Targeted Intraoperative Radiotherapy and Persistent Pain After Treatment

 

EBRT

IORT

p (95 % CI)

Total

No. (%)

112 (47.1)

126 (52.9)
 
238

Non-responders

4

0
 
4

Age, years (mean)

65.74 (SD 6.17)

64.76 (SD 6.45)

0.23 (−0.64–2.60)

65.22 (SD 6.33)

Follow-up, months (mean)

17.06 (SD 10.39)

17.36 (10.64)

0.87

17.22 (SD 10.50)

Endocrine therapy, n (%)
  
0.28
 
No ET

95 (84.8)

99 (79.4)
 
194 (81.9)

AI

17 (15.2)

26 (20.6)
 
43 (18.1)

TAM

0

0
 
0

Unknown

0

0
 
0

Tumour size, mm (mean)

10.75 (SD 3.59)

10.65 (SD 4.14)

0.85 (−0.91–1.12)

10.70 (SD 3.89)

Lymph nodes (mean)

2.32 (SD 1.44)

2.24 (SD 1.33)

0.67

2.28 (SD 1.38)

WHO, n (%)

Invasive ductal

94 (83.9)

106 (84.1)
 
200 (84.0)

Invasive lobular

1 (0.9)

0
 
1 (0.4)

Mucinous

5 (4.5)

6 (4.8)
 
11 (4.6)

Medullary

0

0
 
0

Papillary

1 (0.9)

3 (2.4)
 
4 (1.7)

Tubular

5 (4.5)

8 (6.3)
 
13 (5.4)

Others

3 (2.7)

2 (1.6)
 
5 (2.1)

Unknown

3 (2.7)

1 (0.8)
 
4 (1.7)


EBRT external beam radiotherapy to the breast, IORT intraoperative radiotherapy, ET endocrine therapy, AI aromatase inhibitor, TAM tamoxifen



The prevalence of pain was 33.9 % in the EBRT group and 24.6 % in the IORT group (p = 0.11) (Table 11.2). Pain localisation was similar in the two groups. Pain intensity was low for most patients and was not significantly different between the two groups: of the patients who experienced pain, 71 % in the EBRT group and 77 % in the IORT group scored 3 or lower on the numerical rating scale. As regards frequency of pain, 86.8 % of the patients reporting pain in the EBRT group said that they experienced pain on a weekly basis or more often, versus 64.5 % of the IORT patients (p = 0.044). The prevalence of pain elsewhere (outside the treatment area) was higher in the IORT group than in the EBRT group (40.7 % vs. 26.4 %) (p = 0.027). The prevalence of sensory disturbances was similar in the two groups.


Table 11.2
Persistent pain after breast cancer treatment in the EBRT and IORT groups (Andersen et al. 2012)







































































































































 
EBRT
IORT
p
Total

Reporting pain, n (%)
38 (33.9)
31 (24.6)
0.11
69 (29.0)

cont. OR (95 % CI)
1.57 (0.90–2.77)
1
    

Localisation, n (%)

Breast
31 (81.6)
26 (83.9)
0.80
57 (82.6)

Side of the chest
12 (31.6)
6 (19.4)
0.25
18 (26.1)

Axilla
19 (50.0)
12 (38.7)
0.35
31 (44.9)

Arm
5 (13.2)
7 (22.6)
0.30
12 (17.4)

Pain in more than 1 area, n (%)
21 (55.3)
15 (48.4)
0.57
36 (52.2)

NRS (median, IQR)

Worst (overall)a

3 (2)
3 (1)
0.87
  

Breast
2 (1)
3 (1)
0.98
  

Side of the chest
2,5 (3)
2 (2)
1.00
  

Axilla
2 (2)
2 (2)
0.69
  

Arm
5 (6)
4 (4)
0.68
  

Worst pain, n (%)b
   
0.59
  

Light pain
27 (71.0)
24 (77.4)
  
51 (73.9)

Moderate pain
10 (26.3)
7 (22.6)
  
17 (24.6)

Severe pain
1 (2.6)
0
  
1 (1.4)

Frequency of worst pain, n (%)
    
0.090
  

Daily
19 (50.0)
11 (35.5)
  
30 (43.5)

1–3 day/week
14 (36.8)
9 (29.0)
  
23 (33.3)

Less

Only gold members can continue reading. Log In or Register to continue

Related posts:

Targeted Intraoperative Radiotherapy: Concept and Review of Evidence in Breast Cancer Follow-Up Findings in the Tumour Bed After IORT – What the Radiologist Needs to Know Treating Patients with TARGIT Intra Operative Radiotherapy in Developing Countries: Experience with TARGIT from University of Dammam, Saudi Arabia Intraoperative Photon Radiosurgery in Patients with Malignant Brain Tumours Radiobiology

Stay updated, free articles. Join our Telegram channel
Tags:
Sep 3, 2016 | Posted by in GENERAL RADIOLOGY | Comments Off on Targeted Intraoperative Radiotherapy and Persistent Pain After Treatment

Full access? Get Clinical Tree

 Get Clinical Tree app for offline access