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21.11.2016 | Original Article

Implementation of image-guided intensity-modulated accelerated partial breast irradiation

Three-year results of a phase II clinical study

verfasst von: Norbert Mészáros, M.D., Tibor Major, Gábor Stelczer, Zoltán Zaka, Emőke Mózsa, Dávid Pukancsik, Zoltán Takácsi-Nagy, János Fodor, Csaba Polgár

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 1/2017

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Abstract

Purpose

To report 3‑year results of accelerated partial breast irradiation (APBI) using image-guided intensity-modulated radiotherapy (IG-IMRT) following breast conserving surgery (BCS) for low-risk early invasive breast cancer.

Patients and methods

Between July 2011 and March 2014, 60 patients with low-risk early invasive breast cancer underwent BCS and were enrolled in this phase II prospective study. The total dose was 36.9 Gy (9 fractions of 4.1 Gy, two fractions/day). Patient setup errors were detected in LAT, LONG and VERT directions. Local tumour control, survival results, early and late side effects and cosmetic outcome were assessed.

Results

At a median follow-up of 39 months, all patients were alive and neither locoregional nor distant failure occurred. One contralateral breast cancer and two new primary malignancies outside the breast were observed. No grade (G) 3–4 acute toxicity was detected. G1 and G2 erythema occurred in 21 (35%) and 2 (3.3%) patients, respectively; while G1 oedema was observed in 23 (38.8%) cases. G1 and G2 pain was reported by 6 (10%) and 2 (3.3%) patients, respectively. Among the late radiation side effects, G1 pigmentation or telangiectasia, G1 fibrosis and G1 asymptomatic fat necrosis occurred in 10 (16.7%), 7 (11.7%) and 3 (5%) patients, respectively. No ≥ G2 late toxicity was detected. Cosmetic outcome was excellent in 43 (71.7%) and good in 17 (28.3%) patients.

Conclusion

IG-IMRT is a reproducible and feasible technique for delivery of external beam APBI following BCS for treatment of low-risk, early-stage invasive breast carcinoma. In order to avoid toxicity, image guidance performed before each radiation fraction is necessary to minimize the PTV. Three-year results are promising, early and late radiation side-effects are minimal, and cosmetic results are excellent to good.

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Titel: Implementation of image-guided intensity-modulated accelerated partial breast irradiation
Three-year results of a phase II clinical study
verfasst von: Norbert Mészáros, M.D.
Tibor Major
Gábor Stelczer
Zoltán Zaka
Emőke Mózsa
Dávid Pukancsik
Zoltán Takácsi-Nagy
János Fodor
Csaba Polgár
Publikationsdatum: 21.11.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 1/2017
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-016-1074-9

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Implementation of image-guided intensity-modulated accelerated partial breast irradiation

Three-year results of a phase II clinical study

Abstract

Purpose

Patients and methods

Results

Conclusion

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Abstract

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Patients and methods

Results

Conclusion

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