Umsetzung der bildgeführten intensitätsmodulierten und akzelerierten Teilbrustbestrahlung: Drei-Jahres-Ergebnisse einer Phase-II-Studie

Translated title of the contribution: Implementation of image-guided intensity-modulated accelerated partial breast irradiation: Three-year results of a phase II clinical study

Norbert Mészáros, T. Major, Gábor Stelczer, Zoltán Zaka, Emőke Mózsa, Dávid Pukancsik, Zoltán Takácsi-Nagy, J. Fodor, C. Polgár

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: To report 3-year results of accelerated partial breast irradiation (APBI) using image-guided intensity-modulated radiotherapy (IG-IMRT) following breast conserving surgery (BCS) for low-risk early invasive breast cancer. Patients and methods: Between July 2011 and March 2014, 60 patients with low-risk early invasive breast cancer underwent BCS and were enrolled in this phase II prospective study. The total dose was 36.9 Gy (9 fractions of 4.1 Gy, two fractions/day). Patient setup errors were detected in LAT, LONG and VERT directions. Local tumour control, survival results, early and late side effects and cosmetic outcome were assessed. Results: At a median follow-up of 39 months, all patients were alive and neither locoregional nor distant failure occurred. One contralateral breast cancer and two new primary malignancies outside the breast were observed. No grade (G) 3–4 acute toxicity was detected. G1 and G2 erythema occurred in 21 (35%) and 2 (3.3%) patients, respectively; while G1 oedema was observed in 23 (38.8%) cases. G1 and G2 pain was reported by 6 (10%) and 2 (3.3%) patients, respectively. Among the late radiation side effects, G1 pigmentation or telangiectasia, G1 fibrosis and G1 asymptomatic fat necrosis occurred in 10 (16.7%), 7 (11.7%) and 3 (5%) patients, respectively. No ≥ G2 late toxicity was detected. Cosmetic outcome was excellent in 43 (71.7%) and good in 17 (28.3%) patients. Conclusion: IG-IMRT is a reproducible and feasible technique for delivery of external beam APBI following BCS for treatment of low-risk, early-stage invasive breast carcinoma. In order to avoid toxicity, image guidance performed before each radiation fraction is necessary to minimize the PTV. Three-year results are promising, early and late radiation side-effects are minimal, and cosmetic results are excellent to good.

Original languageGerman
Pages (from-to)70-79
Number of pages10
JournalStrahlentherapie und Onkologie
Volume193
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

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Keywords

  • APBI
  • Breast cancer
  • Image-guided
  • Intensity modulated
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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