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 language | English |
|---|---|
| Pages (from-to) | 1136-1141 |
| Number of pages | 6 |
| Journal | Breast |
| Volume | 22 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 2013 |
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Keywords
- Breast cancer
- Breast-conserving therapy
- Partial breast irradiation
- Three-dimensional conformal irradiation
ASJC Scopus subject areas
- Surgery
Cite this
Accelerated partial breast irradiation using 3D conformal radiotherapy : Toxicity and cosmetic outcome. / Gatti, M.; Ponzone, R.; Bresciani, S.; Panaia, R.; Kubatzki, F.; Maggiorotto, F.; Di Virgilio, M. R.; Salatino, A.; Baiotto, B.; Montemurro, F.; Stasi, M.; Gabriele, P.
In: Breast, Vol. 22, No. 6, 12.2013, p. 1136-1141.Research output: Contribution to journal › Article
}
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 -