Navigation Links
Extended outcomes from APBI show tumor control, breast cosmesis and minimal late toxicity
Date:1/29/2014

Fairfax, Va., January 29, 2014 Long-term (five-year) outcomes of breast cancer patients receiving adjuvant accelerated partial breast irradiation (APBI) after breast-conserving surgery show excellent tumor control and breast cosmesis (cosmetic outcomes) with minimal late toxicity, according to a study published in the February 1, 2014 print edition of the International Journal of Radiation Oncology • Biology • Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO).

APBI delivers highly conformal radiation therapy, during a period of one to two weeks, to the site where the cancer was removed. APBI has seen a 10-fold increase in use from 2002 to 2007 and is currently the focus of several ongoing phase III trials.

The University of Pittsburgh Cancer Institute study examines the long-term outcomes, tumor control and breast cosmesis of a cohort of early-stage and ductal carcinoma in situ (DCIS) breast cancer patients who received a five-day treatment of APBI at the University of Pittsburgh from 2002 to 2007.

The study is a retrospective review of 157 patients with localized breast cancer treated with adjuvant MammoSite, single-lumen balloon-based brachytherapy after breast-conserving surgery from June 1, 2002 to December 31, 2007. For all patients, at least five years had passed since receiving brachytherapy. Patients were all age 40 or older, with 88.5 percent over age 50, and had stage T1-T2 breast cancer, with 82.4 percent in stage T1A-C, 12.2 percent with DCIS, 4.7 percent in stage T2 and 0.7 percent in stage T1mic. Patients were also categorized by demographics and tumor characteristics into suitable, cautionary and unsuitable groups based on recommendations from ASTRO's APBI Consensus Statement.

APBI was delivered to a median dose of 34 Gy in 10 fractions over a five-day period. In addition, 89 percent of patients received additional adjuvant systemic therapy, with 66.9 percent receiving hormonal therapy, 13.4 percent chemotherapy and 8.3 percent chemotherapy with hormonal therapy. Follow-up was conducted every three to four months for the first two years post-treatment, and every six months thereafter at the discretion of the patient's breast surgeon and radiation oncologist. Baseline mammograms were performed three to six months after treatment, and annually thereafter. In addition, cosmetic outcomes were documented via photography at each visit, and toxicity was assessed during the final follow-up visit.

At a median follow-up of 5.5 years post-treatment, the five-year and seven-year actuarial ipsilateral breast control were 98 percent/98 percent, the lymph nodal control were 99 percent/98 percent and the distant control were 99 percent/99 percent. The breast cancer specific survival was 100 percent at five years and 99 percent at seven years. The overall survival was 89 percent at five years and 86 percent at seven years. There were no significant differences in tumor recurrence or survival rates in the appropriateness subgroups based on ASTRO's consensus statement. Good to excellent breast cosmesis was reported in 93.4 percent of patients. Overall toxicity rates were low, and the most common toxicity was telangiectasia, small, dilated blood vessels near the surface of the skin, which was reported in 27 percent of study participants. The study correlated telangiectasia development and the maximum radiation dose to the skin. The study institution practice is to keep maximum skin dose ≤ 100 percent and at maximum ≤ 125 percent to limit the risk of telangiectasia.

"These results may encourage women to choose this convenient five-day treatment and also help radiation oncologists use techniques that can reduce skin dose further, thus further reducing the long-term effects of partial breast radiation therapy on skin changes and breast cosmesis," said Sushil Beriwal, MD, a co-author of the study and a radiation oncologist at the University of Pittsburgh Cancer Center. "The promising outcomes seen across subgroups, as defined by prior consensus definitions for appropriate patient selection, suggest that the current metrics for selecting patients for APBI may need to be redefined such that more women may be candidates for less radiation over a shorter time via APBI."

