Breast IORT reported less painful than EBRT

Intraoperative radiotherapy (IORT) treatments produced fewer incidents of pain that were less severe than external-beam radiotherapy (EBRT) treatments for breast cancer, according to women enrolled in a clinical trial comparing the two treatments. These findings were reported in the February issue of the journal Breast.

Persistent pain following breast cancer treatment is a commonly reported side effect. Researchers at the Rigshospitalet of the University of Copenhagen retrospectively questioned 238 women about incidences and severity of pain they experienced after they completed radiotherapy treatments.

The women had enrolled in the Targeted Intraoperative Radiotherapy Versus Whole Breast Radiotherapy for Breast Cancer (TARGIT-A) clinical trial, in which they were randomly assigned to receive either IORT or EBRT treatments following a lumpectomy from March 2007 through December 2009 (Breast, February 2012, Vol. 21:1, pp. 46-49).

All the women were postmenopausal, with a median age of 65. They were administered a questionnaire in which they were asked about prevalence of pain. Patients who replied affirmatively were asked to specify the location of the pain and its intensity on a 0-10 numeric scale, with 0 equating no pain and 10 the worst imaginable pain. They also were asked about the frequency of pain.

Fewer women who received IORT treatment, representing 47% of the group, reported less persistent pain in the breast area and fewer incidents of pain than women who received conventional radiotherapy treatment.

Specifically, 24.6% of the IORT group experienced persistent pain in the breast area, side of chest, axilla, or arm compared with 33.9% in the EBRT group. The majority of patients in both groups reported experiencing light pain, although 50% of the EBRT group reported that the pain occurred each day as compared with 35.5% in the IORT group.

Interestingly, more than 41% of the women who received IORT treatment stated that they experienced headaches, and neck, shoulder, or low back pain. Only 26% of the EBRT group reported these side effects. While these are commonly reported by patients taking aromatase inhibitors, both groups had a similar number of patients taking this drug. Lead author Dr. Kenneth Given Anderson of the section for surgical pathophysiology and colleagues, had no explanation for this difference.

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