title: Late toxicity and patient self-assessment of breast appearance/satisfaction on RTOG 0319: a phase 2 trial of 3-dimensional conformal radiation therapy-accelerated partial breast irradiation following lumpectomy for stages I and II breast cancer.
abstract: OBJECTIVE
  Late toxicities and cosmetic analyses of patients treated with accelerated partial breast irradiation (APBI) on RTOG 0319 are presented.
  
  
  METHODS
  Patients with stages I to II breast cancer ≤3 cm, negative margins, and ≤3 positive nodes were eligible. Patients received three-dimensional conformal external beam radiation therapy (3D-CRT; 38.5 Gy in 10 fractions twice daily over 5 days). Toxicity and cosmesis were assessed by the patient (P), the radiation oncologist (RO), and the surgical oncologist (SO) at 3, 6, and 12 months from the completion of treatment and then annually. National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0, was used to grade toxicity.
  
  
  RESULTS
  Fifty-two patients were evaluable. Median follow-up was 5.3 years (range, 1.7-6.4 years). Eighty-two percent of patients rated their cosmesis as good/excellent at 1 year, with rates of 64% at 3 years. At 3 years, 31 patients were satisfied with the treatment, 5 were not satisfied but would choose 3D-CRT again, and none would choose standard radiation therapy. The worst adverse event (AE) per patient reported as definitely, probably, or possibly related to radiation therapy was 36.5% grade 1, 50% grade 2, and 5.8% grade 3 events. Grade 3 AEs were all skin or musculoskeletal-related. Treatment-related factors were evaluated to potentially establish an association with observed toxicity. Surgical bed volume, target volume, the number of beams used, and the use of bolus were not associated with late cosmesis.
  
  
  CONCLUSIONS
  Most patients enrolled in RTOG 0319 were satisfied with their treatment, and all would choose to have the 3D-CRT APBI again.
authors.affiliation: Department of Radiation Oncology, Cross Cancer Institute-University of Alberta, Edmonton, Alberta, Canada. susan.chafe@albertahealthservices.ca
authors.forename: Susan
authors.initials: S
authors.lastname: Chafe
authors.forename: Jennifer
authors.initials: J
authors.lastname: Moughan
authors.forename: Beryl
authors.initials: B
authors.lastname: McCormick
authors.forename: John
authors.initials: J
authors.lastname: Wong
authors.forename: Helen
authors.initials: H
authors.lastname: Pass
authors.forename: Rachel
authors.initials: R
authors.lastname: Rabinovitch
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Arthur
authors.forename: Ivy
authors.initials: I
authors.lastname: Petersen
authors.forename: Julia
authors.initials: J
authors.lastname: White
authors.forename: Frank A
authors.initials: FA
authors.lastname: Vicini
mesh_terms: D001940:Breast / Q000473:pathology / Q000528:radiation effects; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000523:psychology / Q000532:radiotherapy* / Q000601:surgery; D059026:Diagnostic Self Evaluation; D019583:Dose Fractionation, Radiation; D004954:Esthetics / Q000523:psychology; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D009367:Neoplasm Staging; D009929:Organ Size / Q000528:radiation effects; D017060:Patient Satisfaction; D011832:Radiation Injuries / Q000473:pathology / Q000523:psychology; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000523:psychology