Five-year results of a prospective clinical trial investigating accelerated partial breast irradiation using 3D conformal radiotherapy after lumpectomy for early stage breast cancer

Breast. 2016 Aug;28:178-83. doi: 10.1016/j.breast.2016.06.001. Epub 2016 Jun 17.

Abstract

Background: Accelerated partial breast irradiation (APBI) is emerging as an alternative to whole-breast irradiation. This study presents the results of a prospective trial evaluating 3-dimensional conformal radiotherapy (3D-CRT) to deliver APBI for early-stage breast cancer.

Methods: Patients with unifocal stage 0-II breast cancer measuring ≤2.5 cm without lymph node involvement were eligible. After lumpectomy, 3D-CRT APBI was delivered to the lumpectomy cavity + margin (34-38.5 Gy in 10 fractions over 5 days).

Results: 141 patients with 143 breast cancers (2 bilateral) were treated with 3D-CRT APBI. Median age was 60. Median tumor size was 1.1 cm. At a median follow up of 60 months (range, 5-113), the 5-year and 8-year cumulative incidence rate of a true recurrence is 0.9%. The 5-year and 8-year cumulative incidence rates of an elsewhere failure are 2.4% and 4.4%, respectively. The 5-year and 8-year overall survival is 100% and 94%, respectively. Among the 62 patients with follow up >5 years, 95% had excellent/good cosmetic results.

Conclusions: Our experience with 3D-CRT APBI demonstrates excellent cosmesis and local control. Longer follow up will be necessary to evaluate long-term efficacy and toxicity of 3D-CRT APBI. CLINICALTRIALS.

Gov identifier: NCT00185744.

Keywords: 3D conformal external beam radiotherapy (3D-CRT); Accelerated partial breast irradiation (APBI); Breast cancer; Breast-conserving therapy; Margin.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / therapy*
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Ductal, Breast / therapy*
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Carcinoma, Intraductal, Noninfiltrating / therapy*
  • Carcinoma, Lobular / pathology
  • Carcinoma, Lobular / therapy*
  • Dose Fractionation, Radiation
  • Female
  • Follow-Up Studies
  • Humans
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Staging
  • Prospective Studies
  • Radiotherapy, Conformal / methods*
  • Survival Rate
  • Tumor Burden

Associated data

  • ClinicalTrials.gov/NCT00185744