Accelerated partial breast irradiation using intensity-modulated radiotherapy technique compared to whole breast irradiation for patients aged 70?years or older: subgroup analysis from a randomized phase 3 trial

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• 作者：Icro Meattini ; Calogero Saieva ; Livia Marrazzo…
• 关键词：Elderly ; IMRT ; Partial breast irradiation ; Endocrine therapy ; Breast cancer ; Phase 3 trial
• 刊名：Breast Cancer Research and Treatment
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：153
• 期：3
• 页码：539-547
• 全文大小：531 KB
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• 作者单位：Icro Meattini (1)
  Calogero Saieva (2)
  Livia Marrazzo (3)
  Lucia Di Brina (1)
  Stefania Pallotta (3)
  Monica Mangoni (1)
  Fiammetta Meacci (1)
  Benedetta Bendinelli (2)
  Giulio Francolini (1)
  Isacco Desideri (1)
  Carla De Luca Cardillo (1)
  Vieri Scotti (1)
  Ilaria Francesca Furfaro (1)
  Francesca Rossi (4)
  Daniela Greto (1)
  Pierluigi Bonomo (1)
  Donato Casella (5)
  Marco Bernini (5)
  Luis Sanchez (5)
  Lorenzo Orzalesi (5)
  Roberta Simoncini (5)
  Jacopo Nori (6)
  Simonetta Bianchi (7)
  Lorenzo Livi (1)
  
  1. Department of Radiation Oncology, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy
  2. Molecular and Nutritional Epidemiology Unit, ISPO (Cancer Research and Prevention Institute), Florence, Italy
  3. Medical Physics Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
  4. Radiotehrapy Unit, Azienda Sanitaria 10, Florence, Italy
  5. Department of Surgery, University of Florence, Florence, Italy
  6. Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
  7. Division of Pathological Anatomy, University of Florence, Florence, Italy
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  
• 出版者：Springer Netherlands
• ISSN：1573-7217

文摘

The purpose of this study was to report the efficacy and the safety profile on the subset of selected early breast cancer (BC) patients aged 70 years or older from a single-center phase 3 trial comparing whole breast irradiation (WBI) to accelerated partial breast irradiation (APBI) using intensity-modulated radiation therapy technique. Between 2005 and 2013, 520 patients aged more than 40 years old were enrolled and randomly assigned to receive either WBI or APBI in a 1:1 ratio. Eligible patients were women with early BC (maximum diameter 2.5 cm) suitable for breast conserving surgery. This study is registered with ClinicalTrials.gov, NCT02104895. A total of 117 patients aged 70 years or more were analyzed (58 in the WBI arm, 59 in the APBI arm). At a median follow-up of 5-years (range 3.4-.0), the ipsilateral breast tumor recurrence (IBTR) rate was 1.9 % in both groups. No significant difference between the two groups was identified (log-rank test p = 0.96). The 5-year disease-free survival (DFS) rates in the WBI group and APBI group were 6.1 and 1.9 %, respectively (p = 0.33). The APBI group presented significantly better results in terms of acute skin toxicity, considering both any grade (p = 0.0001) and grade 2 or higher (p = 0.0001). Our subgroup analyses showed a very low rate and no significant difference in terms of IBTR, using both WBI and APBI. A significant impact on patients compliance in terms of acute and early late toxicity was shown, which could translate in a consistent improvement of overall quality of life. Keywords Elderly IMRT Partial breast irradiation Endocrine therapy Breast cancer Phase 3 trial