The February 1 print edition of the Red Journal also contains two editorials addressing breast brachytherapy and examining the data from this study. Peter Y. Chen, MD, a radiation oncologist at William Beaumont Health System in Royal Oak, Mich., emphasizes the need to ensure guidelines keep up with changing data. Robert R. Kuske, MD, a radiation oncologist at Arizona Breast Cancer Specialists in Scottsdale, Ariz., and S. Stanley Young, PhD, the assistant director for bioinformatics at the National Institute of Statistical Sciences, explore the reported differences between breast brachytherapy and whole breast irradiation from the statistical and clinical implications.


'/>"/>

Contact: Brittany Ashcroft
press@astro.org
703-839-7336
American Society for Radiation Oncology
Source:Eurekalert

Related medicine news :

1. Visual system can retain considerable plasticity after extended blindness
2. Generation Next Film/Television, Journalism and Social Media Competition Deadline Extended to December 13, 2013
3. 2013 Extended Vehicle Warranty Company Reviews and Ratings by BestReviewsHub.com
4. Top Extended Car Warranty Company in the State of Florida by Extended-Car-Warranty.com
5. Actos Lawsuit Filed By Wright & Schulte on Behalf of Ohio Man Alleges Extended Use of Type-2 Diabetes Drug Caused Him to Develop Bladder Cancer
6. Extended-Car-Warranty.com Awards CARCHEX with the 2013 Gold Award after Conducting Reviews of Extended Auto Warranty Companies
7. Saving Money on an Extended Auto Warranty Tips Sheet Released by Extended-Car-Warranty.com
8. Extended Car Warranty Reviews Website Now Available to Consumers by Extended-Car-Warranty.com
9. Vapor Steam Cleaner Super Sale Extended Through August by 1-800-GO-VAPOR.com
10. Extended primary care office hours might help keep kids out of the emergency department
11. Vapor Steam Cleaner Accessories Sale Extended Through June 30th at LadybugSteamCleaners.com
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... NY (PRWEB) , ... October 13, 2017 , ... Ellevate ... people in business to advocate for action towards gender equality at their inaugural Summit ... from around the globe, and reached a social audience of over 3 million. To ...
(Date:10/13/2017)... ... October 13, 2017 , ... ... giving viewers the lowdown on sciatica in a new episode of "Success Files," ... on current events and innovation and investigates each subject in-depth with passion and ...
(Date:10/13/2017)... ... 2017 , ... “America On The Brink”: the Christian history of the United ... the creation of published author, William Nowers. Captain Nowers and his wife, Millie, ... spent thirty years in the Navy. Following his career as a naval aviator ...
(Date:10/12/2017)... ... October 12, 2017 , ... Planet Fitness, one of the largest ... its plans to open a flagship location in Covington, LA at 401 N. U.S. ... Go store next to Office Depot in the Holiday Square shopping center. Its location ...
(Date:10/12/2017)... ... October 12, 2017 , ... The American College of Medical Informatics (ACMI) ... FACMI, during the Opening Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s ... Morris F. Collen, a pioneer in the field of medical informatics, this prestigious award ...
Breaking Medicine News(10 mins):
(Date:9/27/2017)... Sept. 27, 2017  Commended for their devotion to personalized ... Ranked as number one in the South Florida Business Journal,s ... Inc. 5000 yearly list, the national specialty pharmacy has found ... Bardisa will soon be honored by SFBJ as the ... Set to receive his award in October, Bardisa ...
(Date:9/25/2017)... 2017   Montrium , an industry leader ... the IQPC Trial Master Files & Inspection Readiness ... EastHORN Clinical Services has selected eTMF Connect ... management. EastHORN, a leading European contract research organization ... transparency to enable greater collaboration with sponsors, improve ...
(Date:9/23/2017)... 2017 Janssen Biotech, Inc. (Janssen) announced today ... the U.S. Food and Drug Administration (FDA) for the ... the treatment of moderately to severely active rheumatoid arthritis ... are needed to further evaluate the safety of sirukumab ... "We are ...
Breaking Medicine Technology: