Elena Sperk - Academia.edu (original) (raw)

Papers by Elena Sperk

Research paper thumbnail of Intraoperative Radiotherapie beim kleinen Mammakarzinom – Langzeitnachsorge und Lebensqualität

Research paper thumbnail of Follow-Up Findings in the Tumour Bed After IORT – What the Radiologist Needs to Know

Targeted Intraoperative Radiotherapy in Oncology, 2013

Research paper thumbnail of Patient Selection and Information

Targeted Intraoperative Radiotherapy in Oncology, 2013

Research paper thumbnail of ISIORT pooled analysis 2013 update: clinical and technical characteristics of intraoperative radiotherapy

Translational Cancer Research, Feb 25, 2014

Research paper thumbnail of Quality of Life and Late Radiation Toxicity

Targeted Intraoperative Radiotherapy in Oncology, 2013

Research paper thumbnail of Accelerated Partial Breast Irradiation in Clinical Practice

Breast Care, 2015

ago, recent efforts have concentrated on tailoring radiotherapy to the individual risk of the pat... more ago, recent efforts have concentrated on tailoring radiotherapy to the individual risk of the patient. Several studies have tried to identify patients who need no radiotherapy at all . However, none of the prospective randomized trials was successful in identifying a low-risk cohort of patients in whom the local recurrence rates were identical to those in patients undergoing radiotherapy. Trials designed on the analysis of local relapse patterns according to the initial histology have focused on reducing the dose and the volume in appropriately selected patients. Irradiation of a smaller volume, in this case the tumor bed with only a safety margin, allows an increase of the daily dose without excessively increasing the rate of late toxicity. This development was supported by novel insights into breast cancer tumor biology. The concept of accelerated partial breast irradiation (APBI) was rigorously tested in several largescale clinical studies , and has now entered clinical guidelines (for a summary, see ). The current article reviews some of the underlying biological concepts, summarizes the results of the practice-changing clinical trials and tries to give an overview on the current status of ongoing additional clinical studies.

Research paper thumbnail of Oncology Intraoperative Radiotherapy in Breast Cancer

Geburtshilfe und Frauenheilkunde

Research paper thumbnail of Langzeitergebnisse zu Lebensqualität und Patientenzufriedenheit nach Intraoperativer Radiotherapie (IORT) des frühen Mammakarzinoms während brusterhaltender Operation

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Intraoperative Radiotherapie beim Mammakarzinom – Ursachen für das Abweichen von einem geplanten Bestrahlungsprotokoll

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Prozentualer Anteil geeigneter Patientinnen für die Intraoperative Radiotherapie (IORT) am Gesamtkollektiv eines zertifizierten Brustzentrums

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Abstract 3445: Diacylglycerol kinase alpha as a novel epigenetically regulated risk marker for radiotherapy-induced fibrosis

Research paper thumbnail of Niedrige Fibroserate bei adäquatem Zeitintervall zwischen intraoperativem Tumorbettboost und perkutaner Nachbestrahlung

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Intraoperative Radiotherapie (IORT) im Rahmen einer erneuten brusterhaltenden Therapie (BET) bei vorbestrahlten Patientinnen mit Inbrustrezidiv

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Intraoperative Radiotherapie (IORT) als Boost während einer brusterhaltenden Therapie (BET) mit anschließender perkutaner Mammahomogenbestrahlung (EBRT) – Langzeitergebnisse

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Breast Conserving Treatment: External Beam or Intraoperative Boost? A Matched Pair Analysis

Purpose/Objective(s): In the context of breast conserving treatment, radiotherapy leads to a bett... more Purpose/Objective(s): In the context of breast conserving treatment, radiotherapy leads to a better overall survival and in addition to whole breast radiotherapy (WBRT) a boost to the tumor bed leads to a better local control. The tumor bed boost is usually added after WBRT or can be done intraoperatively (IORT). Positive effects, an antitumoral effect and modulation of microenvironment after IORT with 50kV x-rays were already described by Belletti et al. (Clin Cancer Res., 2008). During the San Antonio Breast Cancer Symposium data from the randomized TARGIT A trial were presented (n = >3400 patients) showing a trend towards a better overall survival in patients treated with IORT immediately after tumor removal. For this report a matched pair analysis was performed to investigate the impact of IORT boost on overall survival compared to standard external beam boost.Materials/Methods: In general 370 patients were treated for breast cancer with WBRT + boost (external beam (EBRT) boo...

