Steve Marks, PhD*
*President, MedCom Consultants, Inc, Potomac MD
Address correspondence to: Steven Marks, MedCom Consultants Inc, 1311 Fallsmead Way, Potomac MD 20854. Email: email@example.com
Disclosure statement: Steven Marks reports having no financial or advisory relationship with any corporate, medical, or political organization doing work related to this paper or other business activity at MedCom Consultants, Inc.
Over the past several decades, the use of radiotherapy has contributed to declining mortality rates from breast cancer in patients in Western countries. Accelerated partial breast irradiation (APBI) has become a proven means to avoid total mastectomy in appropriate women with early stage disease by targeting radiation to the borders of the lumpectomy bed, thereby sparing normal tissue. Intraoperative radiation therapy (IORT) is a form of single-dose APBI that's delivered at the time of surgery, directing the radiation closely to the tumor bed and reducing the risk of exposure to nearby organs such as the heart and lungs. Results from well-controlled studies support the use of IORT in appropriate patients, demonstrating low rates of recurrence and acceptable toxicity. Patient-preference research also is highly favorable, as is the cost-effectiveness of treatment. Although some concerns regarding the utility of IORT have been raised, ongoing research is working to clarify outstanding questions regarding patient selection, treatment timing, delivery (single-dose or boost), and emerging breast cancer indications.
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