SUMMARY

Introduction: radiotherapy is an essential part of combined cancer treatment, with growing interest in recent decades in techniques that irradiate only the portion of the breast at greatest risk of developing local recidivation. The philosophy is to achieve higher and more effective doses of radiation without increasing the incidence of adverse effects, since sensitive structures are mobilised and shielded when radiation is administered. Such techniques include intraoperative radiotherapy (IORT), which seeks to enhance local control of the disease by administering a single dose of ionising radiation directly to the tumour bed, thereby enabling dosages to be increased and toxicity decreased through less irradiation of healthy tissue.

Objectives: to assess the effectiveness of IORT as adjuvant or replacement treatment for the current standard treatment of breast cancer, in terms of recurrence, survival, cosmetic results and impact on quality of life; and to ascertain the safety of this procedure, in terms of acute and late toxicity.

Methods: a search of the scientific literature was conducted, from January 2000 to January 2013, in the main biomedical databases: Centre for Reviews and Dissemination (Health Technology Assessment, Database of Abstracts of Reviews of Effectiveness, NHS Economic Evaluation Database), Cochrane Plus Library, Medline, Embase, ISI Web of Knowledge, CSIC-Índice Médico Español, Clinical Trials Registry, WHO International Clinical Trials Registry Platform and Current Controlled Trials. This process was completed by a general search of quality Internet web pages. Two independent reviewers selected the papers in accordance with pre-established inclusion and exclusion criteria, with any disagreements being resolved by consensus. Lastly, a manual review was performed of the bibliographic references cited in the papers selected. The data were then extracted and summarised in evidence tables. Study quality was assessed using the National Health and Medical Research Council scale

Results, discussion and conclusions: see pdf below