Research paper thumbnail of Influence of age on short-term complications after intraoperative radiotherapy in women after breast-conserving surgery

Anticancer research, 2013

We investigated the influence of age on short-term complications in women undergoing intraoperati... more We investigated the influence of age on short-term complications in women undergoing intraoperative radiotherapy (IORT) for early breast cancer. We retrospectively analyzed data of 188 women who underwent IORT during breast-conserving surgery (BCS). The study group consisted of 54 patients aged 70 years or older. One hundred and thirty four patients aged less than 70 years served as the control group. In both collectives, the acute toxicity was low. There were no significant differences regarding type and duration of surgery, and type of radiation treatment, comparing both collectives. The most frequent postoperative side-effects were haematoma/suggillation (13/54, 24.1% vs. 28/134, 20.9%; p=0.633). There was a significantly higher incidence of postoperative axillary haematoma in the study group (10/54, 18.5% vs. 10/134, 7.5%; p=0.026). Acute toxicity after BCS with IORT in women aged 70 years and older does not seem to be higher compared to younger patients.

Research paper thumbnail of Intraoperative radiotherapy of early breast cancer using low-kilovoltage x-rays-reasons for omission of planned intraoperative irradiation

The breast journal

The purpose of this study is to investigate reasons for omission of a planned intraoperative radi... more The purpose of this study is to investigate reasons for omission of a planned intraoperative radiotherapy (IORT) during breast-conserving surgery (BCS). Between 2002 and 2009, in 297 women an IORT during BCS was planned. In 55 women this irradiation was finally not performed. We retrospectively analyzed pre-, peri-, and postoperative data of these 55 women. Main reasons for omission of an IORT were insufficient tumor-skin distance (n = 20, 35.1%), an oversized wound cavity (n = 14, 24.6%), and a combination of both (n = 8, 14%). Further reasons (n = 12, 21.1%) were temporal shortage, unplanned maintenance work of the Intrabeam(®) device, unsuitable anatomicosurgical conditions, and ineligible histologic findings. Apart from suitable anatomic conditions, a precise preoperative ultrasonography as well as a strict interdisciplinary preoperative management is important for successful application of IORT.

Research paper thumbnail of A cohort analysis to identify eligible patients for intraoperative radiotherapy (IORT) of early breast cancer

Radiation Oncology, 2014

Background: Since the results from the randomized TARGIT A trial were published, intraoperative r... more Background: Since the results from the randomized TARGIT A trial were published, intraoperative radiotherapy (IORT) is used more often. IORT can be provided as accelerated partial breast irradiation (APBI) or as a boost. The definition of suitable patients for IORT as APBI differs between different national societies (e.g. ESTRO and ASTRO) and different inclusion criteria of trials and so does the eligibility of patients. This analysis identifies eligible patients for IORT according to available consensus statements and inclusion criteria of the ongoing TARGIT trials. Methods: Between 01/03 -12/09, 1505 breast cancer cases were treated at the breast cancer center at the University Medical Center Mannheim. Complete data sets for age, stage (T, N, and M), histology and hormone receptor status were available in 1108 cases. Parameters to identify eligible patients are as follows: ESTRO: >50 years, invasive ductal carcinoma/other favorable histology (IDC), T1-2 (≤3 cm), N0, any hormone receptor status, M0; ASTRO: ≥60 years, IDC, T1, N0, positive estrogen hormone receptor status, M0; TARGIT E "elderly", risk adapted radiotherapy with IORT followed by external beam radiotherapy in case of risk factors in final histopathology, phase II: ≥70 years, IDC, T1, N0, any hormone receptor status, M0; TARGIT C "consolidation", risk adapted radiotherapy, phase IV: ≥50 years, IDC, T1, N0, positive hormone receptor status, M0; TARGIT BQR "boost quality registry": every age, every histology, T1-2 (max. 3.5 cm), any hormone receptor status, N0/+, M0/+. Results: Out of the 1108 cases, 379 cases (34.2%) were suitable for IORT as APBI regarding the ESTRO and 175 (15.8%) regarding the ASTRO consensus statements. 82 (7.4%) patients were eligible for the TARGIT E trial, 258 (23.3%) for the TARGIT C trial and 671 (60.6%) for the TARGIT BQR registry. According to the consensus statements of ASTRO (45.1%) and ESTRO (41.4%) about half of the eligible patients were treated with IORT as APBI. From the eligible patients fulfilling the criteria for IORT boost (35%) about one third was eventually treated.

