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

Abstract

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 chemotherapymore » 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.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [6];  [7];  [8];  [9];  [10];  [11];  [12];  [13];  [14]
  1. Department of Radiation Oncology, Cancer Institute of New Jersey, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ (United States), E-mail: hafftybg@umdnj.edu
  2. Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)
  3. Department of Surgery, Dallas Breast Center, Dallas, TX (United States)
  4. Department of Radiation Oncology, Arizona Oncology Services, Scottsdale, AZ (United States)
  5. Department of Surgery, Western Pennsylvania Hospital, Pittsburgh, PA (United States)
  6. Department of Radiation Oncology, St. Louis Cancer and Breast Center, St. Louis, MO (United States)
  7. Department of Surgery, Alabama Breast Center, Montgomery, AL (United States)
  8. Department of Surgery, Sacred Heart Hospital, Allentown, PA (United States)
  9. Department of Surgery, Breast Care Center of the Southwest, Phoenix, AZ (United States)
  10. Department of Surgery, M. D. Anderson Cancer Center, Houston, TX (United States)
  11. Department of Surgery, Breast Center of Southern Arizona, Tucson, AZ (United States)
  12. Department of Surgery, Vassar Brothers Medical Center, Poughkeepsie, NY (United States)
  13. Department of Surgery, Advanced Breast Care, Marietta, GA (United States)
  14. Department of Radiation Oncology, Cedars Medical Center, Miami, FL (United States)
Publication Date:
OSTI Identifier:
21172504
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 72; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2008.02.070; PII: S0360-3016(08)00504-X; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The 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; BRACHYTHERAPY; CARCINOMAS; CHEMOTHERAPY; IRRADIATION; MAMMARY GLANDS; PATIENTS; SURGERY

Citation Formats

Haffty, Bruce G., Vicini, Frank A., Beitsch, Peter, Quiet, Coral, Keleher, Angela, Garcia, Delia, Snider, Howard, Gittleman, Mark, Zannis, Victor, Kuerer, Henry, Whitacre, Eric, Whitworth, Pat, Fine, Richard, and Keisch, Martin. Timing of Chemotherapy After MammoSite Radiation Therapy System Breast Brachytherapy: Analysis of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2008.02.070.
Haffty, Bruce G., Vicini, Frank A., Beitsch, Peter, Quiet, Coral, Keleher, Angela, Garcia, Delia, Snider, Howard, Gittleman, Mark, Zannis, Victor, Kuerer, Henry, Whitacre, Eric, Whitworth, Pat, Fine, Richard, & Keisch, Martin. Timing of Chemotherapy After MammoSite Radiation Therapy System Breast Brachytherapy: Analysis of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial. United States. doi:10.1016/j.ijrobp.2008.02.070.
Haffty, Bruce G., Vicini, Frank A., Beitsch, Peter, Quiet, Coral, Keleher, Angela, Garcia, Delia, Snider, Howard, Gittleman, Mark, Zannis, Victor, Kuerer, Henry, Whitacre, Eric, Whitworth, Pat, Fine, Richard, and Keisch, Martin. Mon . "Timing of Chemotherapy After MammoSite Radiation Therapy System Breast Brachytherapy: Analysis of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial". United States. doi:10.1016/j.ijrobp.2008.02.070.
@article{osti_21172504,
title = {Timing of Chemotherapy After MammoSite Radiation Therapy System Breast Brachytherapy: Analysis of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial},
author = {Haffty, Bruce G. and Vicini, Frank A. and Beitsch, Peter and Quiet, Coral and Keleher, Angela and Garcia, Delia and Snider, Howard and Gittleman, Mark and Zannis, Victor and Kuerer, Henry and Whitacre, Eric and Whitworth, Pat and Fine, Richard and Keisch, Martin},
abstractNote = {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.},
doi = {10.1016/j.ijrobp.2008.02.070},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 72,
place = {United States},
year = {Mon Dec 01 00:00:00 EST 2008},
month = {Mon Dec 01 00:00:00 EST 2008}
}