Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System—A Systematic Review and First Bulgarian Experience in Breast Cancer Patients
(1) Background: We aimed to analyze currently available studies with intraoperative radiotherapy (IORT) as a choice of treatment where the Xoft Axxent<sup>®</sup> electronic brachytherapy (eBx) system was used as a single-dose irradiation and an exclusive radiotherapy approach at the tim...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/28/5/335 |
| _version_ | 1797514896423780352 |
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| author | Desislava Kostova-Lefterova Mariela Vasileva-Slaveva Svilen Maslyankov Assia Konsoulova Margarita Atanasova Tsvetelina Paycheva Alexandrina Vlahova Marusya Genadieva-Yordanova Ginka Prodanova Zahari Zahariev Vasil Pavlov Georgi Todorov Boris Vasilev Kostadin Angelov Tashko Deliyski Ivelina Petrova Desislava Hitova Ivo Petrov |
| author_facet | Desislava Kostova-Lefterova Mariela Vasileva-Slaveva Svilen Maslyankov Assia Konsoulova Margarita Atanasova Tsvetelina Paycheva Alexandrina Vlahova Marusya Genadieva-Yordanova Ginka Prodanova Zahari Zahariev Vasil Pavlov Georgi Todorov Boris Vasilev Kostadin Angelov Tashko Deliyski Ivelina Petrova Desislava Hitova Ivo Petrov |
| author_sort | Desislava Kostova-Lefterova |
| collection | DOAJ |
| description | (1) Background: We aimed to analyze currently available studies with intraoperative radiotherapy (IORT) as a choice of treatment where the Xoft Axxent<sup>®</sup> electronic brachytherapy (eBx) system was used as a single-dose irradiation and an exclusive radiotherapy approach at the time of surgery in patients with early breast cancer (EBC). We also compared the results of the systematic review to the Bulgarian experience. (2) Methods and Materials: We performed a systematic review of the studies published before February 2021, which investigate the application of a single-fraction 20 Gy radiation treatment, delivered at the time of lumpectomy in EBC patients with the Xoft Axxent<sup>®</sup> eBx System. A systematic search in PubMed, Scopus, and ScienceDirect was performed. The results are reported following the PRISMA guidelines. The criteria on patients’ selection for IORT (the additional need for EBRT), cosmetic outcomes, and recurrence rate from the eligible studies are compared to the treatment results in Bulgarian patients. (3) Results: We searched through 1032 results to find 17 eligible studies. There are no published outcomes from randomized trials. When reported, the cosmetic outcomes in most of the studies are defined as excellent. The observed recurrence rate is low (1–5.8%). Still, the number of patients additionally referred to postoperative external breast radiotherapy (EBRT) is up to 31%. Amongst the 20 patients treated in Bulgaria, the cosmetic outcomes are also evaluated as excellent, five of which (25%) are referred for EBRT. Within median follow-up of 39 months, there was one local and one distal recurrence. (4) Conclusions: Current evidence demonstrates the Xoft Axxent<sup>®</sup> eBx system as a safe and feasible technique for IORT delivery in EBC patients. There are no randomized controlled trials conducted at this time point to prove its long-term effectiveness. Better patient selection and a reimbursement strategy have to be proposed to extend the application of this technique in Bulgaria. |
| first_indexed | 2024-03-10T06:38:02Z |
| format | Article |
| id | doaj.art-de42e7803a764ac9985d15998c88ba45 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T06:38:02Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-de42e7803a764ac9985d15998c88ba452023-11-22T17:55:10ZengMDPI AGCurrent Oncology1198-00521718-77292021-10-012853932394410.3390/curroncol28050335Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System—A Systematic Review and First Bulgarian Experience in Breast Cancer PatientsDesislava Kostova-Lefterova0Mariela Vasileva-Slaveva1Svilen Maslyankov2Assia Konsoulova3Margarita Atanasova4Tsvetelina Paycheva5Alexandrina Vlahova6Marusya Genadieva-Yordanova7Ginka Prodanova8Zahari Zahariev9Vasil Pavlov10Georgi Todorov11Boris Vasilev12Kostadin Angelov13Tashko Deliyski14Ivelina Petrova15Desislava Hitova16Ivo Petrov17Department of Medical Diagnostic Activities, Medical University—Pleven, 1 Saint Kliment Ohridski Str., 5800 Pleven, BulgariaDepartment of Surgery, University Hospital Acibadem City Clinic Sofia, 66A Tsarigradsko Shose Str., 1784 Sofia, BulgariaDepartment of Surgery, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, BulgariaWomen for Oncology—Bulgaria, 9000 Varna, BulgariaDepartment of Intensive Care, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, BulgariaDepartment of Surgery, Military Medical Academy, 3 Georgi Sofiiski Str., 1431 Sofia, BulgariaDepartment of Pathology, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, BulgariaDepartment of Pathology, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, BulgariaDepartment