Research paper thumbnail of Lebensqualität nach intraoperativer Radiotherapie (IORT) als Boost beim Mammakarzinom

Geburtshilfe und Frauenheilkunde, 2010

... Int J Radiat Oncol Biol 2008; 72: 1575-1581 20 Wenz F, Welzel G, Blank E. et al Intraoperativ... more ... Int J Radiat Oncol Biol 2008; 72: 1575-1581 20 Wenz F, Welzel G, Blank E. et al Intraoperative Radiotherapy as a boost during breast-conserving ... Cancer 2001; 91: 2282-2287 31 Whelan TJ, Levine M, Julian J. et al The effects of radiation therapy on quality of life of women with ...

Research paper thumbnail of Strahlentherapeutisch relevante Lebensqualitätsparameter nach intraoperativer Radiotherapie (IORT) versus externer Radiotherapie (whole breast irradiation, WBI) bei Patientinnen mit Mammakarzinom: Ergebnisse aus der randomisierten Phase III TARGIT-A Studie

Senologie - Zeitschrift für Mammadiagnostik und -therapie, 2011

Research paper thumbnail of Intraoperative Radiotherapie beim kleinen Mammakarzinom – Langzeitnachsorge und Lebensqualität

Research paper thumbnail of Follow-Up Findings in the Tumour Bed After IORT – What the Radiologist Needs to Know

Targeted Intraoperative Radiotherapy in Oncology, 2013

Research paper thumbnail of Patient Selection and Information

Targeted Intraoperative Radiotherapy in Oncology, 2013

Research paper thumbnail of ISIORT pooled analysis 2013 update: clinical and technical characteristics of intraoperative radiotherapy

Translational Cancer Research, Feb 25, 2014

Research paper thumbnail of Quality of Life and Late Radiation Toxicity

Targeted Intraoperative Radiotherapy in Oncology, 2013

Research paper thumbnail of Accelerated Partial Breast Irradiation in Clinical Practice

Breast Care, 2015

ago, recent efforts have concentrated on tailoring radiotherapy to the individual risk of the pat... more ago, recent efforts have concentrated on tailoring radiotherapy to the individual risk of the patient. Several studies have tried to identify patients who need no radiotherapy at all . However, none of the prospective randomized trials was successful in identifying a low-risk cohort of patients in whom the local recurrence rates were identical to those in patients undergoing radiotherapy. Trials designed on the analysis of local relapse patterns according to the initial histology have focused on reducing the dose and the volume in appropriately selected patients. Irradiation of a smaller volume, in this case the tumor bed with only a safety margin, allows an increase of the daily dose without excessively increasing the rate of late toxicity. This development was supported by novel insights into breast cancer tumor biology. The concept of accelerated partial breast irradiation (APBI) was rigorously tested in several largescale clinical studies , and has now entered clinical guidelines (for a summary, see ). The current article reviews some of the underlying biological concepts, summarizes the results of the practice-changing clinical trials and tries to give an overview on the current status of ongoing additional clinical studies.

