¿Se puede realizar la radioterapia intraoperatoria de forma asistencial en el tratamiento del cáncer de mama en estadios iniciales?

Abstract

After conservative surgery in breast cancer adjuvant radiation therapy is indicated, such treatment can be performed as partial irradiation in well-selected cases and without risk factors for local relapse following the guidelines of international consensus. Partial irradiation is performed by several techniques such as interstitial brachytherapy, external radiation therapy, and also through intraoperative radiation therapy techniques at the same surgical act due to mobile electron accelerators or low-energy photons units. This allows local treatment to be performed in a single day, increasing the surgical time, but with advantages in terms of the tumor bed localization accuracy, immediacy of irradiation and greater patient satisfaction. There is extensive experience in the use of this technique with results comparable to other ways of partial irradiation in terms of local control, minimal side effects, good cosmetic results and even better no cancer related survival. This article reviews the evidence in the use of intraoperative radiation therapy in early-stage breast cancer derived from the main trials comparing it to whole breast irradiation, to confirm that it is already available for standard of care practice in patients who are candidates for partial irradiation.