Disease Control Efficacy of Ductal Carcinoma In Situ (DCIS) Treated With Accelerated Partial Breast Irradiation (APBI)
| Autor: | Charles E. Leonard, P. Henkenberns, Lora Barke, R.M. LaPorte, S.P. Fryman, Jodi L. Widner, Rachel Y. Lei, Dennis L. Carter, R.D. Higdon, K. Howell |
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| Rok vydání: | 2013 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty Radiation business.industry Breast pain Cosmesis Partial Breast Irradiation medicine.disease Atrophy Internal medicine Edema Ductal carcinoma in situ (DCIS) medicine Radiology Nuclear Medicine and imaging Fat necrosis medicine.symptom Nuclear medicine business Telangiectasia |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 87:S196 |
| ISSN: | 0360-3016 |
| Popis: | RTOG/EORTC Late Radiation Morbidity systems were used for evaluation of skin, subcutaneous and non-cutaneous toxicities. Median follow-up was 82.5 months (range, 2-104 months). Results: At 4 years, the physician rating of overall cosmesis was good or excellent for 94% of photon patients, compared to 77% of proton patients, with fair or poor results for 6% and 27%, respectively (p Z 0.05). The incidence between the groups were: telangiectasia 11% for photon and 73% for proton patients (p < 0.01); any skin color change, 14% and 60% (p < 0.01); and late atrophy, 19% and 67% (p < 0.01). There were no significant differences between the groups in the incidences of breast pain, edema, fibrosis, fat necrosis, skin desquamation or rib pain or fracture. Patient-reported cosmetic outcomes at 4 years did not significantly differ (good or excellent for 95% of photon patients and 93% of proton patients) (p Z 0.4). There were no differences in breast pain, swelling, skin color or overall satisfaction. Conclusions: Proton 3D-APBI, with a single field used per treatment, led to higher rates of telangiectasia, skin color change and atrophy than treatment with photon or mixed photon and electron plans using 3 or more fields per treatment. Multiple fields per treatment should be used with proton 3D-APBI, similarly to photon 3D-APBI, to minimize the per day integral dose to normal tissue. Pencil beam scanning and other techniques should be explored to reduce proton APBI toxicity. Author Disclosure: S. Galland: None. I.M. Pashtan: None. S.M. MacDonald: None. M. Ancukiewicz: None. M. Specht: None. M.A. Gadd: None. B.L. Smith: None. A. Recht: G. Consultant; medical advisory board of CareCore National, Inc. A.G. Taghian: None. |
| Databáze: | OpenAIRE |
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