A Single Institution Retrospective Comparison Study of Locoregional Recurrence After Accelerated Partial Breast Irradiation Using External Beam Fractionation Compared with Whole Breast Irradiation with 8 Years of Follow-Up

Shah, Shalin; Kyrillos, Alexandra; Kuchta, Kristine; Habib, Hussain; Raghavan, V.; Shaikh, Arif; Bloomer, William D.; Pesce, Catherine; Yao, Katharine

doi:10.1245/s10434-017-5953-9

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…The good VMAT target coverage in the study was not at the expense of a high‐dose bath to healthy tissue. Reidunsdatter et al found that the V 40 Gy was a significant predictor of increased fatigue during RT 37 . However, the VMAT plans in the study were more conformal than the 3DCRT plans were; the latter was associated with a 17.8% larger tissue volume receiving a high dose (i.e., above 40 Gy) inside the external contour compared to the former.…”

Section: Discussionmentioning

confidence: 59%

Free breathing VMAT versus deep inspiration breath‐hold 3D conformal radiation therapy for early stage left‐sided breast cancer

Jensen

Funderud

Lervåg

2021

J Applied Clin Med Phys

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The purpose of the in silico study was to compare free breathing volumetric modulated arc therapy (VMAT) to standard deep inspiration breath‐hold (DIBH) three‐dimensional conformal radiotherapy (3DCRT) and determine whether the former is a viable option for elderly patients with left‐sided early stage breast cancer. Data from 22 patients with early‐stage left breast carcinoma requiring breast‐only radiation therapy were used for this planning study. The robustness of VMAT plans when using the free breathing method was compared to that of standard 3DCRT plans using the DIBH method. The endpoints for evaluation were the target dose coverage as well as doses to the organs‐at‐risk. The free breathing VMAT plans produced a significantly higher mean dose to the heart and right breast than the DIBH‐3DCRT plans. Free breathing VMAT plans resulted in significantly better target coverage than did 3DCRT using DIBH. The external volume that received more than 40 Gy was significantly smaller in the VMAT plans. Free breathing VMAT is a viable alternative to DIBH 3DCRT in elderly patients with a limited life expectancy and in subjects who are unable to perform DIBH. The choice of treatment should be individualized, and all relevant risks ought to be considered.

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Section: Discussionmentioning

confidence: 59%

Free breathing VMAT versus deep inspiration breath‐hold 3D conformal radiation therapy for early stage left‐sided breast cancer

Jensen

Funderud

Lervåg

2021

J Applied Clin Med Phys

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“…Shah et al reported on 290 patients treated with a more prolonged partial-breast irradiation regimen to 43.2 Gy in 16 fractions. 25 At a median follow-up of 8 years, there was no difference in ipsilateral breast recurrences between suitable, cautionary, and unsuitable patients, although recurrence after partial-breast irradiation did outpace whole-breast RT recurrences, highlighting the importance of appropriate patient selection. Jawad et al published a study on a larger cohort of 690 patients treated with a variety of APBI techniques (interstitial brachytherapy, balloon brachytherapy, and 3dimensional conformal external beam radiation).…”

Section: Discussionmentioning

confidence: 87%

Patterns of Recurrence Among Higher-Risk Patients Receiving Daily External Beam Accelerated Partial-Breast Irradiation to 40 Gy in 10 Fractions

Fitzgerald¹,

Flynn

Zhang

et al. 2020

Advances in Radiation Oncology

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The 2016 American Society for Radiation Oncology consensus guidelines for the use of accelerated partial-breast irradiation (APBI) define "suitable," "cautionary," and "unsuitable" populations for this adjuvant breast radiation therapy technique. We sought to determine whether patients in the cautionary group exhibited adverse outcomes after APBI compared with their suitable counterparts. Methods and Materials: We identified 252 consecutively treated patients from a single institution with in situ or early-stage invasive breast cancer who underwent APBI between 2008 and 2017. Treatment technique was uniform throughout the population, consisting of 3-dimensional conformal radiation therapy to 40 Gy administered in 10 daily fractions. Results: One hundred seventy-eight patients (70%) were classified as suitable, 69 (27%) as cautionary, and 5 (2.0%) as unsuitable. Because unsuitable patients were few and had no recurrences, they were excluded from analysis. At a median follow-up time of 3.9 years, 97.2% of patients were free of recurrence. Four patients (1.5% overall; 3 suitable and 1 cautionary) experienced ipsilateral inbreast recurrences, and 1 cautionary patient developed an ipsilateral regional recurrence in an axillary lymph node. There was no significant difference in the rate of ipsilateral breast recurrence (2.4% vs 1.0%) between cautionary and suitable groups. Conclusions: Local recurrences are rare among guideline-defined cautionary patients with in situ or invasive breast cancer treated with APBI delivered via daily 3-dimensional conformal radiation therapy to 40 Gy. At a median follow-up of 3.9 years, no significant differences in local control were noted between cautionary and suitable patient groups. Further study is needed to characterize long-term disease outcomes among various risk groups.

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DCIS: When is accelerated partial breast irradiation an option? A meta-analysis on outcomes and eligibility

Chua¹,

Chua²,

Aniceto³

et al. 2023

The American Journal of Surgery

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A Single Institution Retrospective Comparison Study of Locoregional Recurrence After Accelerated Partial Breast Irradiation Using External Beam Fractionation Compared with Whole Breast Irradiation with 8 Years of Follow-Up

Abstract: IBTR rates were higher in external beam APBI group compared with WBI, but APBI had fewer toxicities. Clinicians must weigh the risks and benefits of APBI when making a recommendation for partial breast irradiation after lumpectomy.

Cited by 4 publications

References 25 publications

Free breathing VMAT versus deep inspiration breath‐hold 3D conformal radiation therapy for early stage left‐sided breast cancer

Free breathing VMAT versus deep inspiration breath‐hold 3D conformal radiation therapy for early stage left‐sided breast cancer

Patterns of Recurrence Among Higher-Risk Patients Receiving Daily External Beam Accelerated Partial-Breast Irradiation to 40 Gy in 10 Fractions

DCIS: When is accelerated partial breast irradiation an option? A meta-analysis on outcomes and eligibility

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