Research paper thumbnail of Oncology Intraoperative Radiotherapy in Breast Cancer

Geburtshilfe und Frauenheilkunde

Research paper thumbnail of Langzeitergebnisse zu Lebensqualität und Patientenzufriedenheit nach Intraoperativer Radiotherapie (IORT) des frühen Mammakarzinoms während brusterhaltender Operation

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Intraoperative Radiotherapie beim Mammakarzinom – Ursachen für das Abweichen von einem geplanten Bestrahlungsprotokoll

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Prozentualer Anteil geeigneter Patientinnen für die Intraoperative Radiotherapie (IORT) am Gesamtkollektiv eines zertifizierten Brustzentrums

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Abstract 3445: Diacylglycerol kinase alpha as a novel epigenetically regulated risk marker for radiotherapy-induced fibrosis

Research paper thumbnail of Niedrige Fibroserate bei adäquatem Zeitintervall zwischen intraoperativem Tumorbettboost und perkutaner Nachbestrahlung

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Intraoperative Radiotherapie (IORT) im Rahmen einer erneuten brusterhaltenden Therapie (BET) bei vorbestrahlten Patientinnen mit Inbrustrezidiv

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Intraoperative Radiotherapie (IORT) als Boost während einer brusterhaltenden Therapie (BET) mit anschließender perkutaner Mammahomogenbestrahlung (EBRT) – Langzeitergebnisse

Senologie - Zeitschrift für Mammadiagnostik und -therapie

Research paper thumbnail of Breast Conserving Treatment: External Beam or Intraoperative Boost? A Matched Pair Analysis

Purpose/Objective(s): In the context of breast conserving treatment, radiotherapy leads to a bett... more Purpose/Objective(s): In the context of breast conserving treatment, radiotherapy leads to a better overall survival and in addition to whole breast radiotherapy (WBRT) a boost to the tumor bed leads to a better local control. The tumor bed boost is usually added after WBRT or can be done intraoperatively (IORT). Positive effects, an antitumoral effect and modulation of microenvironment after IORT with 50kV x-rays were already described by Belletti et al. (Clin Cancer Res., 2008). During the San Antonio Breast Cancer Symposium data from the randomized TARGIT A trial were presented (n = >3400 patients) showing a trend towards a better overall survival in patients treated with IORT immediately after tumor removal. For this report a matched pair analysis was performed to investigate the impact of IORT boost on overall survival compared to standard external beam boost.Materials/Methods: In general 370 patients were treated for breast cancer with WBRT + boost (external beam (EBRT) boo...

Research paper thumbnail of Influence of age on short-term complications after intraoperative radiotherapy in women after breast-conserving surgery

Anticancer research, 2013

We investigated the influence of age on short-term complications in women undergoing intraoperati... more We investigated the influence of age on short-term complications in women undergoing intraoperative radiotherapy (IORT) for early breast cancer. We retrospectively analyzed data of 188 women who underwent IORT during breast-conserving surgery (BCS). The study group consisted of 54 patients aged 70 years or older. One hundred and thirty four patients aged less than 70 years served as the control group. In both collectives, the acute toxicity was low. There were no significant differences regarding type and duration of surgery, and type of radiation treatment, comparing both collectives. The most frequent postoperative side-effects were haematoma/suggillation (13/54, 24.1% vs. 28/134, 20.9%; p=0.633). There was a significantly higher incidence of postoperative axillary haematoma in the study group (10/54, 18.5% vs. 10/134, 7.5%; p=0.026). Acute toxicity after BCS with IORT in women aged 70 years and older does not seem to be higher compared to younger patients.

