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Patterns of Recurrence Among Higher-Risk Patients Receiving Daily External Beam Accelerated Partial-Breast Irradiation to 40 Gy in 10 Fractions

PURPOSE: The 2016 American Society for Radiation Oncology consensus guidelines for the use of accelerated partial-breast irradiation (APBI) define “suitable,” “cautionary,” and “unsuitable” populations for this adjuvant breast radiation therapy technique. We sought to determine whether patients in t...

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Autores principales: Fitzgerald, Kelly, Flynn, Jessica, Zhang, Zhigang, Cost, Zachary, Mueller, Boris, Gillespie, Erin F., McCormick, Beryl, Khan, Atif, Cahlon, Oren, Powell, Simon N., Braunstein, Lior Z.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004933/
https://www.ncbi.nlm.nih.gov/pubmed/32051887
http://dx.doi.org/10.1016/j.adro.2019.07.017
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author Fitzgerald, Kelly
Flynn, Jessica
Zhang, Zhigang
Cost, Zachary
Mueller, Boris
Gillespie, Erin F.
McCormick, Beryl
Khan, Atif
Cahlon, Oren
Powell, Simon N.
Braunstein, Lior Z.
author_facet Fitzgerald, Kelly
Flynn, Jessica
Zhang, Zhigang
Cost, Zachary
Mueller, Boris
Gillespie, Erin F.
McCormick, Beryl
Khan, Atif
Cahlon, Oren
Powell, Simon N.
Braunstein, Lior Z.
author_sort Fitzgerald, Kelly
collection PubMed
description PURPOSE: The 2016 American Society for Radiation Oncology consensus guidelines for the use of accelerated partial-breast irradiation (APBI) define “suitable,” “cautionary,” and “unsuitable” populations for this adjuvant breast radiation therapy technique. We sought to determine whether patients in the cautionary group exhibited adverse outcomes after APBI compared with their suitable counterparts. METHODS AND MATERIALS: We identified 252 consecutively treated patients from a single institution with in situ or early-stage invasive breast cancer who underwent APBI between 2008 and 2017. Treatment technique was uniform throughout the population, consisting of 3-dimensional conformal radiation therapy to 40 Gy administered in 10 daily fractions. RESULTS: One hundred seventy-eight patients (70%) were classified as suitable, 69 (27%) as cautionary, and 5 (2.0%) as unsuitable. Because unsuitable patients were few and had no recurrences, they were excluded from analysis. At a median follow-up time of 3.9 years, 97.2% of patients were free of recurrence. Four patients (1.5% overall; 3 suitable and 1 cautionary) experienced ipsilateral in-breast recurrences, and 1 cautionary patient developed an ipsilateral regional recurrence in an axillary lymph node. There was no significant difference in the rate of ipsilateral breast recurrence (2.4% vs 1.0%) between cautionary and suitable groups. CONCLUSIONS: Local recurrences are rare among guideline-defined cautionary patients with in situ or invasive breast cancer treated with APBI delivered via daily 3-dimensional conformal radiation therapy to 40 Gy. At a median follow-up of 3.9 years, no significant differences in local control were noted between cautionary and suitable patient groups. Further study is needed to characterize long-term disease outcomes among various risk groups.
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spelling pubmed-70049332020-02-12 Patterns of Recurrence Among Higher-Risk Patients Receiving Daily External Beam Accelerated Partial-Breast Irradiation to 40 Gy in 10 Fractions Fitzgerald, Kelly Flynn, Jessica Zhang, Zhigang Cost, Zachary Mueller, Boris Gillespie, Erin F. McCormick, Beryl Khan, Atif Cahlon, Oren Powell, Simon N. Braunstein, Lior Z. Adv Radiat Oncol Breast Cancer PURPOSE: The 2016 American Society for Radiation Oncology consensus guidelines for the use of accelerated partial-breast irradiation (APBI) define “suitable,” “cautionary,” and “unsuitable” populations for this adjuvant breast radiation therapy technique. We sought to determine whether patients in the cautionary group exhibited adverse outcomes after APBI compared with their suitable counterparts. METHODS AND MATERIALS: We identified 252 consecutively treated patients from a single institution with in situ or early-stage invasive breast cancer who underwent APBI between 2008 and 2017. Treatment technique was uniform throughout the population, consisting of 3-dimensional conformal radiation therapy to 40 Gy administered in 10 daily fractions. RESULTS: One hundred seventy-eight patients (70%) were classified as suitable, 69 (27%) as cautionary, and 5 (2.0%) as unsuitable. Because unsuitable patients were few and had no recurrences, they were excluded from analysis. At a median follow-up time of 3.9 years, 97.2% of patients were free of recurrence. Four patients (1.5% overall; 3 suitable and 1 cautionary) experienced ipsilateral in-breast recurrences, and 1 cautionary patient developed an ipsilateral regional recurrence in an axillary lymph node. There was no significant difference in the rate of ipsilateral breast recurrence (2.4% vs 1.0%) between cautionary and suitable groups. CONCLUSIONS: Local recurrences are rare among guideline-defined cautionary patients with in situ or invasive breast cancer treated with APBI delivered via daily 3-dimensional conformal radiation therapy to 40 Gy. At a median follow-up of 3.9 years, no significant differences in local control were noted between cautionary and suitable patient groups. Further study is needed to characterize long-term disease outcomes among various risk groups. Elsevier 2019-08-06 /pmc/articles/PMC7004933/ /pubmed/32051887 http://dx.doi.org/10.1016/j.adro.2019.07.017 Text en © 2019 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Breast Cancer
Fitzgerald, Kelly
Flynn, Jessica
Zhang, Zhigang
Cost, Zachary
Mueller, Boris
Gillespie, Erin F.
McCormick, Beryl
Khan, Atif
Cahlon, Oren
Powell, Simon N.
Braunstein, Lior Z.
Patterns of Recurrence Among Higher-Risk Patients Receiving Daily External Beam Accelerated Partial-Breast Irradiation to 40 Gy in 10 Fractions
title Patterns of Recurrence Among Higher-Risk Patients Receiving Daily External Beam Accelerated Partial-Breast Irradiation to 40 Gy in 10 Fractions
title_full Patterns of Recurrence Among Higher-Risk Patients Receiving Daily External Beam Accelerated Partial-Breast Irradiation to 40 Gy in 10 Fractions
title_fullStr Patterns of Recurrence Among Higher-Risk Patients Receiving Daily External Beam Accelerated Partial-Breast Irradiation to 40 Gy in 10 Fractions
title_full_unstemmed Patterns of Recurrence Among Higher-Risk Patients Receiving Daily External Beam Accelerated Partial-Breast Irradiation to 40 Gy in 10 Fractions
title_short Patterns of Recurrence Among Higher-Risk Patients Receiving Daily External Beam Accelerated Partial-Breast Irradiation to 40 Gy in 10 Fractions
title_sort patterns of recurrence among higher-risk patients receiving daily external beam accelerated partial-breast irradiation to 40 gy in 10 fractions
topic Breast Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004933/
https://www.ncbi.nlm.nih.gov/pubmed/32051887
http://dx.doi.org/10.1016/j.adro.2019.07.017
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