INTRAOPERATIVE BREAST RADIOTHERAPY: A LOOK BEYOND THE THERAPEUTIC BENEFIT

Introduction: The success of cancer treatment requires patient adherence and easy access to the treatment center. Intraoperative radiotherapy (IORT) reduce the duration of treatment, to a single dose during surgery, and IORT with eletrons or with the Intrabeam ®, can be, indicated for selected women diagnosed with early stage breast cancer. In a country like Brazil where just 50.8% of the required amount of radiotherapy equipment is avaiable, IORT could provide acess to radiotherapy to many women. Objectives: Calculate the distance, the time of travel and the amount of money saved by patients with IORT instead of External Radiotherapy (EBRT). Methods: This study was based on the AC Camargo Cancer Center database with 259 women diagnosed with breast cancer, treated with IORT from 2005 to 2019. 27 patients living in cities more than 100km from the Hospital were excluded. To calculate the distance between the house and the hospital, by public or automobile, the Google Maps® tool was used. For all patients, treatments were prescribed with the number of EBRT sessions that would be necessary, using the current protocol of the Institution (2019). Based on this prescription, we performed the analysis of daily travel time, and money spent for the treatment and for the simulation. The criteria for selecting lowrisk patients was equivalent to those established by the consensus of the ESTRO and ASTRO. Results: The mean age was 65 years. If EBRT were indicated, an average of 17 sessions would be performed. The distance to a single day of treatment with IORT was 35.05 km to reach the institution (round trip), and if EBRT was performed, it could reach a total of up to 545 km for all treatment days. The mean daily travel time was 137 minutes by car and 129 minutes by pubic transport, with a transit time spent ranging from 2204.6 at 2557.6 minutes respectively for the entire treatment. The cost with the journey for single dose treatment would be approximately 3,13 dolars. Conclusion: For selected patients with early breast cancer, a single dose of radiotherapy delivered at the time of surgery with IORT should be considered as an alternative to external beam radiotherapy. It was demonstrated that the time spent, as well as the distance traveled, is much lower in the IORT treatment. And it can improve patients‘ adherence and quality of life and reduce the number of patients that cant receive the radiotherapy due to the lack of equipment in Brazil.