Purpose: External beam radiotherapy (EBRT) after conservative surgery for early breast cancer requires 5-7 weeks. For elderly patients and those distant from an RT center, attending for EBRT may be difficult or impossible. We investigated local toxicity, cosmetic outcomes, and quality of life in a new breast irradiation technique-intraoperative avidination for radionuclide therapy (IART)-in which avidin is administered to the tumor bed and 90Y-labelled biotin later administered intravenously to bind the avidin and provide irradiation. Reduced duration EBRT (40 Gy) is given subsequently. Methods: After surgery, 50 (ten patients), 100 (15 patients) or 150 mg (ten patients) of avidin was injected into the tumor bed. After 12-24 h, 3.7 GBq 90Y-biotin (beta source for therapeutic effect) plus 185 MBq 111In-biotin (gamma source for imaging and dosimetry) was infused slowly. Whole-body scintigraphy and SPECT/CT images were taken for up to 30 h. Shortened EBRT started 4 weeks later. Local toxicity was assessed by RTOG scale; quality of life was assessed by EORTC QOL-30. Results: Of 35 patients recruited (mean age 63 years; range 42-74) 32 received IART plus EBRT. 100 mg avidin provided 19.5±4.0 Gy to the tumor bed and was considered the optimum dose. No side-effects of avidin or 90Y-biotin occurred, with no hematological or local toxicity. Local G3 toxicity occurred in 3/32 patients during EBRT. IART plus EBRT was well accepted, with good cosmetic outcomes and maintained quality of life. Conclusions: IART plus reduced EBRT can accelerate irradiation after conservative breast surgery. © 2009 Springer-Verlag.

Intraoperative avidination for radionuclide treatment as a radiotherapy boost in breast cancer: Results of a phase II study with 90Y-labeled biotin

Paganelli, Giovanni
;
2010

Abstract

Purpose: External beam radiotherapy (EBRT) after conservative surgery for early breast cancer requires 5-7 weeks. For elderly patients and those distant from an RT center, attending for EBRT may be difficult or impossible. We investigated local toxicity, cosmetic outcomes, and quality of life in a new breast irradiation technique-intraoperative avidination for radionuclide therapy (IART)-in which avidin is administered to the tumor bed and 90Y-labelled biotin later administered intravenously to bind the avidin and provide irradiation. Reduced duration EBRT (40 Gy) is given subsequently. Methods: After surgery, 50 (ten patients), 100 (15 patients) or 150 mg (ten patients) of avidin was injected into the tumor bed. After 12-24 h, 3.7 GBq 90Y-biotin (beta source for therapeutic effect) plus 185 MBq 111In-biotin (gamma source for imaging and dosimetry) was infused slowly. Whole-body scintigraphy and SPECT/CT images were taken for up to 30 h. Shortened EBRT started 4 weeks later. Local toxicity was assessed by RTOG scale; quality of life was assessed by EORTC QOL-30. Results: Of 35 patients recruited (mean age 63 years; range 42-74) 32 received IART plus EBRT. 100 mg avidin provided 19.5±4.0 Gy to the tumor bed and was considered the optimum dose. No side-effects of avidin or 90Y-biotin occurred, with no hematological or local toxicity. Local G3 toxicity occurred in 3/32 patients during EBRT. IART plus EBRT was well accepted, with good cosmetic outcomes and maintained quality of life. Conclusions: IART plus reduced EBRT can accelerate irradiation after conservative breast surgery. © 2009 Springer-Verlag.
2010
Paganelli, Giovanni; De Cicco, Concetta; Ferrari, Mahila E.; Carbone, Giuseppe; Pagani, Gianmatteo; Leonardi, Maria Cristina; Cremonesi, Marta; Ferrari, Annamaria; Pacifici, Monica; Di Dia, Amalia; De Santis, Rita; Galimberti, Viviana; Luini, Alberto; Orecchia, Roberto; Zurrida, Stefano; Veronesi, Umberto
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/2378406
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