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Title: Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial

Abstract

Purpose: To assess the feasibility of utilizing 3-dimensional conformal accelerated partial-breast irradiation (APBI) in the preoperative setting followed by standard breast-conserving therapy. Patients and Methods: This was a prospective trial testing the feasibility of preoperative APBI followed by lumpectomy for patients with early-stage invasive ductal breast cancer. Eligible patients had T1-T2 (<3 cm), N0 tumors. Patients received 38.5 Gy in 3.85-Gy fractions delivered twice daily. Surgery was performed >21 days after radiation therapy. Adjuvant therapy was given as per standard of care. Results: Twenty-seven patients completed treatment. With a median follow-up of 3.6 years (range, 0.5-5 years), there have been no local or regional failures. A complete pathologic response according to hematoxylin and eosin stains was seen in 4 patients (15%). There were 4 grade 3 seromas. Patient-reported cosmetic outcome was rated as good to excellent in 79% of patients after treatment. Conclusions: Preoperative 3-dimensional conformal radiation therapy−APBI is feasible and well tolerated in select patients with early-stage breast cancer, with no reported local recurrences and good to excellent cosmetic results. The pathologic response rates associated with this nonablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.

Authors:
 [1]; ; ;  [2];  [3]; ; ;  [1];  [4]; ;  [1]
  1. Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States)
  2. Department of Surgical Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States)
  3. Department of Medical Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States)
  4. Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland (United States)
Publication Date:
OSTI Identifier:
22649863
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 97; Journal Issue: 4; Other Information: Copyright (c) 2016 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; CONSUMER PRODUCTS; GY RANGE 10-100; IRRADIATION; MAMMARY GLANDS; NEOPLASMS; PATIENTS; RADIOTHERAPY

Citation Formats

Nichols, Elizabeth, E-mail: Enichols1@umm.edu, Kesmodel, Susan B., Bellavance, Emily, Drogula, Cynthia, Tkaczuk, Katherine, Cohen, Randi J., Citron, Wendla, Morgan, Michelle, Staats, Paul, Feigenberg, Steven, and Regine, William F. Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2016.11.030.
Nichols, Elizabeth, E-mail: Enichols1@umm.edu, Kesmodel, Susan B., Bellavance, Emily, Drogula, Cynthia, Tkaczuk, Katherine, Cohen, Randi J., Citron, Wendla, Morgan, Michelle, Staats, Paul, Feigenberg, Steven, & Regine, William F. Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial. United States. doi:10.1016/J.IJROBP.2016.11.030.
Nichols, Elizabeth, E-mail: Enichols1@umm.edu, Kesmodel, Susan B., Bellavance, Emily, Drogula, Cynthia, Tkaczuk, Katherine, Cohen, Randi J., Citron, Wendla, Morgan, Michelle, Staats, Paul, Feigenberg, Steven, and Regine, William F. Wed . "Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial". United States. doi:10.1016/J.IJROBP.2016.11.030.
@article{osti_22649863,
title = {Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial},
author = {Nichols, Elizabeth, E-mail: Enichols1@umm.edu and Kesmodel, Susan B. and Bellavance, Emily and Drogula, Cynthia and Tkaczuk, Katherine and Cohen, Randi J. and Citron, Wendla and Morgan, Michelle and Staats, Paul and Feigenberg, Steven and Regine, William F.},
abstractNote = {Purpose: To assess the feasibility of utilizing 3-dimensional conformal accelerated partial-breast irradiation (APBI) in the preoperative setting followed by standard breast-conserving therapy. Patients and Methods: This was a prospective trial testing the feasibility of preoperative APBI followed by lumpectomy for patients with early-stage invasive ductal breast cancer. Eligible patients had T1-T2 (<3 cm), N0 tumors. Patients received 38.5 Gy in 3.85-Gy fractions delivered twice daily. Surgery was performed >21 days after radiation therapy. Adjuvant therapy was given as per standard of care. Results: Twenty-seven patients completed treatment. With a median follow-up of 3.6 years (range, 0.5-5 years), there have been no local or regional failures. A complete pathologic response according to hematoxylin and eosin stains was seen in 4 patients (15%). There were 4 grade 3 seromas. Patient-reported cosmetic outcome was rated as good to excellent in 79% of patients after treatment. Conclusions: Preoperative 3-dimensional conformal radiation therapy−APBI is feasible and well tolerated in select patients with early-stage breast cancer, with no reported local recurrences and good to excellent cosmetic results. The pathologic response rates associated with this nonablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.},
doi = {10.1016/J.IJROBP.2016.11.030},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 97,
place = {United States},
year = {2017},
month = {3}
}