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Title: Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer

Abstract

Purpose: To examine 10-year rates of local, regional, and distant recurrences, patterns of recurrence, and survival rates for breast cancer patients enrolled on Study NRG Oncology/Radiation Therapy Oncology Group 9517, a multi-institutional prospective trial that studied one of the earliest methods of accelerated partial breast irradiation (APBI), multicatheter brachytherapy (MCT). Methods and Materials: Eligibility included stage I/II unifocal breast cancer <3 cm in size after lumpectomy with negative surgical margins and 0 to 3 positive axillary nodes without extracapsular extension. The APBI dose delivered was 34 Gy in 10 twice-daily fractions over 5 days for high-dose-rate (HDR); and 45 Gy in 3.5 to 5 days for low-dose-rate (LDR) brachytherapy. The primary endpoint was HDR and LDR MCT reproducibility. This analysis focuses on long-term ipsilateral breast recurrence (IBR), contralateral breast cancer events (CBE), regional recurrence (RR), and distant metastases (DM), disease-free, and overall survival. Results: The median follow-up was 12.1 years. One hundred patients were accrued from 1997 to 2000; 98 were evaluable; 65 underwent HDR and 33 LDR MCT. Median age was 62 years; 88% had T1 tumors; 81% were pN0. Seventy-seven percent were estrogen receptor and/or progesterone receptor positive; 33% received adjuvant chemotherapy and 64% antiendocrine therapy. There have been 4 isolated IBRs and 1 IBR withmore » RR, for 5.2% 10-year IBR without DM. There was 1 isolated RR, 1 with IBR, and 1 with a CBE, for 3.1% 10-year RR without DM. The 10-year CBE rate was 4.2%, with 5 total events. Eleven patients have developed DM, 8 have died of breast cancer, and 22 have died from other causes. The 10-year DFS and OS rates are 69.8% and 78.0%, respectively. Conclusion: This multi-institutional, phase 2 trial studying MCT-APBI continues to report durable in-breast cancer control rates with long-term follow-up.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [4];  [6];  [7];  [8];  [9];  [10]
  1. Department of Radiation Oncology, The James, Ohio State University, Columbus, Ohio (United States)
  2. NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States)
  3. Department of Radiation Oncology, Arizona Breast Cancer Specialists, Scottsdale, Arizona (United States)
  4. Department of Radiation Oncology, Oschner Clinic, New Orleans, Louisiana (United States)
  5. Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States)
  6. Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado (United States)
  7. Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States)
  8. Mount Sinai Comprehensive Cancer Center, Miami, Florida (United States)
  9. Department of Radiation Oncology, Botsford Hospital, Farmington Hills, Michigan (United States)
  10. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)
Publication Date:
OSTI Identifier:
22648765
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 95; Journal Issue: 5; Other Information: Copyright (c) 2016 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; CHEMOTHERAPY; GY RANGE 10-100; IRRADIATION; MAMMARY GLANDS; NEOPLASMS; PATIENTS

Citation Formats

White, Julia, E-mail: Julia.White@osumc.edu, Winter, Kathryn, Kuske, Robert R., Bolton, John S., Arthur, Douglas W., Scroggins, Troy, Rabinovitch, Rachel A., Kelly, Tracy, Toonkel, Leonard M., Vicini, Frank A., and McCormick, Beryl. Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.03.037.
White, Julia, E-mail: Julia.White@osumc.edu, Winter, Kathryn, Kuske, Robert R., Bolton, John S., Arthur, Douglas W., Scroggins, Troy, Rabinovitch, Rachel A., Kelly, Tracy, Toonkel, Leonard M., Vicini, Frank A., & McCormick, Beryl. Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer. United States. doi:10.1016/J.IJROBP.2016.03.037.
White, Julia, E-mail: Julia.White@osumc.edu, Winter, Kathryn, Kuske, Robert R., Bolton, John S., Arthur, Douglas W., Scroggins, Troy, Rabinovitch, Rachel A., Kelly, Tracy, Toonkel, Leonard M., Vicini, Frank A., and McCormick, Beryl. Mon . "Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer". United States. doi:10.1016/J.IJROBP.2016.03.037.
@article{osti_22648765,
title = {Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer},
author = {White, Julia, E-mail: Julia.White@osumc.edu and Winter, Kathryn and Kuske, Robert R. and Bolton, John S. and Arthur, Douglas W. and Scroggins, Troy and Rabinovitch, Rachel A. and Kelly, Tracy and Toonkel, Leonard M. and Vicini, Frank A. and McCormick, Beryl},
abstractNote = {Purpose: To examine 10-year rates of local, regional, and distant recurrences, patterns of recurrence, and survival rates for breast cancer patients enrolled on Study NRG Oncology/Radiation Therapy Oncology Group 9517, a multi-institutional prospective trial that studied one of the earliest methods of accelerated partial breast irradiation (APBI), multicatheter brachytherapy (MCT). Methods and Materials: Eligibility included stage I/II unifocal breast cancer <3 cm in size after lumpectomy with negative surgical margins and 0 to 3 positive axillary nodes without extracapsular extension. The APBI dose delivered was 34 Gy in 10 twice-daily fractions over 5 days for high-dose-rate (HDR); and 45 Gy in 3.5 to 5 days for low-dose-rate (LDR) brachytherapy. The primary endpoint was HDR and LDR MCT reproducibility. This analysis focuses on long-term ipsilateral breast recurrence (IBR), contralateral breast cancer events (CBE), regional recurrence (RR), and distant metastases (DM), disease-free, and overall survival. Results: The median follow-up was 12.1 years. One hundred patients were accrued from 1997 to 2000; 98 were evaluable; 65 underwent HDR and 33 LDR MCT. Median age was 62 years; 88% had T1 tumors; 81% were pN0. Seventy-seven percent were estrogen receptor and/or progesterone receptor positive; 33% received adjuvant chemotherapy and 64% antiendocrine therapy. There have been 4 isolated IBRs and 1 IBR with RR, for 5.2% 10-year IBR without DM. There was 1 isolated RR, 1 with IBR, and 1 with a CBE, for 3.1% 10-year RR without DM. The 10-year CBE rate was 4.2%, with 5 total events. Eleven patients have developed DM, 8 have died of breast cancer, and 22 have died from other causes. The 10-year DFS and OS rates are 69.8% and 78.0%, respectively. Conclusion: This multi-institutional, phase 2 trial studying MCT-APBI continues to report durable in-breast cancer control rates with long-term follow-up.},
doi = {10.1016/J.IJROBP.2016.03.037},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 95,
place = {United States},
year = {Mon Aug 01 00:00:00 EDT 2016},
month = {Mon Aug 01 00:00:00 EDT 2016}
}