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Accelerated partial breast irradiation with intensity-modulated radiotherapy is feasible for chinese breast cancer patients.

He Z, Wu S, Zhou J, Li F, Sun J, Lin Q, Lin H, Guan X - J Breast Cancer (2014)

Bottom Line: Of the 38 patients, six patients did not meet the planning criteria.Thirty-one patients (96.8%) had fine or excellent cosmetic outcomes, and only one patient had a poor cosmetic outcome.The radiotherapeutic toxicity is acceptable, and both the initial efficacy and cosmetic outcomes are good.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.

ABSTRACT

Purpose: Several accelerated partial breast irradiation (APBI) techniques are being investigated in patients with early-stage breast cancer. The present study evaluated the feasibility, early toxicity, initial efficacy, and cosmetic outcomes of accelerated partial breast intensity-modulated radiotherapy (IMRT) for Chinese female patients with early-stage breast cancer after breast-conserving surgery.

Methods: A total of 38 patients met the inclusion criteria and an accelerated partial breast intensity-modulated radiotherapy (APBI-IMRT) plan was designed for each patient. The prescription dose was 34 Gy in 10 fractions, 3.4 Gy per fraction, twice a day, in intervals of more than 6 hours.

Results: Of the 38 patients, six patients did not meet the planning criteria. The remaining 32 patients received APBI-IMRT with a mean target volume conformity index of 0.67 and a dose homogeneity index of 1.06. The median follow-up time was 53 months and no local recurrence or distant metastasis was detected. The most common acute toxicities observed within 3 months after radiotherapy were erythema, breast edema, pigmentation, and pain in the irradiated location, among which 43.8%, 12.5%, 31.3%, and 28.1% were grade 1 toxicities, respectively. The most common late toxicities occurring after 3 months until the end of the follow-up period were breast edema, pigmentation, pain in the irradiated location, and subcutaneous fibrosis, among which 6.2%, 28.1%, 21.9%, and 37.5% were grade 1 toxicities, respectively. Thirty-one patients (96.8%) had fine or excellent cosmetic outcomes, and only one patient had a poor cosmetic outcome.

Conclusion: It is feasible for Chinese females to receive APBI-IMRT after breast conserving surgery. The radiotherapeutic toxicity is acceptable, and both the initial efficacy and cosmetic outcomes are good.

No MeSH data available.


Related in: MedlinePlus

Delineation of the surgical cavity (white arrows) based on surgical clips (A), seroma (B), and ultrasound (C).
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Figure 1: Delineation of the surgical cavity (white arrows) based on surgical clips (A), seroma (B), and ultrasound (C).

Mentions: The surgical cavity was delineated under a CT window width of 500 and level of 0, in accordance with the following factors: the metal marker placed during operation; the residual seroma after operation; the interruption and density variations of the breast glands in the CT images; and the surgical cavity shown by ultrasonography in the same position, including the distance between the surgical cavity or interruption of breast glands and certain fixed points on the skin; and the depth, width and height of the cavity. The delineation of the surgical cavity was finally approved by three experienced radiation oncologists (Figure 1).


Accelerated partial breast irradiation with intensity-modulated radiotherapy is feasible for chinese breast cancer patients.

He Z, Wu S, Zhou J, Li F, Sun J, Lin Q, Lin H, Guan X - J Breast Cancer (2014)

Delineation of the surgical cavity (white arrows) based on surgical clips (A), seroma (B), and ultrasound (C).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4197356&req=5

Figure 1: Delineation of the surgical cavity (white arrows) based on surgical clips (A), seroma (B), and ultrasound (C).
Mentions: The surgical cavity was delineated under a CT window width of 500 and level of 0, in accordance with the following factors: the metal marker placed during operation; the residual seroma after operation; the interruption and density variations of the breast glands in the CT images; and the surgical cavity shown by ultrasonography in the same position, including the distance between the surgical cavity or interruption of breast glands and certain fixed points on the skin; and the depth, width and height of the cavity. The delineation of the surgical cavity was finally approved by three experienced radiation oncologists (Figure 1).

Bottom Line: Of the 38 patients, six patients did not meet the planning criteria.Thirty-one patients (96.8%) had fine or excellent cosmetic outcomes, and only one patient had a poor cosmetic outcome.The radiotherapeutic toxicity is acceptable, and both the initial efficacy and cosmetic outcomes are good.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.

ABSTRACT

Purpose: Several accelerated partial breast irradiation (APBI) techniques are being investigated in patients with early-stage breast cancer. The present study evaluated the feasibility, early toxicity, initial efficacy, and cosmetic outcomes of accelerated partial breast intensity-modulated radiotherapy (IMRT) for Chinese female patients with early-stage breast cancer after breast-conserving surgery.

Methods: A total of 38 patients met the inclusion criteria and an accelerated partial breast intensity-modulated radiotherapy (APBI-IMRT) plan was designed for each patient. The prescription dose was 34 Gy in 10 fractions, 3.4 Gy per fraction, twice a day, in intervals of more than 6 hours.

Results: Of the 38 patients, six patients did not meet the planning criteria. The remaining 32 patients received APBI-IMRT with a mean target volume conformity index of 0.67 and a dose homogeneity index of 1.06. The median follow-up time was 53 months and no local recurrence or distant metastasis was detected. The most common acute toxicities observed within 3 months after radiotherapy were erythema, breast edema, pigmentation, and pain in the irradiated location, among which 43.8%, 12.5%, 31.3%, and 28.1% were grade 1 toxicities, respectively. The most common late toxicities occurring after 3 months until the end of the follow-up period were breast edema, pigmentation, pain in the irradiated location, and subcutaneous fibrosis, among which 6.2%, 28.1%, 21.9%, and 37.5% were grade 1 toxicities, respectively. Thirty-one patients (96.8%) had fine or excellent cosmetic outcomes, and only one patient had a poor cosmetic outcome.

Conclusion: It is feasible for Chinese females to receive APBI-IMRT after breast conserving surgery. The radiotherapeutic toxicity is acceptable, and both the initial efficacy and cosmetic outcomes are good.

No MeSH data available.


Related in: MedlinePlus