choice in eligible patients.