Timing of Chemotherapy After MammoSite Radiation Therapy System Breast Brachytherapy: Analysis of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial

Journal Article · Mon Dec 01 04:00:00 EST 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.02.070· OSTI ID:21172504

Vicini, Frank A ^[1]; Beitsch, Peter ^[2]; Quiet, Coral ^[3]; Keleher, Angela ^[4]; Garcia, Delia ^[5]; Snider, Howard ^[6]; Gittleman, Mark ^[7]; Zannis, Victor ^[8]; Kuerer, Henry ^[9]; Whitacre, Eric ^[10]; Whitworth, Pat ^[11]; Fine, Richard ^[12]; Keisch, Martin ^[13]

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1. Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)
2. Department of Surgery, Dallas Breast Center, Dallas, TX (United States)
3. Department of Radiation Oncology, Arizona Oncology Services, Scottsdale, AZ (United States)
4. Department of Surgery, Western Pennsylvania Hospital, Pittsburgh, PA (United States)
5. Department of Radiation Oncology, St. Louis Cancer and Breast Center, St. Louis, MO (United States)
6. Department of Surgery, Alabama Breast Center, Montgomery, AL (United States)
7. Department of Surgery, Sacred Heart Hospital, Allentown, PA (United States)
8. Department of Surgery, Breast Care Center of the Southwest, Phoenix, AZ (United States)
9. Department of Surgery, M. D. Anderson Cancer Center, Houston, TX (United States)
10. Department of Surgery, Breast Center of Southern Arizona, Tucson, AZ (United States)
11. Department of Surgery, Vassar Brothers Medical Center, Poughkeepsie, NY (United States)
12. Department of Surgery, Advanced Breast Care, Marietta, GA (United States)
13. Department of Radiation Oncology, Cedars Medical Center, Miami, FL (United States)

Purpose: To evaluate cosmetic outcome and radiation recall in the American Society of Breast Surgeons registry trial, as a function of the interval between accelerated partial breast irradiation (APBI) and initiation of chemotherapy (CTX). Methods and Materials: A total of 1440 patients at 97 institutions participated in this trial. After lumpectomy for early-stage breast cancer, patients received APBI (34 Gy in 10 fractions) with MammoSite RTS brachytherapy. A total of 148 patients received CTX within 90 days of APBI. Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good or fair/poor. Results: Chemotherapy was initiated at a mean of 3.9 weeks after the final MammoSite procedure and was administered {<=}3 weeks after APBI in 54 patients (36%) and >3 weeks after APBI in 94 patients (64%). The early and delayed groups were well balanced with respect to multiple factors that may impact on cosmetic outcome. There was a superior cosmetic outcome in those receiving chemotherapy >3 weeks after APBI (excellent/good in 72.2% at {<=}3 weeks vs. excellent/good in 93.8% at >3 weeks; p = 0.01). Radiation recall in those receiving CTX at {<=}3 weeks was 9 of 50 (18%), compared with 6 of 81(7.4%) in those receiving chemotherapy at >3 weeks (p = 0.09). Conclusion: The majority of patients receiving CTX after APBI have excellent/good cosmetic outcomes, with a low rate of radiation recall. Chemotherapy initiated >3 weeks after the final MammoSite procedure seems to be associated with a better cosmetic outcome and lower rate of radiation recall. An excellent/good cosmetic outcome in patients receiving CTX after 3 weeks was similar to the cosmetic outcome of the overall patient population who did not receive CTX.

• OSTI ID: 21172504
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 72; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
CARCINOMAS
CHEMOTHERAPY
IRRADIATION
MAMMARY GLANDS
PATIENTS
SURGERY