Accelerated partial breast irradiation using 3D conformal radiotherapy: Toxicity and cosmetic outcome

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: The aim of this paper is to analyze the incidence of acute and late toxicity and cosmetic outcome in breast cancer patients submitted to breast conserving surgery and three-dimensional conformal radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI). Methods and materials: 84 patients were treated with 3D-CRT for APBI. This technique was assessed in patients with low risk stage I breast cancer enrolled from September 2005 to July 2011. The prescribed dose was 34/38.5Gy delivered in 10 fractions twice daily over 5 consecutive days. Four to five no-coplanar 6MV beams were used. In all CT scans Gross Tumor Volume (GTV) was defined around the surgical clips. A 1.5cm margin was added by defining a Clinical Target Volume (CTV). A margin of 1cm was added to CTV to define the planning target volume (PTV). The dose-volume constraints were followed in accordance with the NSABP/RTOG protocol. Late toxicity was evaluated according to the RTOG grading schema. The cosmetic assessment was performed using the Harvard scale. Results: Median patient age was 66 years (range 51-87). Median follow-up was 36.5 months (range 13-83). The overall incidence of acute skin toxicities was 46.4% for grade 1 and 1% for grade 2. The incidence of late toxicity was 16.7% for grade 1, 2.4% for grade 2 and 3.6% for grade 3. No grade 4 toxicity was observed. The most pronounced grade 2 late toxicity was telangiectasia, developed in three patients. Cosmetics results were excellent for 52%, good for 42%, fair for 5% and poor for 1% of the patients. There was no statistical correlation between toxicity rates and prescribed doses (. p=0.33) or irradiated volume (. p=0.45). Conclusions: APBI using 3D-CRT is technically feasible with very low acute and late toxicity. Long-term results are needed to assess its efficacy in reducing the incidence of breast relapse.

Original languageEnglish
Pages (from-to)1136-1141
Number of pages6
JournalBreast
Volume22
Issue number6
DOIs
Publication statusPublished - Dec 2013

Fingerprint

Conformal Radiotherapy
Cosmetics
Breast
Incidence
Breast Neoplasms
Telangiectasis
Segmental Mastectomy
Tumor Burden
Surgical Instruments
Recurrence
Skin

Keywords

  • Breast cancer
  • Breast-conserving therapy
  • Partial breast irradiation
  • Three-dimensional conformal irradiation

ASJC Scopus subject areas

  • Surgery

Cite this

@article{16a38598e04a4afdbd53b23b56f3adac,
title = "Accelerated partial breast irradiation using 3D conformal radiotherapy: Toxicity and cosmetic outcome",
abstract = "Purpose: The aim of this paper is to analyze the incidence of acute and late toxicity and cosmetic outcome in breast cancer patients submitted to breast conserving surgery and three-dimensional conformal radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI). Methods and materials: 84 patients were treated with 3D-CRT for APBI. This technique was assessed in patients with low risk stage I breast cancer enrolled from September 2005 to July 2011. The prescribed dose was 34/38.5Gy delivered in 10 fractions twice daily over 5 consecutive days. Four to five no-coplanar 6MV beams were used. In all CT scans Gross Tumor Volume (GTV) was defined around the surgical clips. A 1.5cm margin was added by defining a Clinical Target Volume (CTV). A margin of 1cm was added to CTV to define the planning target volume (PTV). The dose-volume constraints were followed in accordance with the NSABP/RTOG protocol. Late toxicity was evaluated according to the RTOG grading schema. The cosmetic assessment was performed using the Harvard scale. Results: Median patient age was 66 years (range 51-87). Median follow-up was 36.5 months (range 13-83). The overall incidence of acute skin toxicities was 46.4{\%} for grade 1 and 1{\%} for grade 2. The incidence of late toxicity was 16.7{\%} for grade 1, 2.4{\%} for grade 2 and 3.6{\%} for grade 3. No grade 4 toxicity was observed. The most pronounced grade 2 late toxicity was telangiectasia, developed in three patients. Cosmetics results were excellent for 52{\%}, good for 42{\%}, fair for 5{\%} and poor for 1{\%} of the patients. There was no statistical correlation between toxicity rates and prescribed doses (. p=0.33) or irradiated volume (. p=0.45). Conclusions: APBI using 3D-CRT is technically feasible with very low acute and late toxicity. Long-term results are needed to assess its efficacy in reducing the incidence of breast relapse.",
keywords = "Breast cancer, Breast-conserving therapy, Partial breast irradiation, Three-dimensional conformal irradiation",
author = "M. Gatti and R. Ponzone and S. Bresciani and R. Panaia and F. Kubatzki and F. Maggiorotto and {Di Virgilio}, {M. R.} and A. Salatino and B. Baiotto and F. Montemurro and M. Stasi and P. Gabriele",
year = "2013",
month = "12",
doi = "10.1016/j.breast.2013.07.042",
language = "English",
volume = "22",
pages = "1136--1141",
journal = "Breast",
issn = "0960-9776",
publisher = "Churchill Livingstone",
number = "6",

}

TY - JOUR

T1 - Accelerated partial breast irradiation using 3D conformal radiotherapy

T2 - Toxicity and cosmetic outcome

AU - Gatti, M.

