Long-term Results of a Randomized Trial of Accelerated Hypofractionated Whole Breast Irradiation Following Breast Conserving Surgery in Women with Node-Negative Breast Cancer

2008 ◽  
Vol 72 (1) ◽  
pp. S28 ◽  
Author(s):  
T.J. Whelan ◽  
J. Pignol ◽  
J. Julian ◽  
L. Grimard ◽  
J. Bowen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Trial ◽  
Breast Conserving Surgery ◽  
Long Term Results ◽  
Whole Breast Irradiation ◽  
Breast Irradiation ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Hypofractionated Whole Breast Irradiation

scholarly journals Long-term results of hypofractionation with concomitant boost in patients with early breast cancer: A prospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258186
Author(s):  
Kitwadee Saksornchai ◽  
Thitiporn Jaruthien ◽  
Chonnipa Nantavithya ◽  
Kanjana Shotelersuk ◽  
Prayuth Rojpornpradit
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Early Breast Cancer ◽  
Long Term Results ◽  
Whole Breast Irradiation ◽  
Breast Irradiation ◽  
Sequential Boost ◽  
Concomitant Boost ◽  
Hypofractionated Whole Breast Irradiation

Aim To report the long-term local control and survival of patients with early breast cancer who had hypofractionated whole breast irradiation with concomitant boost (Hypo-CB). Methods and materials Between October 2009 and June 2010, 73 patients with early breast cancer (T1-3N0-1M0) who underwent breast conserving surgery were enrolled into the study. Thirty-six of these participants received 50 Gy of conventional irradiation in 25 fractions over 5 weeks to the whole breast with a sequential boost to the tumor bed with 10–16 Gy in 5–8 fractions (Conv-SEQ). The other 37 participants received a hypofractionated dose of 43.2 Gy in 16 fractions with an additional daily concomitant boost (CB) of 0.6 Gy over 3 weeks (Hypo-CB). Results At a median follow-up time of 123 months, ipsilateral local recurrence (ILR) was found in 3 participants, 1 of whom was in the hypofractionated group. All 3 ILR were true local recurrence (TR). There were no significant differences in the 10-year disease free survival (DFS) and 10-year overall survival rates (OS) between the conventional and hypofractionated groups (93.9% vs. 94.4%, p = 0.96 and 91.9% vs. 91.6%, p = 0.792, respectively). Conclusion This study showed that the effectiveness, DFS and OS were comparable between hypofractionated whole breast irradiation with a CB and the conventional irradiation with a sequential boost.

Accelerated Partial-Breast Irradiation Compared With Whole-Breast Irradiation for Early Breast Cancer: Long-Term Results of the Randomized Phase III APBI-IMRT-Florence Trial

2020 ◽  
Vol 38 (35) ◽  
pp. 4175-4183 ◽  
Author(s):  
Icro Meattini ◽  
Livia Marrazzo ◽  
Calogero Saieva ◽  
Isacco Desideri ◽  
Vieri Scotti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Phase Iii ◽  
Accelerated Partial Breast Irradiation ◽  
Long Term Results ◽  
Partial Breast Irradiation ◽  
Whole Breast Irradiation ◽  
Breast Irradiation ◽  
Once Daily

PURPOSE To report the long-term results of external-beam accelerated partial-breast irradiation (APBI) intensity-modulated radiation therapy (IMRT) Florence phase III trial comparing whole-breast irradiation (WBI) to APBI in early-stage breast cancer. PATIENTS AND METHODS The primary end point was to determine the 5-year difference in ipsilateral breast tumor recurrence (IBTR) between 30 Gy in 5 once-daily fractions (APBI arm) and 50 Gy in 25 fractions with a tumor bed boost (WBI arm) after breast-conserving surgery. RESULTS Five hundred twenty patients, more than 90% of whom had characteristics associated with low recurrence risk, were randomly assigned (WBI, n = 260; APBI, n = 260) between 2005 and 2013. Median follow-up was 10.7 years. The 10-year cumulative incidence of IBTR was 2.5% (n = 6) in the WBI and 3.7% (n = 9) in the APBI arm (hazard ratio [HR], 1.56; 95% CI, 0.55 to 4.37; P = .40). Overall survival at 10 years was 91.9% in both arms (HR, 0.95; 95% CI, 0.50 to 1.79; P = .86). Breast cancer–specific survival at 10 years was 96.7% in the WBI and 97.8% in the APBI arm (HR, 0.65; 95% CI, 0.21 to 1.99; P = .45). The APBI arm showed significantly less acute toxicity ( P = .0001) and late toxicity ( P = .0001) and improved cosmetic outcome as evaluated by both physician ( P = .0001) and patient ( P = .0001). CONCLUSION The 10-year cumulative IBTR incidence in early breast cancer treated with external APBI using IMRT technique in 5 once-daily fractions is low and not different from that after WBI. Acute and late treatment-related toxicity and cosmesis outcomes were significantly in favor of APBI.

Long-Term Results of the TARGIT-A Trial: More Questions than Answers

Breast Care ◽  
2021 ◽  
pp. 1-4
Author(s):  
Marc D. Piroth ◽  
Vratislav Strnad ◽  
David Krug ◽  
Gerd Fastner ◽  
René Baumann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Intraoperative Radiotherapy ◽  
Breast Conserving Surgery ◽  
Long Term Results ◽  
Partial Breast Irradiation ◽  
X Rays ◽  
Breast Irradiation ◽  
Number Of Patients

<b><i>Background:</i></b> During the last decade, partial breast irradiation (PBI) has gained traction as a relevant treatment option for patients with early-stage low-risk breast cancer after breast-conserving surgery. The TARGIT-A prospective randomized trial compared a “risk-adapted” intraoperative radiotherapy (IORT) approach with 50-kv X-rays (INTRABEAM®) as the PBI followed by optional whole-breast irradiation (WBI) and conventional adjuvant WBI in terms of observed 5-year in-breast recurrence rates. Recently, long-term data were published. Since the first publication of the TARGIT-A trial, a broad debate has been emerged regarding several uncertainties and limitations associated with data analysis and interpretation. Our main objective was to summarize the data, with an emphasis on the updated report and the resulting implications. <b><i>Summary:</i></b> From our point of view, the previously unresolved questions still remain and more have been added, especially with regard to the study design, a change in the primary outcome measure, the significant number of patients lost to follow-up, and the lack of a subgroup analysis according to risk factors and treatment specifications. <b><i>Key Message:</i></b> Taking into account the abovementioned limitations of the recently published long-term results of the TARGIT-A trial, the German Society of Radiation Oncology (DEGRO) Breast Cancer Expert Panel adheres to its recently published recommendations on PBI: “the 50-kV system (INTRABEAM) cannot be recommended for routine adjuvant PBI treatment after breast-conserving surgery.”

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