Management of ductal carcinoma in situ with accelerated partial breast irradiation brachytherapy: Implications for guideline expansion.

Autor:	Mills MN; Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL., Russo NW; University of South Florida Morsani College of Medicine, Tampa, FL., Nanda RH; Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL., Wilson JP; Comprehensive Breast Cancer Center of Tampa Bay, Morton Plant Hospital, Clearwater, FL., Altoos TA; Countryside Cancer Center, Clearwater, FL., Caldwell DL; Lykes Radiation Pavilion, Morton Plant Hospital, Clearwater, FL., Stout LL; Lykes Radiation Pavilion, Morton Plant Hospital, Clearwater, FL., Dube S; Lykes Radiation Pavilion, Morton Plant Hospital, Clearwater, FL., Blumencranz PW; Comprehensive Breast Cancer Center of Tampa Bay, Morton Plant Hospital, Clearwater, FL., Allen KG; Comprehensive Breast Cancer Center of Tampa Bay, Morton Plant Hospital, Clearwater, FL., Diaz R; Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. Electronic address: Roberto.Diaz@moffitt.org.
Jazyk:	angličtina
Zdroj:	Brachytherapy [Brachytherapy] 2021 Mar-Apr; Vol. 20 (2), pp. 345-352. Date of Electronic Publication: 2020 Dec 11.
DOI:	10.1016/j.brachy.2020.11.002
Abstrakt:	Purpose: Accelerated partial breast irradiation (APBI) for patients with ductal carcinoma in situ (DCIS) is controversial, and the suitability criteria from the American Brachytherapy Society (ABS), American Society of Therapeutic Radiology and Oncology (ASTRO), and the European Society for Radiotherapy and Oncology (GEC-ESTRO) have important differences. Methods and Materials: This is a single-institution retrospective review of 169 consecutive patients with DCIS who underwent lumpectomy followed by APBI intracavitary brachytherapy from 2003 to 2018. Outcomes, including overall survival, recurrence-free survival (RFS), ipsilateral breast tumor recurrence, and distant metastasis, were estimated with the Kaplan-Meier method. Results: The median followup time was 62.5 months. Median age was 66 years (47-89 years). The majority of patients had estrogen receptor-positive disease (89%). Fifty patients (30%) had Grade 3 disease. Of the 142 patients with adequate pathology interpretation, 91 and 108 cases had margins ≥ 3 mm and ≥2 mm, respectively. Most patients (72%) were prescribed and started endocrine therapy. Of the patients evaluable for ABS criteria (N = 130), 97 met the suitability criteria. Of the patients evaluable for ASTRO criteria (N = 129), 42 were deemed cautionary and 33 were deemed unsuitable. Of the patients evaluable for GEC-ESTRO criteria (N = 143), 141 cases were at intermediate risk and two were at high risk. Five-year ipsilateral breast tumor recurrence, RFS, and overall survival were 0.6%, 97.7%, and 97.2%, respectively. The ABS, ASTRO, and GEC-ESTRO criteria failed to significantly predict for RFS. Conclusions: These results, although limited by short-term followup, indicate that expansion of the eligibility criteria of APBI for patients with DCIS should be considered. (Copyright © 2020 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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