Multi-institutional registry study evaluating the feasibility and toxicity of accelerated partial breast irradiation using noninvasive image-guided breast brachytherapy
| Autor: | Sandra Sha, David E. Wazer, Michael Kerley, Paul G. Kocheril, Leann Smith, Dean Mastras, John Chinault, Kara L. Leonard, Bushra Rana, Andrea B. McKee, Ann Pittier, Mark J. Rivard, Rashmi Benda, Jaroslaw T. Hepel, Tushar R. Shah |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Registry study medicine.medical_treatment Brachytherapy Breast Neoplasms Mastectomy Segmental 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Breast cancer medicine Humans Radiology Nuclear Medicine and imaging Registries Aged Breast brachytherapy business.industry Partial Breast Irradiation Radiotherapy Dosage Common Terminology Criteria for Adverse Events medicine.disease Radiation therapy Treatment Outcome Oncology 030220 oncology & carcinogenesis Toxicity Feasibility Studies Female Radiology Neoplasm Recurrence Local business |
| Zdroj: | Brachytherapy. 20:631-637 |
| ISSN: | 1538-4721 |
| DOI: | 10.1016/j.brachy.2021.01.002 |
| Popis: | Purpose The noninvasive image-guided breast brachytherapy (NIBB) technique is a novel noninvasive yet targeted method for accelerated partial breast irradiation. We established a multi-institutional registry to evaluate the toxicity and efficacy of this technique across various practice settings. Methods and Materials Institutions using the NIBB technique were invited to participate. Data for acute/late toxicity, cosmetic outcome, and tumor recurrence were collected. Toxicity and cosmetic outcome were graded based on the Common Terminology Criteria for Adverse Events version 3.0 and NRG/Radiation Therapy Oncology Group scale, respectively. Treatment variables were analyzed for association with outcomes. Results A total of 252 patients from eight institutions were analyzed. The median age was 69 years. The mean tumor size was 1.1 cm (0.1–4.0 cm). Treatment was delivered 10 fractions (34–36 Gy) in 75% and five fractions (28.5 Gy) in 22%. B.i.d. fractionation was used in 9%. Acute radiation dermatitis was Grade 0–1, 2, and 3 in 77%, 19%, and 4%, respectively. One hundred ninety-one patients with a median followup of 18 months (4–72 months) were evaluable for late outcomes. Late toxicity Grades 2 and 3 were observed in 8.8% and 1%, respectively. Cosmetic outcome was excellent, good, and fair/poor in 62%, 36%, and 2%, respectively. B.i.d. fractionation was associated with higher acute and late toxicity. Second-generation applicators were associated with lower late toxicity and better cosmetic outcome. Actuarial freedom from ipsilateral breast tumor recurrence and true recurrence were 98.3% and 98.3% at 2 years and 90.9% and 95.4% at 5 years, respectively. Conclusions Accelerated partial breast irradiation using NIBB was well tolerated with a low rate of acute and late toxicity across various practice settings. Ipsilateral breast tumor recurrence and cosmetic outcomes were favorable. b.i.d. fractionation was associated with higher toxicity. Longer followup is needed to confirm late endpoints. |
| Databáze: | OpenAIRE |
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