Once Daily Accelerated Partial Breast Irradiation: Preliminary Results with Helical Tomotherapy®.
BACKGROUND
Accelerated partial breast irradiation (APBI) is becoming an option for patients with low-risk breast cancer. The current practice is 38.5 Gy in 10 fractions b.i.d. over 5 days. This fractionation has a higher bioequivalent dose compared to the standard schedule. We report on preliminary results of once-daily APBI in patients treated with TomoTherapy®.


METHODS
Patients with unifocal-breast disease who underwent breast-conserving surgery were enrolled in the study. Treatment was administered with TomoTherapy, by contouring in accordance with the NSABP B-39/RTOG 0413 APBI protocol. Treatment schedule was 38.5 Gy in 10 once-daily fractions. EORTC Cosmetic Rating System was adopted for cosmetic outcome.


RESULTS
From 2010 to 2013, 111 patients were treated. With a median follow-up of 34 months, no ipsilateral breast recurrence was observed. Very few patients (1-4%) assessed their cosmetic outcome as fair or poor during follow-up.


CONCLUSIONS
Once-daily APBI with TomoTherapy yielded good cosmetic results without compromising local control efficacy.
Department of Radiation Oncology, San Giovanni-Addolorata Hospital, Rome, Italy udepaula@hsangiovanni.roma.it.
Ugo
U
DE Paula
Department of Radiation Oncology, Campus Bio-Medico University, Rome, Italy.
Rolando M
RM
D'Angelillo
Department of Radiation Oncology, San Giovanni-Addolorata Hospital, Rome, Italy.
Raffaele
R
Barbara
Department of Radiation Oncology, San Giovanni-Addolorata Hospital, Rome, Italy.
Cristina
C
Caruso
Department of Radiation Oncology, San Giovanni-Addolorata Hospital, Rome, Italy.
Sara
S
Gomellini
Department of Medical Physics, San Giovanni-Addolorata Hospital, Rome, Italy.
Aurelia
A
Caccavari
Department of Pathology, San Giovanni-Addolorata Hospital, Rome, Italy.
Leopoldo
L
Costarelli
Department of Medical Oncology, San Giovanni-Addolorata Hospital, Rome, