GERICO-03 phase II trial of accelerated and partial breast irradiation in elderly women: Feasibility, reproducibility, and impact on functional status

Hannoun‐Lévi, Jean‐Michel; Gourgou-Bourgade, Sophie; Belkacémi, Yazid; Chara-Bruneau, Claire; Hennequin, Christophe; Quétin, Philippe; Orsini, C.; Brain, Étienne; Marsiglia, H.

doi:10.1016/j.brachy.2012.06.004

Cited by 25 publications

(13 citation statements)

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“…From now, four different studies were published focusing on APBI in the elderly. Three of them consisted in phase II prospective trials using either HDR brachytherapy based on a balloon device [32], IORT using electron beam radiation therapy [33] and HIBT [34]. All these studies confirmed that these different irradiation techniques were feasible with encouraging results in terms of clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

“…All these studies confirmed that these different irradiation techniques were feasible with encouraging results in terms of clinical outcome. Furthermore, GERICO-03 study specifically analyzed the functional status after APBI and concluded that HIBT had no deleterious impact in the elderly [34]. The fourth study was a non-randomized retrospective one recently published by Smith et al [35].…”

Section: Discussionmentioning

confidence: 99%

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Accelerated partial breast irradiation in the elderly: 5-year results of high-dose rate multi-catheter brachytherapy

et al. 2014

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ObjectiveTo evaluate clinical outcome after accelerated partial breast irradiation (APBI) in the elderly after high-dose-rate interstitial multi-catheter brachytherapy (HIBT).Methods and materialsBetween 2005 and 2013, 70 patients underwent APBI using HIBT. Catheter implant was performed intra or post-operatively (referred patients) after lumpectomy and axillary sentinel lymph node dissection. Once the pathological results confirmed the indication of APBI, planification CT-scan was performed to deliver 34 Gy/10f/5d or 32 Gy/8f/4d. Dose-volume adaptation was manually achieved (graphical optimization). Dosimetric results and clinical outcome were retrospectively analyzed. Physician cosmetic evaluation was reported.ResultsWith a median follow-up of 60.9 months [4.6 – 90.1], median age was 80.7 years [62 – 93.1]. Regarding APBI ASTRO criteria, 61.4%, 18.6% and 20% were classified as suitable, cautionary and non-suitable respectively. Axillary sentinel lymph node dissection was performed in 94.3%; 8 pts (11.5%) presented an axillary involvement. A median dose of 34 Gy [32 – 35] in 8 to 10 fractions was delivered. Median CTV was 75.2 cc [16.9 – 210], median D90 EQD2 was 43.3 Gy [35 – 72.6] and median DHI was 0.54 [0.19 – 0.74]. One patient experienced ipsilateral recurrence (5-year local free recurrence rate: 97.6%. Five-year specific and overall survival rates were 97.9% and 93.2% respectively. Thirty-four patients (48%) presented 47 late complications classified grade 1 (80.8%) and grade 2 (19.2%) with no grade ≥ 3. Cosmetic results were considered excellent/good for 67 pts (95.7%).ConclusionAPBI using HIBT and respecting strict rules of implantation and planification, represents a smart alternative between no post-operative irradiation and whole breast irradiation delivered over 6 consecutive weeks.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Accelerated partial breast irradiation in the elderly: 5-year results of high-dose rate multi-catheter brachytherapy

et al. 2014

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“…Keeping this in mind, accelerated partial breast irradiation (APBI) based on multicatheter brachytherapy (MIB) represents a smart and validated option to shorter radiation therapy from 4 to 6 weeks to 4 to 5 days, especially for low-risk breast cancer (7). More specifically for the elderly, considering different associated comorbidity factors playing a deleterious impact on the treatment observance, APBI allows to reduce the overall treatment time and the number of transportations without any significant alteration of the patient's functional status (8,9). In the frame of APBI, intraoperative radiation therapy also represents an attractive solution by combining at the same time, breast surgery and adjuvant irradiation (10).…”

