title: Accelerated partial breast irradiation with external beam three-dimensional conformal radiotherapy. Five-year results of a prospective phase II clinical study.
abstract: OBJECTIVE
  The aim of this study was to report the 5-year results of accelerated partial breast irradiation (APBI) using external beam three-dimensional conformal radiotherapy (3D-CRT).
  
  
  METHODS
  Between 2006 and 2011, 44 patients with low-risk, stage I-II breast cancer underwent breast-conserving surgery. Postoperative APBI was given by means of 3D-CRT using three to five non-coplanar fields. The total dose of APBI was 36.9 Gy (nine fractions of 4.1 Gy b.i.d.). The mean follow-up time was 58.2 months for surviving patients. Survival results, side effects, and cosmetic results were assessed.
  
  
  RESULTS
  One (2.3%) local recurrence was observed, for a 5-year actuarial rate of 3.7%. Neither regional nor distant failure was observed. Two patients died of internal disease. The 5-year disease-free, cancer-specific, and overall survival rates were 96.3, 100, and 95.1%, respectively. Acute side effects included grade 1 (G1) erythema in 75%, G1 parenchymal induration in 46%, and G1 pain in 46% of patients. No G2 or higher acute side effect occurred. Late side effects included G1, G2, and G3 fibrosis in 44, 7, and 2% of patients, respectively, G1 skin pigmentation in 12%, and G1 pain in 2%. Asymptomatic fat necrosis occurred in 14%. Cosmetic results were rated excellent or good in 86% of cases by the patients themselves and 84% by the physicians.
  
  
  CONCLUSIONS
  The 5-year local tumor control, toxicity profile, and cosmetic results of APBI delivered with external beam 3D-CRT are encouraging and comparable to other APBI series.
authors.affiliation: Centre of Radiotherapy, National Institute of Oncology, Ráth György u. 7-9, 1122, Budapest, Hungary, emozsa@gmail.com.
authors.forename: Emöke
authors.initials: E
authors.lastname: Mózsa
authors.forename: Norbert
authors.initials: N
authors.lastname: Mészáros
authors.forename: Tibor
authors.initials: T
authors.lastname: Major
authors.forename: Georgina
authors.initials: G
authors.lastname: Fröhlich
authors.forename: Gábor
authors.initials: G
authors.lastname: Stelczer
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Sulyok
authors.forename: János
authors.initials: J
authors.lastname: Fodor
authors.forename: Csaba
authors.initials: C
authors.lastname: Polgár
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology / Q000628:therapy; D018275:Carcinoma, Lobular / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002291:Carcinoma, Papillary / Q000401:mortality / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D009367:Neoplasm Staging; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal / Q000379:methods*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods; D047368:Tumor Burden