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Title: Interim Cosmetic Results and Toxicity Using 3D Conformal External Beam Radiotherapy to Deliver Accelerated Partial Breast Irradiation in Patients With Early-Stage Breast Cancer Treated With Breast-Conserving Therapy

Abstract

Purpose: We present our ongoing clinical experience utilizing three-dimensional (3D)-conformal radiation therapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer treated with breast-conserving therapy. Methods and Materials: Ninety-one consecutive patients were treated with APBI using our previously reported 3D-CRT technique. The clinical target volume consisted of the lumpectomy cavity plus a 10- to 15 -mm margin. The prescribed dose was 34 or 38.5 Gy in 10 fractions given over 5 consecutive days. The median follow-up was 24 months. Twelve patients have been followed for {>=}4 years, 20 for {>=}3.5 years, 29 for >3.0 years, 33 for {>=}2.5 years, and 46 for {>=}2.0 years. Results: No local recurrences developed. Cosmetic results were rated as good/excellent in 100% of evaluable patients at {>=} 6 months (n = 47), 93% at 1 year (n = 43), 91% at 2 years (n = 21), and in 90% at {>=}3 years (n = 10). Erythema, hyperpigmentation, breast edema, breast pain, telangiectasias, fibrosis, and fat necrosis were evaluated at 6, 24, and 36 months after treatment. All factors stabilized by 3 years posttreatment with grade I or II rates of 0%, 0%, 0%, 0%, 9%, 18%, and 9%, respectively. Onlymore » 2 patients (3%) developed grade III toxicity (breast pain), which resolved with time. Conclusions: Delivery of APBI with 3D-CRT resulted in minimal chronic ({>=}6 months) toxicity to date with good/excellent cosmetic results. Additional follow-up is needed to assess the long-term efficacy of this form of APBI.« less

Authors:
 [1]; ; ; ; ; ;  [2];  [3];  [4];  [5];  [6];  [2]
  1. Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States), E-mail: fvicini@beaumont.edu
  2. Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)
  3. Department of Surgery, William Beaumont Hospital, Royal Oak, MI (United States)
  4. Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, MI (United States)
  5. Western Michigan University, Kalamazoo, MI (United States)
  6. University of Michigan, Ann Arbor, MI (United States)
Publication Date:
OSTI Identifier:
21039624
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 69; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2007.04.033; PII: S0360-3016(07)00759-6; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BEAMS; BRACHYTHERAPY; CARCINOMAS; EDEMA; ERYTHEMA; FIBROSIS; IRRADIATION; MAMMARY GLANDS; NECROSIS; PAIN; PATIENTS; RADIATION DOSES; TOXICITY

Citation Formats

Vicini, Frank A., Chen, Peter, Wallace, Michelle, Mitchell, Christina, Hasan, Yasmin, Grills, Inga, Kestin, Larry, Schell, Scott, Goldstein, Neal S., Kunzman, Jonathan, Gilbert, Sam, and Martinez, Alvaro. Interim Cosmetic Results and Toxicity Using 3D Conformal External Beam Radiotherapy to Deliver Accelerated Partial Breast Irradiation in Patients With Early-Stage Breast Cancer Treated With Breast-Conserving Therapy. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2007.04.033.
Vicini, Frank A., Chen, Peter, Wallace, Michelle, Mitchell, Christina, Hasan, Yasmin, Grills, Inga, Kestin, Larry, Schell, Scott, Goldstein, Neal S., Kunzman, Jonathan, Gilbert, Sam, & Martinez, Alvaro. Interim Cosmetic Results and Toxicity Using 3D Conformal External Beam Radiotherapy to Deliver Accelerated Partial Breast Irradiation in Patients With Early-Stage Breast Cancer Treated With Breast-Conserving Therapy. United States. doi:10.1016/j.ijrobp.2007.04.033.
Vicini, Frank A., Chen, Peter, Wallace, Michelle, Mitchell, Christina, Hasan, Yasmin, Grills, Inga, Kestin, Larry, Schell, Scott, Goldstein, Neal S., Kunzman, Jonathan, Gilbert, Sam, and Martinez, Alvaro. Thu . "Interim Cosmetic Results and Toxicity Using 3D Conformal External Beam Radiotherapy to Deliver Accelerated Partial Breast Irradiation in Patients With Early-Stage Breast Cancer Treated With Breast-Conserving Therapy". United States. doi:10.1016/j.ijrobp.2007.04.033.
@article{osti_21039624,
title = {Interim Cosmetic Results and Toxicity Using 3D Conformal External Beam Radiotherapy to Deliver Accelerated Partial Breast Irradiation in Patients With Early-Stage Breast Cancer Treated With Breast-Conserving Therapy},
author = {Vicini, Frank A. and Chen, Peter and Wallace, Michelle and Mitchell, Christina and Hasan, Yasmin and Grills, Inga and Kestin, Larry and Schell, Scott and Goldstein, Neal S. and Kunzman, Jonathan and Gilbert, Sam and Martinez, Alvaro},
abstractNote = {Purpose: We present our ongoing clinical experience utilizing three-dimensional (3D)-conformal radiation therapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer treated with breast-conserving therapy. Methods and Materials: Ninety-one consecutive patients were treated with APBI using our previously reported 3D-CRT technique. The clinical target volume consisted of the lumpectomy cavity plus a 10- to 15 -mm margin. The prescribed dose was 34 or 38.5 Gy in 10 fractions given over 5 consecutive days. The median follow-up was 24 months. Twelve patients have been followed for {>=}4 years, 20 for {>=}3.5 years, 29 for >3.0 years, 33 for {>=}2.5 years, and 46 for {>=}2.0 years. Results: No local recurrences developed. Cosmetic results were rated as good/excellent in 100% of evaluable patients at {>=} 6 months (n = 47), 93% at 1 year (n = 43), 91% at 2 years (n = 21), and in 90% at {>=}3 years (n = 10). Erythema, hyperpigmentation, breast edema, breast pain, telangiectasias, fibrosis, and fat necrosis were evaluated at 6, 24, and 36 months after treatment. All factors stabilized by 3 years posttreatment with grade I or II rates of 0%, 0%, 0%, 0%, 9%, 18%, and 9%, respectively. Only 2 patients (3%) developed grade III toxicity (breast pain), which resolved with time. Conclusions: Delivery of APBI with 3D-CRT resulted in minimal chronic ({>=}6 months) toxicity to date with good/excellent cosmetic results. Additional follow-up is needed to assess the long-term efficacy of this form of APBI.},
doi = {10.1016/j.ijrobp.2007.04.033},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 69,
place = {United States},
year = {Thu Nov 15 00:00:00 EST 2007},
month = {Thu Nov 15 00:00:00 EST 2007}
}