title: Phase II trial of 3D-conformal accelerated partial breast irradiation: lessons learned from patients and physicians' evaluation.
abstract: BACKGROUND
  The present study prospectively reported both physicians' and patients' assessment for toxicities, cosmetic assessment and patients' satisfaction after 3D-conformal accelerated partial breast irradiation (APBI).
  
  
  METHODS
  From October 2007 to September 2009, 30 early breast cancer patients were enrolled in a 3D-conformal APBI Phase II trial (40 Gy/10 fractions/5 days). Treatment related toxicities and cosmetic results were assessed by both patients and physicians at each visit (at 1, 2, 6 months, and then every 6 months). Patient satisfaction was also scored.
  
  
  RESULTS
  After a median follow-up of 27.7 months, all patients were satisfied with APBI treatment, regardless of cosmetic results or late adverse events. Good/excellent cosmetic results were noticed by 80% of patients versus 92% of cases by radiation oncologists. Breast pain was systematically underestimated by physicians (8-20% vs. 16.6-26.2%; Kappa coefficient KC=0.16-0.44). Grade 1 and 2 fibrosis and/or breast retraction occurred in 7-12% of patients and were overestimated by patients (KC=0.14-0.27).
  
  
  CONCLUSIONS
  Present results have shown discrepancies between patient and physician assessments. In addition to the assessment of efficacy and toxicity after 3D-conformal APBI, patients' cosmetic results consideration and satisfaction should be also evaluated.
authors.affiliation: Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France.
authors.forename: Fares
authors.initials: F
authors.lastname: Azoury
authors.forename: Steve
authors.initials: S
authors.lastname: Heymann
authors.forename: Catalina
authors.initials: C
authors.lastname: Acevedo
authors.forename: Marc
authors.initials: M
authors.lastname: Spielmann
authors.forename: Philippe
authors.initials: P
authors.lastname: Vielh
authors.forename: Jean-Rémi
authors.initials: JR
authors.lastname: Garbay
authors.forename: Alphonse G
authors.initials: AG
authors.lastname: Taghian
authors.forename: Hugo
authors.initials: H
authors.lastname: Marsiglia
authors.forename: Céline
authors.initials: C
authors.lastname: Bourgier
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D017060:Patient Satisfaction; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*