{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:47:21Z","timestamp":1782211641666,"version":"3.54.5"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Fakult\u00e4t Heidelberg der Universit\u00e4t Heidelberg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study investigates objective long-term cosmetic outcomes in patients with breast cancer after intraoperative radiotherapy applied as a\u00a0boost (IORT boost) from a\u00a0pooled international cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A\u00a0pooled analysis of two prospective studies with IORT boost (low-energy X\u2011rays, 20\u202fGy; inclusion criteria: 3.5\u202fcm maximum tumor size and preoperative indication for a\u00a0boost according to local criteria) during breast-conserving surgery followed by whole-breast radiotherapy (46\u201350\u202fGy). The analysis included photos from a\u00a0subgroup of the prospective phase\u00a0IV TARGeted Intraoperative radioTherapy (TARGIT) Boost Quality Registry (BQR) study (NCT01440010) with a\u00a0follow-up of up to 10\u00a0years as well as patients from a\u00a0Swiss study (ROKSM; Spital Thurgau AG; NCT02114086) with a\u00a0follow-up of 5\u00a0years. The pooled analysis included photos from both trials taken at the same timepoints (6\u00a0weeks, 6\u00a0months, 1\u00a0year, 2\u00a0years, and 5\u00a0years after completion of whole-breast radiotherapy). Cosmetic results were evaluated with the validated BCCT.core software (BCCT.core\u00a02.0, INESC Porto, Portugal) to assess symmetry, color, and scars. A\u00a0generalized estimating equation (GEE) regression model was used to compare the two cohorts over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The pooled analysis included 777 cosmetic assessments from 276 patients. Across all follow-ups in the pooled analysis, the majority of cosmetic results were rated as excellent or good (61.9%). Patients from TARGIT-BQR had significantly more excellent or good ratings than patients from ROKSM (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.0001). The proportion of patients receiving \u201cexcellent\u201d and \u201cgood\u201d ratings remained higher in TARGIT-BQR than in ROKSM at every timepoint during follow-up. Overall, for up to 10\u00a0years, the majority of ratings in the whole cohort were \u201cexcellent\u201d or \u201cgood.\u201d\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this international pooled analysis, the cosmetic outcome after IORT boost followed by whole-breast irradiation shows a\u00a0good esthetic long-term outcome. Further studies should explore factors that influence cosmetic outcomes and consider additional treatment-related parameters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00066-026-02506-3","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:09:30Z","timestamp":1770041370000},"page":"785-795","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term cosmetic outcome after intraoperative radiotherapy boost with low-energy X-rays in breast-conserving therapy: a\u00a0pooled cohort analysis of the TARGIT-BQR and ROKSM trials"],"prefix":"10.1007","volume":"202","author":[{"given":"Paulina","family":"Schimmelfennig","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Reuter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uta","family":"Kraus-Tiefenbacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria","family":"Br\u00fcck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Kaiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Keymer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Abo-Madyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Fleckenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Tuschy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"S\u00fctterlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Wenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Reichardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Fehr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Kuther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"B\u00fcttner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8771-8124","authenticated-orcid":false,"given":"Elena","family":"Sperk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"issue":"10","key":"2506_CR1","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1007\/s00066-013-0437-8","volume":"189","author":"F Sedlmayer","year":"2013","unstructured":"Sedlmayer\u00a0F et\u00a0al (2013) DEGRO practical guidelines: radiotherapy of breast cancer I: radiotherapy following breast conserving therapy for invasive breast cancer. 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P.\u00a0Schimmelfennig, C.\u00a0Reuter, U.\u00a0Kraus-Tiefenbacher, V.\u00a0Br\u00fcck, C.\u00a0Kaiser, R.\u00a0Keymer, Y.\u00a0Abo-Madyan, K.\u00a0Fleckenstein, B.\u00a0Tuschy, F.\u00a0Wenz, H.\u00a0Reichardt, M.\u00a0Fehr, M.\u00a0Kuther, and S.\u00a0B\u00fcttner declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}