Local Control, Toxicity, and Cosmesis in Women >70 Years Enrolled in the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

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• 作者：Atif J. Khan ; Frank A. Vicini ; Peter Beitsch ; Sharad Goyal ; Henry M. Kuerer ; Martin Keisch ; Coral Quiet ; Victor Zannis ; Angela Keleher ; Howard Snyder ; Mark Gittleman ; Pat Whitworth Jr. ; Richard Fine ; Maureen Lyden ; Bruce G. Haffty
• 关键词：Breast cancer ; MammoSite ; Partial breast irradiation
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2012
• 出版时间：1 October, 2012
• 年：2012
• 卷：84
• 期：2
• 页码：323-330
• 全文大小：238 K

文摘

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Purpose

The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial.

Methods and Materials

A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher¡¯s exact test was performed to correlate age (¡Ü70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model.

Results

Older women were less likely to develop telangiectasias than younger women (7.9 % vs. 12.4 % , m>pm> = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92 % of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79 % and 2.92 % , respectively (m>pm> = 0.5780). In women >70 years with hormone-sensitive tumors ¡Ü2 cm who received hormonal therapy (m>nm> = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06 % , 89.3 % , 87 % , and 97.5 % , respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients.

Conclusions

Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.