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

M. Gatti, R. Ponzone, S. Bresciani, R. Panaia, F. Kubatzki, F. Maggiorotto, M. R. Di Virgilio, A. Salatino, B. Baiotto, F. Montemurro, M. Stasi, P. Gabriele

Research output: Contribution to journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

  • Surgery

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