of Surgery, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, BulgariaDepartment of Radiotherapy, Uni Hospital, Panagyurishte, 100 Georgi Benkovski Str., 4500 Panagyurishte, BulgariaDepartment of Surgery, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, BulgariaDepartment of Surgery, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, BulgariaDepartment of Basic Training, University of Telecommunications and Post, 1 Acad. Stephan Mladenov Str., 1700 Sofia, BulgariaDepartment of Surgery, Alexandrovska University Hospital, 1 Georgi Sofiiski Str., 1431 Sofia, BulgariaDepartment of Surgery, Medical University—Pleven, 1 Saint Kliment Ohridski Str., 5800 Pleven, BulgariaDepartment of Surgery, Medical University—Pleven, 1 Saint Kliment Ohridski Str., 5800 Pleven, BulgariaDepartment of Radiotherapy, Dr. Georgi Stranski University Hospital—Pleven, 8a Georgi Kochev Str., 5809 Pleven, BulgariaDepartment of Medical Physics, Heart and Brain University Hospital, 2 Pierre Curie Str., 5800 Pleven, Bulgaria(1) Background: We aimed to analyze currently available studies with intraoperative radiotherapy (IORT) as a choice of treatment where the Xoft Axxent<sup>®</sup> electronic brachytherapy (eBx) system was used as a single-dose irradiation and an exclusive radiotherapy approach at the time of surgery in patients with early breast cancer (EBC). We also compared the results of the systematic review to the Bulgarian experience. (2) Methods and Materials: We performed a systematic review of the studies published before February 2021, which investigate the application of a single-fraction 20 Gy radiation treatment, delivered at the time of lumpectomy in EBC patients with the Xoft Axxent<sup>®</sup> eBx System. A systematic search in PubMed, Scopus, and ScienceDirect was performed. The results are reported following the PRISMA guidelines. The criteria on patients’ selection for IORT (the additional need for EBRT), cosmetic outcomes, and recurrence rate from the eligible studies are compared to the treatment results in Bulgarian patients. (3) Results: We searched through 1032 results to find 17 eligible studies. There are no published outcomes from randomized trials. When reported, the cosmetic outcomes in most of the studies are defined as excellent. The observed recurrence rate is low (1–5.8%). Still, the number of patients additionally referred to postoperative external breast radiotherapy (EBRT) is up to 31%. Amongst the 20 patients treated in Bulgaria, the cosmetic outcomes are also evaluated as excellent, five of which (25%) are referred for EBRT. Within median follow-up of 39 months, there was one local and one distal recurrence. (4) Conclusions: Current evidence demonstrates the Xoft Axxent<sup>®</sup> eBx system as a safe and feasible technique for IORT delivery in EBC patients. There are no randomized controlled trials conducted at this time point to prove its long-term effectiveness. Better patient selection and a reimbursement strategy have to be proposed to extend the application of this technique in Bulgaria.https://www.mdpi.com/1718-7729/28/5/335early breast cancerintraoperative radiotherapyelectronic brachytherapyAxxent electronic brachytherapy |
| spellingShingle | Desislava Kostova-Lefterova Mariela Vasileva-Slaveva Svilen Maslyankov Assia Konsoulova Margarita Atanasova Tsvetelina Paycheva Alexandrina Vlahova Marusya Genadieva-Yordanova Ginka Prodanova Zahari Zahariev Vasil Pavlov Georgi Todorov Boris Vasilev Kostadin Angelov Tashko Deliyski Ivelina Petrova Desislava Hitova Ivo Petrov Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System—A Systematic Review and First Bulgarian Experience in Breast Cancer Patients Current Oncology early breast cancer intraoperative radiotherapy electronic brachytherapy Axxent electronic brachytherapy |
| title | Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System—A Systematic Review and First Bulgarian Experience in Breast Cancer Patients |
| title_full | Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System—A Systematic Review and First Bulgarian Experience in Breast Cancer Patients |
| title_fullStr | Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System—A Systematic Review and First Bulgarian Experience in Breast Cancer Patients |
| title_full_unstemmed | Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System—A Systematic Review and First Bulgarian Experience in Breast Cancer Patients |
| title_short | Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System—A Systematic Review and First Bulgarian Experience in Breast Cancer Patients |
| title_sort | intraoperative radiotherapy with balloon based electronic brachytherapy system a systematic review and first bulgarian experience in breast cancer patients |
| topic | early breast cancer intraoperative radiotherapy electronic brachytherapy Axxent electronic brachytherapy |
| url | https://www.mdpi.com/1718-7729/28/5/335 |
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