Specialist commentator comments

Advice

It was generally felt that there is a lack of data and long-term follow-up data on the Axxent eBx system, and that larger and longer studies are needed. It was noted that the Axxent eBx system is indicated for a very specific group of patients who typically have a low rate of recurrence, so 5- and 10‑year data are needed to determine non-inferiority compared with EBRT. One commentator noted that the length of follow-up in the current evidence base is insufficient.

One commentator also raised concerns that unlike EBRT, SD‑IORT with the Axxent eBx system would be delivered before gaining pathology data which would have indicated that the patient needed EBRT. This commentator noted that SD‑IORT is recommended for a specific group of early breast cancer patients, and so some people would not be eligible to have this treatment. Nevertheless, commentators acknowledged that SD‑IORT would improve patient accessibility, where appropriate.

One commentator reflected that the use of SD‑IORT has the potential to increase capacity at radiotherapy centres in the UK because it reduces patient visits compared with EBRT. The commentator added that avoidance of daily transport for EBRT may also offer advantages for patients with limited access to transport.