skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study

Abstract

Purpose: External beam accelerated partial breast irradiation (APBI) is an increasingly popular technique for treatment of patients with early stage breast cancer following breast-conserving surgery. Here we present 5-year results of a prospective trial. Methods and Materials: From October 2003 through November 2005, 98 evaluable patients with stage I breast cancer were enrolled in the first dose step (32 Gy delivered in 8 twice-daily fractions) of a prospective, multi-institutional, dose escalation clinical trial of 3-dimensional conformal external beam APBI (3D-APBI). Median age was 61 years; median tumor size was 0.8 cm; 89% of tumors were estrogen receptor positive; 10% had a triple-negative phenotype; and 1% had a HER-2-positive subtype. Median follow-up was 71 months (range, 2-88 months; interquartile range, 64-75 months). Results: Five patients developed ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial IBTR rate of 5% (95% confidence interval [CI], 1%-10%). Three of these cases occurred in patients with triple-negative disease and 2 in non-triple-negative patients, for 5-year actuarial IBTR rates of 33% (95% CI, 0%-57%) and 2% (95% CI, 0%-6%; P<.0001), respectively. On multivariable analysis, triple-negative phenotype was the only predictor of IBTR, with borderline statistical significance after adjusting for tumor grade (P=.0537). Conclusions: Overall outcomes weremore » excellent, particularly for patients with estrogen receptor-positive disease. Patients in this study with triple-negative breast cancer had a significantly higher IBTR rate than patients with other receptor phenotypes when treated with 3D-APBI. Larger, prospective 3D-APBI clinical trials should continue to evaluate the effect of hormone receptor phenotype on IBTR rates.« less

Authors:
 [1];  [2];  [3];  [4];  [3];  [5]; ;  [3];  [6];  [7];  [3]; ; ;  [7];  [3];  [3]
  1. Harvard Radiation Oncology Program, Boston, Massachusetts (United States)
  2. Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States)
  3. Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)
  4. Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts (United States)
  5. Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts (United States)
  6. Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts (United States)
  7. Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts (United States)
Publication Date:
OSTI Identifier:
22149558
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CLINICAL TRIALS; ESTROGENS; IRRADIATION; MAMMARY GLANDS; NEOPLASMS; PATIENTS; PHENOTYPE; RADIATION DOSES; RECEPTORS; SURGERY

Citation Formats

Pashtan, Itai M., Recht, Abram, Ancukiewicz, Marek, Brachtel, Elena, Abi-Raad, Rita F., D'Alessandro, Helen A., Levy, Antonin, Wo, Jennifer Y., Hirsch, Ariel E., Kachnic, Lisa A., Goldberg, Saveli, Specht, Michelle, Gadd, Michelle, Smith, Barbara L., Powell, Simon N., and Taghian, Alphonse G., E-mail: ataghian@partners.org. External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.04.019.
Pashtan, Itai M., Recht, Abram, Ancukiewicz, Marek, Brachtel, Elena, Abi-Raad, Rita F., D'Alessandro, Helen A., Levy, Antonin, Wo, Jennifer Y., Hirsch, Ariel E., Kachnic, Lisa A., Goldberg, Saveli, Specht, Michelle, Gadd, Michelle, Smith, Barbara L., Powell, Simon N., & Taghian, Alphonse G., E-mail: ataghian@partners.org. External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study. United States. doi:10.1016/J.IJROBP.2012.04.019.
Pashtan, Itai M., Recht, Abram, Ancukiewicz, Marek, Brachtel, Elena, Abi-Raad, Rita F., D'Alessandro, Helen A., Levy, Antonin, Wo, Jennifer Y., Hirsch, Ariel E., Kachnic, Lisa A., Goldberg, Saveli, Specht, Michelle, Gadd, Michelle, Smith, Barbara L., Powell, Simon N., and Taghian, Alphonse G., E-mail: ataghian@partners.org. Thu . "External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study". United States. doi:10.1016/J.IJROBP.2012.04.019.
@article{osti_22149558,
title = {External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study},
author = {Pashtan, Itai M. and Recht, Abram and Ancukiewicz, Marek and Brachtel, Elena and Abi-Raad, Rita F. and D'Alessandro, Helen A. and Levy, Antonin and Wo, Jennifer Y. and Hirsch, Ariel E. and Kachnic, Lisa A. and Goldberg, Saveli and Specht, Michelle and Gadd, Michelle and Smith, Barbara L. and Powell, Simon N. and Taghian, Alphonse G., E-mail: ataghian@partners.org},
abstractNote = {Purpose: External beam accelerated partial breast irradiation (APBI) is an increasingly popular technique for treatment of patients with early stage breast cancer following breast-conserving surgery. Here we present 5-year results of a prospective trial. Methods and Materials: From October 2003 through November 2005, 98 evaluable patients with stage I breast cancer were enrolled in the first dose step (32 Gy delivered in 8 twice-daily fractions) of a prospective, multi-institutional, dose escalation clinical trial of 3-dimensional conformal external beam APBI (3D-APBI). Median age was 61 years; median tumor size was 0.8 cm; 89% of tumors were estrogen receptor positive; 10% had a triple-negative phenotype; and 1% had a HER-2-positive subtype. Median follow-up was 71 months (range, 2-88 months; interquartile range, 64-75 months). Results: Five patients developed ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial IBTR rate of 5% (95% confidence interval [CI], 1%-10%). Three of these cases occurred in patients with triple-negative disease and 2 in non-triple-negative patients, for 5-year actuarial IBTR rates of 33% (95% CI, 0%-57%) and 2% (95% CI, 0%-6%; P<.0001), respectively. On multivariable analysis, triple-negative phenotype was the only predictor of IBTR, with borderline statistical significance after adjusting for tumor grade (P=.0537). Conclusions: Overall outcomes were excellent, particularly for patients with estrogen receptor-positive disease. Patients in this study with triple-negative breast cancer had a significantly higher IBTR rate than patients with other receptor phenotypes when treated with 3D-APBI. Larger, prospective 3D-APBI clinical trials should continue to evaluate the effect of hormone receptor phenotype on IBTR rates.},
doi = {10.1016/J.IJROBP.2012.04.019},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}