Timing of Chemotherapy After MammoSite Radiation Therapy System Breast Brachytherapy: Analysis of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)
- Department of Surgery, Dallas Breast Center, Dallas, TX (United States)
- Department of Radiation Oncology, Arizona Oncology Services, Scottsdale, AZ (United States)
- Department of Surgery, Western Pennsylvania Hospital, Pittsburgh, PA (United States)
- Department of Radiation Oncology, St. Louis Cancer and Breast Center, St. Louis, MO (United States)
- Department of Surgery, Alabama Breast Center, Montgomery, AL (United States)
- Department of Surgery, Sacred Heart Hospital, Allentown, PA (United States)
- Department of Surgery, Breast Care Center of the Southwest, Phoenix, AZ (United States)
- Department of Surgery, M. D. Anderson Cancer Center, Houston, TX (United States)
- Department of Surgery, Breast Center of Southern Arizona, Tucson, AZ (United States)
- Department of Surgery, Vassar Brothers Medical Center, Poughkeepsie, NY (United States)
- Department of Surgery, Advanced Breast Care, Marietta, GA (United States)
- Department of Radiation Oncology, Cedars Medical Center, Miami, FL (United States)
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.
- OSTI ID:
- 21172504
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 72, 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); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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