Research paper thumbnail of Intraoperative radiotherapy of early breast cancer using low-kilovoltage x-rays-reasons for omission of planned intraoperative irradiation

The breast journal

The purpose of this study is to investigate reasons for omission of a planned intraoperative radi... more The purpose of this study is to investigate reasons for omission of a planned intraoperative radiotherapy (IORT) during breast-conserving surgery (BCS). Between 2002 and 2009, in 297 women an IORT during BCS was planned. In 55 women this irradiation was finally not performed. We retrospectively analyzed pre-, peri-, and postoperative data of these 55 women. Main reasons for omission of an IORT were insufficient tumor-skin distance (n = 20, 35.1%), an oversized wound cavity (n = 14, 24.6%), and a combination of both (n = 8, 14%). Further reasons (n = 12, 21.1%) were temporal shortage, unplanned maintenance work of the Intrabeam(®) device, unsuitable anatomicosurgical conditions, and ineligible histologic findings. Apart from suitable anatomic conditions, a precise preoperative ultrasonography as well as a strict interdisciplinary preoperative management is important for successful application of IORT.

Research paper thumbnail of A cohort analysis to identify eligible patients for intraoperative radiotherapy (IORT) of early breast cancer

Radiation Oncology, 2014

Background: Since the results from the randomized TARGIT A trial were published, intraoperative r... more Background: Since the results from the randomized TARGIT A trial were published, intraoperative radiotherapy (IORT) is used more often. IORT can be provided as accelerated partial breast irradiation (APBI) or as a boost. The definition of suitable patients for IORT as APBI differs between different national societies (e.g. ESTRO and ASTRO) and different inclusion criteria of trials and so does the eligibility of patients. This analysis identifies eligible patients for IORT according to available consensus statements and inclusion criteria of the ongoing TARGIT trials. Methods: Between 01/03 -12/09, 1505 breast cancer cases were treated at the breast cancer center at the University Medical Center Mannheim. Complete data sets for age, stage (T, N, and M), histology and hormone receptor status were available in 1108 cases. Parameters to identify eligible patients are as follows: ESTRO: >50 years, invasive ductal carcinoma/other favorable histology (IDC), T1-2 (≤3 cm), N0, any hormone receptor status, M0; ASTRO: ≥60 years, IDC, T1, N0, positive estrogen hormone receptor status, M0; TARGIT E "elderly", risk adapted radiotherapy with IORT followed by external beam radiotherapy in case of risk factors in final histopathology, phase II: ≥70 years, IDC, T1, N0, any hormone receptor status, M0; TARGIT C "consolidation", risk adapted radiotherapy, phase IV: ≥50 years, IDC, T1, N0, positive hormone receptor status, M0; TARGIT BQR "boost quality registry": every age, every histology, T1-2 (max. 3.5 cm), any hormone receptor status, N0/+, M0/+. Results: Out of the 1108 cases, 379 cases (34.2%) were suitable for IORT as APBI regarding the ESTRO and 175 (15.8%) regarding the ASTRO consensus statements. 82 (7.4%) patients were eligible for the TARGIT E trial, 258 (23.3%) for the TARGIT C trial and 671 (60.6%) for the TARGIT BQR registry. According to the consensus statements of ASTRO (45.1%) and ESTRO (41.4%) about half of the eligible patients were treated with IORT as APBI. From the eligible patients fulfilling the criteria for IORT boost (35%) about one third was eventually treated.

Research paper thumbnail of Lebensqualität nach intraoperativer Radiotherapie (IORT) als Boost beim Mammakarzinom

Geburtshilfe und Frauenheilkunde, 2010

... Int J Radiat Oncol Biol 2008; 72: 1575-1581 20 Wenz F, Welzel G, Blank E. et al Intraoperativ... more ... Int J Radiat Oncol Biol 2008; 72: 1575-1581 20 Wenz F, Welzel G, Blank E. et al Intraoperative Radiotherapy as a boost during breast-conserving ... Cancer 2001; 91: 2282-2287 31 Whelan TJ, Levine M, Julian J. et al The effects of radiation therapy on quality of life of women with ...

Research paper thumbnail of Strahlentherapeutisch relevante Lebensqualitätsparameter nach intraoperativer Radiotherapie (IORT) versus externer Radiotherapie (whole breast irradiation, WBI) bei Patientinnen mit Mammakarzinom: Ergebnisse aus der randomisierten Phase III TARGIT-A Studie

Senologie - Zeitschrift für Mammadiagnostik und -therapie, 2011