Document Detail


Four-year efficacy, cosmesis, and toxicity using three-dimensional conformal external beam radiation therapy to deliver accelerated partial breast irradiation.
MedLine Citation:
PMID:  19515514     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This prospective study examines the use of three-dimensional conformal external beam radiation therapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI). Four-year data on efficacy, cosmesis, and toxicity are presented. METHODS: Patients with Stage O, I, or II breast cancer with lesions </=3 cm, negative margins, and negative nodes were eligible. The 3D-CRT delivered was 38.5 Gy in 3.85 Gy/fraction. Ipsilateral breast, ipsilateral nodal, contralateral breast, and distant failure (IBF, INF, CBF, DF) were estimated using the cumulative incidence method. Disease-free, overall, and cancer-specific survival (DFS, OS, CSS) were recorded. The National Cancer Institute Common Terminology Criteria for Adverse Events (version 3) toxicity scale was used to grade acute and late toxicities. RESULTS: Ninety-four patients are evaluable for efficacy. Median patient age was 62 years with the following characteristics: 68% tumor size <1 cm, 72% invasive ductal histology, 77% estrogen receptor (ER) (+), 88% postmenopausal; 88% no chemotherapy and 44% with no hormone therapy. Median follow-up was 4.2 years (range, 1.3-8.3). Four-year estimates of efficacy were IBF: 1.1% (one local recurrence); INF: 0%; CBF: 1.1%; DF: 3.9%; DFS: 95%; OS: 97%; and CSS: 99%. Four (4%) Grade 3 toxicities (one transient breast pain and three fibrosis) were observed. Cosmesis was rated good/excellent in 89% of patients at 4 years. CONCLUSIONS: Four-year efficacy, cosmesis, and toxicity using 3D-CRT to deliver APBI appear comparable to other experiences with similar follow-up. However, additional patients, further follow-up, and mature Phase III data are needed to evaluate thoroughly the extent of application, limitations, and complete value of this particular form of APBI.
Authors:
Peter Y Chen; Michelle Wallace; Christina Mitchell; Inga Grills; Larry Kestin; Ashley Fowler; Alvaro Martinez; Frank Vicini
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-08
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  76     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-03-31     Revised Date:  2010-07-09    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  991-7     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI 48073, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Breast Neoplasms / pathology,  radiotherapy*,  surgery
Carcinoma, Ductal, Breast / pathology,  radiotherapy
Esthetics
Female
Follow-Up Studies
Humans
Mastectomy, Segmental
Middle Aged
Prospective Studies
Radiotherapy Dosage
Radiotherapy, Conformal / adverse effects,  methods*
Tumor Burden
Comments/Corrections
Comment In:
Int J Radiat Oncol Biol Phys. 2010 Jul 15;77(4):969-73   [PMID:  20610037 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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