Long-term Follow-up of Patients Treated with Whole-Breast External Beam Radiotherapy or Intraoperative Radiotherapy After Breast-Conserving Surgery
| Author | Farzam Shahpouri | en |
| Author | Farzin Roozafzai | en |
| Author | Atieh Akbari | en |
| Author | Mehrdad Daliri | en |
| Author | Mohammad Esmaeil Akbari | en |
| Author | Reza Valiandoost | en |
| Orcid | Farzam Shahpouri [0009-0002-3203-0151] | en |
| Orcid | Farzin Roozafzai [0000-0003-1366-9830] | en |
| Orcid | Atieh Akbari [0000-0001-5628-0409] | en |
| Orcid | Mehrdad Daliri [0000-0002-3009-3880] | en |
| Orcid | Mohammad Esmaeil Akbari [0000-0002-9938-3587] | en |
| Orcid | Reza Valiandoost [0009-0002-7395-9135] | en |
| Accessioned Date | 2026-11-03T11:01:53Z | |
| Issued Date | 2026-12-31 | en |
| Abstract | Background: Breast-conserving surgery with radiotherapy is the standard treatment for breast cancer. Because of the duration and complications of external beam radiotherapy (EBRT), patients may prefer mastectomy. Intraoperative radiotherapy (IORT) shortens treatment duration and may reduce radiation-related complications. Objectives: To investigate whether IORT was noninferior to EBRT by assessing breast cancer recurrence during follow-up among patients treated at a single research center. Methods: In this prospective cohort, 9,749 patients were followed for up to 10 years after breast-conserving surgery and radiotherapy. The outcome was breast cancer recurrence. External beam radiotherapy was delivered to 8,812 participants. Intraoperative radiotherapy was administered according to the Iranian IORT consensus criteria. A total of 541, 305, 66, and 25 patients received boost intraoperative electron radiotherapy (IOeRT), radical IOeRT, boost intraoperative 50 kV X-ray radiotherapy (IOxRT), and radical IOxRT, respectively. Independent-samples t tests, chi-square tests, and Fisher's exact tests were used to compare patients with and without recurrence. Predictors of recurrence were evaluated using univariate and multivariate logistic regression. Kaplan-Meier analysis assessed recurrence-free survival. Results: During follow-up, breast cancer recurred in 353 participants. Among these patients, the mean time to recurrence was 40.5 months (95% confidence interval, 37.0 - 44.0). Recurrence rates were 3.67% in the EBRT group and 3.09% in the IORT group, with no significant difference (P = 0.408). Within the IORT group, recurrence rates were 4.6% after boost IOeRT and 1.3% after radical IOeRT; no recurrences occurred after boost or radical IOxRT. Disease-free survival was comparable between EBRT and boost IOeRT but was better after IOxRT and radical IOeRT. Conclusions: Intraoperative radiotherapy was noninferior to EBRT. Boost IOeRT yielded outcomes comparable to those of EBRT, whereas IOxRT and radical IOeRT were associated with lower recurrence rates and improved disease-free survival, supporting their use. | en |
| DOI | https://doi.org/10.5812/ijcm-175391 | en |
| URI | https://brieflands.com/journals/ijcm/articles/175391 | en |
| Keyword | Accelerated Partial Breast Irradiation | en |
| Keyword | Breast Cancer | en |
| Keyword | Intraoperative Radiotherapy | en |
| Keyword | Recurrence | en |
| Publisher | Brieflands | en |
| Title | Long-term Follow-up of Patients Treated with Whole-Breast External Beam Radiotherapy or Intraoperative Radiotherapy After Breast-Conserving Surgery | en |
| Type | Research Article | en |
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