EP-1018 PHASE III STUDY COMPARING ACCELERATED PARTIAL BREAST IRRADIATION VS WHOLE BREAST RADIATION THERAPY USING 3D-CRT

2012 ◽  
Vol 103 ◽  
pp. S400 ◽  
Author(s):  
N. Rodriguez ◽  
X. Sanz ◽  
P. Foro ◽  
A. Reig ◽  
I. Membrive ◽  
...  
2013 ◽  
Vol 31 (32) ◽  
pp. 4038-4045 ◽  
Author(s):  
Ivo A. Olivotto ◽  
Timothy J. Whelan ◽  
Sameer Parpia ◽  
Do-Hoon Kim ◽  
Tanya Berrang ◽  
...  

Purpose To report interim cosmetic and toxicity results of a multicenter randomized trial comparing accelerated partial-breast irradiation (APBI) using three-dimensional conformal external beam radiation therapy (3D-CRT) with whole-breast irradiation (WBI). Patients and Methods Women age > 40 years with invasive or in situ breast cancer ≤ 3 cm were randomly assigned after breast-conserving surgery to 3D-CRT APBI (38.5 Gy in 10 fractions twice daily) or WBI (42.5 Gy in 16 or 50 Gy in 25 daily fractions ± boost irradiation). The primary outcome was ipsilateral breast tumor recurrence (IBTR). Secondary outcomes were cosmesis and toxicity. Adverse cosmesis was defined as a fair or poor global cosmetic score. After a planned interim cosmetic analysis, the data, safety, and monitoring committee recommended release of results. There have been too few IBTR events to trigger an efficacy analysis. Results Between 2006 and 2011, 2,135 women were randomly assigned to 3D-CRT APBI or WBI. Median follow-up was 36 months. Adverse cosmesis at 3 years was increased among those treated with APBI compared with WBI as assessed by trained nurses (29% v 17%; P < .001), by patients (26% v 18%; P = .0022), and by physicians reviewing digital photographs (35% v 17%; P < .001). Grade 3 toxicities were rare in both treatment arms (1.4% v 0%), but grade 1 and 2 toxicities were increased among those who received APBI compared with WBI (P < .001). Conclusion 3D-CRT APBI increased rates of adverse cosmesis and late radiation toxicity compared with standard WBI. Clinicians and patients are cautioned against the use of 3D-CRT APBI outside the context of a controlled trial.


2010 ◽  
Vol 06 (02) ◽  
pp. 18
Author(s):  
Antonis Valachis ◽  
Davide Mauri ◽  
◽  

Accelerated partial breast irradiation (APBI) is a novel method of post-operative radiotherapy that consists of irradiation of a limited volume of mammary gland immediately surrounding the tumour bed over a shorter time than whole breast irradiation. Several modalities are currently being explored as a means to deliver APBI, including multicatheter interstitial brachytherapy, the MammoSite breast brachytherapy catheter (Cytyc Corporation, Marlborough, MA), intraoperative radiation therapy and 3D conformal external-beam radiation therapy. To date, although still limited, randomised evidence is encouraging about the future role of APBI since it does not seem to jeopardise overall survival in patients with early breast cancer. Additional phase III studies are under way to determine the subgroups of patients who will really benefit from APBI.


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