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Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer
BACKGROUND: Local recurrences after breast conserving treatment are mainly close to the original tumor site, and as such shorter fractionation strategies focused on and nearest mammary gland, i.e. accelerated partial breast irradiation (APBI), have been developed. Stereotactic APBI has been attempte...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865347/ https://www.ncbi.nlm.nih.gov/pubmed/29566762 http://dx.doi.org/10.1186/s13014-018-0991-4 |
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author | Lozza, Laura Fariselli, Laura Sandri, Marco Rampa, Mario Pinzi, Valentina De Santis, Maria Carmen Franceschini, Marzia Trecate, Giovanna Maugeri, Ilaria Fumagalli, Luisa Bonfantini, Francesca Bianchi, Giulia Pignoli, Emanuele De Martin, Elena Agresti, Roberto |
author_facet | Lozza, Laura Fariselli, Laura Sandri, Marco Rampa, Mario Pinzi, Valentina De Santis, Maria Carmen Franceschini, Marzia Trecate, Giovanna Maugeri, Ilaria Fumagalli, Luisa Bonfantini, Francesca Bianchi, Giulia Pignoli, Emanuele De Martin, Elena Agresti, Roberto |
author_sort | Lozza, Laura |
collection | PubMed |
description | BACKGROUND: Local recurrences after breast conserving treatment are mainly close to the original tumor site, and as such shorter fractionation strategies focused on and nearest mammary gland, i.e. accelerated partial breast irradiation (APBI), have been developed. Stereotactic APBI has been attempted, although there is little experience using CyberKnife (CK) for early breast cancer. METHODS: This pilot study was designed to assess the feasibility of CK-APBI on 20 evaluable patients of 29 eligible, followed for 2 years. The primary endpoint was acute/sub-acute toxicity; secondary endpoints were late toxicity and the cosmetic result. RESULTS: Mean pathological tumor size was 10.5 mm (±4.3, range 3–18), 8 of these patients were classified as LumA-like, 11 as LumB-like, and 1 as LumB-HER2-enriched. Using CK-APBI with Iris, the treatment time was approximately 60 min (range~ 35 to ~ 120). All patients received 30 Gy in five fractions delivered to the PTV. The median number of beams was 180 (IQR 107–213; range:56–325) with a median PTV isodose prescription of 86.0% (IQR 85.0–88.5; range:82–94). The median PTV was 88.1 cm3 (IQR 63.8–108.6; range:32.3–238.8). The median breast V100 and V50 was 0.6 (IQR 0.1–1.5; range:0–13) and 18.6 (IQR 13.1–21.7; range:7.5–37), respectively. The median PTV minimum dose was 26.2 Gy (IQR 24.7–27.6; range 22.3–29.3). Mild side effects were recorded during the period of observation. Cosmetic evaluations were performed by three observers from the start of radiotherapy up to 2 years. Patients’ evaluation progressively increase from 60% to 85% of excellent rating; this trend was similar to that of external observer. CONCLUSIONS: These preliminary results showed the safe feasibility of CK-APBI in early breast cancer, with mild acute and late toxicity and very good cosmetic results. TRIAL REGISTRATION: The present study is registered at Clinicaltrial.gov (NCT02896322). Retrospectively egistered August 4, 2016. |
format | Online Article Text |
id | pubmed-5865347 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-58653472018-03-27 Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer Lozza, Laura Fariselli, Laura Sandri, Marco Rampa, Mario Pinzi, Valentina De Santis, Maria Carmen Franceschini, Marzia Trecate, Giovanna Maugeri, Ilaria Fumagalli, Luisa Bonfantini, Francesca Bianchi, Giulia Pignoli, Emanuele De Martin, Elena Agresti, Roberto Radiat Oncol Research BACKGROUND: Local recurrences after breast conserving treatment are mainly close to the original tumor site, and as such shorter fractionation strategies focused on and nearest mammary gland, i.e. accelerated partial breast irradiation (APBI), have been developed. Stereotactic APBI has been attempted, although there is little experience using CyberKnife (CK) for early breast cancer. METHODS: This pilot study was designed to assess the feasibility of CK-APBI on 20 evaluable patients of 29 eligible, followed for 2 years. The primary endpoint was acute/sub-acute toxicity; secondary endpoints were late toxicity and the cosmetic result. RESULTS: Mean pathological tumor size was 10.5 mm (±4.3, range 3–18), 8 of these patients were classified as LumA-like, 11 as LumB-like, and 1 as LumB-HER2-enriched. Using CK-APBI with Iris, the treatment time was approximately 60 min (range~ 35 to ~ 120). All patients received 30 Gy in five fractions delivered to the PTV. The median number of beams was 180 (IQR 107–213; range:56–325) with a median PTV isodose prescription of 86.0% (IQR 85.0–88.5; range:82–94). The median PTV was 88.1 cm3 (IQR 63.8–108.6; range:32.3–238.8). The median breast V100 and V50 was 0.6 (IQR 0.1–1.5; range:0–13) and 18.6 (IQR 13.1–21.7; range:7.5–37), respectively. The median PTV minimum dose was 26.2 Gy (IQR 24.7–27.6; range 22.3–29.3). Mild side effects were recorded during the period of observation. Cosmetic evaluations were performed by three observers from the start of radiotherapy up to 2 years. Patients’ evaluation progressively increase from 60% to 85% of excellent rating; this trend was similar to that of external observer. CONCLUSIONS: These preliminary results showed the safe feasibility of CK-APBI in early breast cancer, with mild acute and late toxicity and very good cosmetic results. TRIAL REGISTRATION: The present study is registered at Clinicaltrial.gov (NCT02896322). Retrospectively egistered August 4, 2016. BioMed Central 2018-03-23 /pmc/articles/PMC5865347/ /pubmed/29566762 http://dx.doi.org/10.1186/s13014-018-0991-4 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Lozza, Laura Fariselli, Laura Sandri, Marco Rampa, Mario Pinzi, Valentina De Santis, Maria Carmen Franceschini, Marzia Trecate, Giovanna Maugeri, Ilaria Fumagalli, Luisa Bonfantini, Francesca Bianchi, Giulia Pignoli, Emanuele De Martin, Elena Agresti, Roberto Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
title | Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
title_full | Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
title_fullStr | Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
title_full_unstemmed | Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
title_short | Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
title_sort | partial breast irradiation with cyberknife after breast conserving surgery: a pilot study in early breast cancer |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865347/ https://www.ncbi.nlm.nih.gov/pubmed/29566762 http://dx.doi.org/10.1186/s13014-018-0991-4 |
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