Section: Introductionmentioning

confidence: 99%

Accelerated partial breast irradiation in the elderly: 5-Year results of the single fraction elderly breast irradiation (SiFEBI) phase I/II trial

et al. 2020

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PURPOSE: To evaluate the clinical outcomes of a very-accelerated partial breast irradiation (vAP-BI) in the elderly based on a single fraction of multicatheter interstitial high-dose rate brachytherapy (MIB). Mature results with a median follow-up of 5 years. METHODS AND MATERIALS: From November 2012 to September 2014, 26 patients (pts) ($70) with early breast cancer were enrolled in a prospective phase II trial (NCT01727011). After lumpectomy, intraoperative catheter implant was performed for postoperative APBI (single fraction 16 Gy). Surveillance was performed twice a year after APBI. Oncologic outcome (local [LRFS], metastasis-free survival, cancer-specific survival, and overall survival [OS]) as well as late toxicity and cosmetic outcome were investigated. RESULTS: Median age was 77 years [69e89]. After a median follow-up of 63 months [60e68], 5-year LRFS, metastasis-free survival, cancer-specific survival, and overall survival rates were 100%, 95.5%, 100%, and 88.5%, respectively. Late toxicity was observed in 5 pts (19.2%) with a total of five events: 3 pts G1 (60%); and 2 pts G2 (40%). The observed late side effects were breast pain in 1 pt (G2 cytosteatonecrosis with occasional acetaminophen consumption), hypopigmentation (puncture site) in 2 pts (G1) and breast fibrosis in 2 pts (G1: 1 pt; G2: 1 pt). Cosmetic evaluation was excellent for 21 pts (81%) and good for 2 pts (19%). CONCLUSION: For elderly with early breast cancer, a vAPBI using a single fraction of postoperative MIB (16 Gy) provides excellent oncologic results, mainly in terms of local control and cancer death. Late toxicity and cosmetic profile are acceptable.

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“…Les auteurs ont conclu qu'il est possible de ne proposer qu'une hormonothérapie pour cette catégorie de patiente, sous-entendant que la radiothérapie pourrait être supprimée dans la mesure où aucune différence en termes de probabilité de survie globale n'a été observée entre les deux groupes (67 % après radiothérapie contre 66 % après tamoxifène seul) alors que la radiothérapie réduisait toujours significativement le taux de contrôle local (98 % contre 90 %). Il pourrait, en fait, être suggéré que l'irradiation partielle et accélérée du sein chez les patientes âgées présentant un cancer du sein à faible risque de rechute locale serait être un compromis acceptable entre « absence d'irradiation postopératoire » et « irradiation classique » sur cinq à six semaines [28]. À notre connaissance, aucun essai ne prévoit de randomiser irradiation partielle et accélérée du sein et observation chez les patientes âgées.…”

Section: Discussionunclassified

“…À un an, les taux de toxicité globale de grade 1, 2 et 3 étaient de 59 %, 28 % et 2 % et le résultat cosmétique bon/excellent dans 87 % des cas[28].…”

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État de l’art et perspectives de l’irradiation partielle et accélérée du sein en 2014

Chand-Fouché

Hannoun‐Lévi

2014

Cancer/Radiothérapie

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GERICO-03 phase II trial of accelerated and partial breast irradiation in elderly women: Feasibility, reproducibility, and impact on functional status

Cited by 25 publications

References 29 publications

Accelerated partial breast irradiation in the elderly: 5-year results of high-dose rate multi-catheter brachytherapy

Accelerated partial breast irradiation in the elderly: 5-year results of high-dose rate multi-catheter brachytherapy

Accelerated partial breast irradiation in the elderly: 5-Year results of the single fraction elderly breast irradiation (SiFEBI) phase I/II trial

État de l’art et perspectives de l’irradiation partielle et accélérée du sein en 2014

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