Predictors for Clinical Outcomes After Accelerated Partial Breast Intensity-Modulated Radiotherapy

Journal Article · Fri May 01 00:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.06.1917· OSTI ID:21276776

Reeder, Reed ^[1]; Howell, Kathryn; Henkenberns, Phyllis ^[2]; Tallhamer, Michael ^[3]; Johnson, Tim ^[2]; Kercher, Jane; Widner, Jodi ^[4]; Kaske, Terese ^[5]; Paul, Devchand; Sedlacek, Scot ^[6]; Leonard, Charles E ^[2]

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1. Northwest Nazarene University, Nampa, ID (United States)
2. Rocky Mountain Cancer Centers, Littleton, CO (United States)
3. Rocky Mountain Cancer Centers, Aurora, CO (United States)
4. Arapahoe Surgical Associates, Greenwood Village, CO (United States)
5. Sally Jobe Diagnostic Breast Center, Greenwood Village, CO (United States)
6. Rocky Mountain Cancer Centers, Rose Hospital, Denver, CO (United States)

Purpose: To correlate the treatment planning parameters with the clinical outcomes in patients treated with accelerated partial breast intensity-modulated radiotherapy. Methods and Materials: A total of 105 patients with Stage I breast cancer were treated between February 2004 and March 2007 in a Phase II prospective trial and had detailed information available on the planning target volume (PTV), ipsilateral breast volume (IBV), PTV/IBV ratio, lung volume, chest wall volume, surgery to radiotherapy interval, follow-up interval, breast pain, and cosmesis. The first 7 of these patients were treated to 34 Gy, and the remaining 98 were treated to 38.5 Gy. All patients were treated twice daily for 5 consecutive days. Univariate and multivariate analyses were performed. Results: The median follow-up was 13 months. No recurrences or deaths were observed. Of the 105 patients, 30 reported mild or moderate breast pain in their most recently recorded follow-up visit. The irradiated lung volume (p < 0.05) and chest wall volume receiving >35 Gy (p < 0.01) were associated with pain. The PTV, but not the PTV/IBV ratio, also correlated with pain (p < 0.01 and p = 0.42, respectively). A total of 72 patients reported excellent, 32 reported good, and 1 reported poor cosmesis. Physician-rated cosmesis reported 90 excellent and 15 good. None of the tested variables correlated with the cosmetic outcomes. Conclusion: Radiotherapy to the chest wall (chest wall volume receiving >35 Gy) and to lung correlated with reports of mild pain after accelerated partial breast intensity-modulated radiotherapy. Also, the PTV, but not the PTV/IBV ratio, was predictive of post-treatment reports of pain.

• OSTI ID: 21276776
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 74, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2008.06.1917; PII: S0360-3016(08)02950-7; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEST
DEATH
LUNGS
MAMMARY GLANDS
MULTIVARIATE ANALYSIS
NEOPLASMS
PAIN
PATIENTS
PLANNING
RADIOTHERAPY
STANDARD OF LIVING
SURGERY