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Medline ® Abstract for Reference 14

of 'Radiation therapy techniques for newly diagnosed, non-metastatic breast cancer'

Three-year outcomes of a Canadian multicenter study of accelerated partial breast irradiation using conformal radiation therapy.
Berrang TS, Olivotto I, Kim DH, Nichol A, Cho BC, Mohamed IG, Parhar T, Wright JR, Truong P, Tyldesley S, Sussman J, Wai E, Whelan T
Int J Radiat Oncol Biol Phys. 2011;81(5):1220. Epub 2010 Oct 23.
PURPOSE: To report 3-year toxicity, cosmesis, and efficacy of a multicenter study of external beam, accelerated partial breast irradiation (APBI) for early-stage breast cancer.
METHODS AND MATERIALS: Between March 2005 and August 2006, 127 women aged≥40 years with ductal carcinoma in situ or node-negative invasive breast cancer≤3 cm in diameter, treated with breast-conserving surgery achieving negative margins, were accrued to a prospective study involving five Canadian cancer centers. Women meeting predefined dose constraints were treated with APBI using 3 to 5 photon beams, delivering 35 to 38.5 Gy in 10 fractions, twice a day, over 1 week. Patients were assessed for treatment-related toxicities, cosmesis, and efficacy before APBI and at specified time points for as long as 3 years after APBI.
RESULTS: 104 women had planning computed tomography scans showing visible seromas, met dosimetric constraints, and were treated with APBI to doses of 35 Gy (n=9), 36 Gy (n=33),or 38.5 Gy (n=62). Eighty-seven patients were evaluated with minimum 3-year follow-up after APBI. Radiation dermatitis, breast edema, breast induration, and fatigue decreased from baseline levels or stabilized by the 3-year follow-up. Hypopigmentation, hyperpigmentation, breast pain, and telangiectasia slightly increased from baseline levels. Most toxicities at 3 years were Grade 1. Only 1 patient had a Grade 3 toxicity with telangiectasia in a skin fold inside the 95% isodose. Cosmesis was good to excellent in 86% (89/104) of women at baseline and 82% (70/85) at 3 years. The 3-year disease-free survival was 97%, with only one local recurrence that occurred in a different quadrant away from the treated site and two distant recurrences.
CONCLUSIONS: At 3 years, toxicity and cosmesis were acceptable, and local control and disease-free survival were excellent, supporting continued accrual to randomized APBI trials.
British Columbia Cancer Agency-Vancouver Island, Victoria, BC, Canada. tberrang@bccancer.bc.ca