AU - Ponzone, R.

AU - Bresciani, S.

AU - Panaia, R.

AU - Kubatzki, F.

AU - Maggiorotto, F.

AU - Di Virgilio, M. R.

AU - Salatino, A.

AU - Baiotto, B.

AU - Montemurro, F.

AU - Stasi, M.

AU - Gabriele, P.

PY - 2013/12

Y1 - 2013/12

N2 - Purpose: The aim of this paper is to analyze the incidence of acute and late toxicity and cosmetic outcome in breast cancer patients submitted to breast conserving surgery and three-dimensional conformal radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI). Methods and materials: 84 patients were treated with 3D-CRT for APBI. This technique was assessed in patients with low risk stage I breast cancer enrolled from September 2005 to July 2011. The prescribed dose was 34/38.5Gy delivered in 10 fractions twice daily over 5 consecutive days. Four to five no-coplanar 6MV beams were used. In all CT scans Gross Tumor Volume (GTV) was defined around the surgical clips. A 1.5cm margin was added by defining a Clinical Target Volume (CTV). A margin of 1cm was added to CTV to define the planning target volume (PTV). The dose-volume constraints were followed in accordance with the NSABP/RTOG protocol. Late toxicity was evaluated according to the RTOG grading schema. The cosmetic assessment was performed using the Harvard scale. Results: Median patient age was 66 years (range 51-87). Median follow-up was 36.5 months (range 13-83). The overall incidence of acute skin toxicities was 46.4% for grade 1 and 1% for grade 2. The incidence of late toxicity was 16.7% for grade 1, 2.4% for grade 2 and 3.6% for grade 3. No grade 4 toxicity was observed. The most pronounced grade 2 late toxicity was telangiectasia, developed in three patients. Cosmetics results were excellent for 52%, good for 42%, fair for 5% and poor for 1% of the patients. There was no statistical correlation between toxicity rates and prescribed doses (. p=0.33) or irradiated volume (. p=0.45). Conclusions: APBI using 3D-CRT is technically feasible with very low acute and late toxicity. Long-term results are needed to assess its efficacy in reducing the incidence of breast relapse.

AB - Purpose: The aim of this paper is to analyze the incidence of acute and late toxicity and cosmetic outcome in breast cancer patients submitted to breast conserving surgery and three-dimensional conformal radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI). Methods and materials: 84 patients were treated with 3D-CRT for APBI. This technique was assessed in patients with low risk stage I breast cancer enrolled from September 2005 to July 2011. The prescribed dose was 34/38.5Gy delivered in 10 fractions twice daily over 5 consecutive days. Four to five no-coplanar 6MV beams were used. In all CT scans Gross Tumor Volume (GTV) was defined around the surgical clips. A 1.5cm margin was added by defining a Clinical Target Volume (CTV). A margin of 1cm was added to CTV to define the planning target volume (PTV). The dose-volume constraints were followed in accordance with the NSABP/RTOG protocol. Late toxicity was evaluated according to the RTOG grading schema. The cosmetic assessment was performed using the Harvard scale. Results: Median patient age was 66 years (range 51-87). Median follow-up was 36.5 months (range 13-83). The overall incidence of acute skin toxicities was 46.4% for grade 1 and 1% for grade 2. The incidence of late toxicity was 16.7% for grade 1, 2.4% for grade 2 and 3.6% for grade 3. No grade 4 toxicity was observed. The most pronounced grade 2 late toxicity was telangiectasia, developed in three patients. Cosmetics results were excellent for 52%, good for 42%, fair for 5% and poor for 1% of the patients. There was no statistical correlation between toxicity rates and prescribed doses (. p=0.33) or irradiated volume (. p=0.45). Conclusions: APBI using 3D-CRT is technically feasible with very low acute and late toxicity. Long-term results are needed to assess its efficacy in reducing the incidence of breast relapse.

KW - Breast cancer

KW - Breast-conserving therapy

KW - Partial breast irradiation

KW - Three-dimensional conformal irradiation

UR - http://www.scopus.com/inward/record.url?scp=84887156384&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84887156384&partnerID=8YFLogxK

U2 - 10.1016/j.breast.2013.07.042

DO - 10.1016/j.breast.2013.07.042

M3 - Article

C2 - 23958374

AN - SCOPUS:84887156384

VL - 22

SP - 1136

EP - 1141

JO - Breast

JF - Breast

SN - 0960-9776

IS - 6

ER -