title: [Accelerated partial breast irradiation with three-dimensional conformal external beam radiotherapy following breast-conserving surgery -- preliminary results of a phase II clinical study].
abstract: The aim of the study was to implement accelerated partial breast irradiation (APBI) by means of three-dimensional conformal radiotherapy (3D-CRT) following breast-conserving surgery (BCS) for early-stage breast cancer. Between December 2006 and February 2011, in 45 cases of low-risk, stage I-II breast cancer the tumour bed was marked with titanium clips during BCS. Postoperative APBI was given by means of 3D-CRT using 3 to 5 non-coplanar fields. The total dose of APBI was 36.9 Gy (9 x 4.1 Gy) using a twice-a-day fractionation over 5 consecutive days. Early and late radiation side effects and cosmetic results were analysed for the first 30 patients with a minimum follow-up of 1 year. At a mean follow-up of 25.2 months neither loco-regional nor distant failure was observed. Excellent, good, fair, and poor cosmetic outcome was detected in 10 (33.3%), 16 (53.4%), 4 (13.3%), and 0 (0%) patients, respectively. Grade 2 or worse acute side effect was not observed. Grade 1 fibrosis, grade 2 teleangiectasia and asymptomatic fat necrosis occurred in 4 (13.3%), 1 (3.3%) and 5 (16.7%) patients, respectively. No grade 3-4 late side effects were detected. 3D-CRT is a reproducible and feasible technique for the delivery of APBI following conservative surgery for the treatment of low-risk, early-stage invasive breast carcinoma. The preliminary results are promising, early- and mid-term radiation side effects are rare, and cosmetic results are excellent.
authors.affiliation: Sugárterápiás Központ, Országos Onkológiai Intézet, Budapest, Hungary. emozsa@gmail.com
authors.forename: Emőke
authors.initials: E
authors.lastname: Mózsa
authors.forename: Csaba
authors.initials: C
authors.lastname: Polgár
authors.forename: Georgina
authors.initials: G
authors.lastname: Fröhlich
authors.forename: Tibor
authors.initials: T
authors.lastname: Major
authors.forename: Levente
authors.initials: L
authors.lastname: Jánváry
authors.forename: Katalin
authors.initials: K
authors.lastname: Lövey
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Sulyok
authors.forename: László
authors.initials: L
authors.lastname: Takácsi Nagy
authors.forename: János
authors.initials: J
authors.lastname: Fodor
authors.forename: Miklós
authors.initials: M
authors.lastname: Kásler
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology / Q000528:radiation effects; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy; D018275:Carcinoma, Lobular / Q000532:radiotherapy; D002291:Carcinoma, Papillary / Q000532:radiotherapy; D019583:Dose Fractionation, Radiation; D005218:Fat Necrosis / Q000209:etiology; D005260:Female; D005355:Fibrosis / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods; D013684:Telangiectasis / Q000209:etiology; D016896:Treatment Outcome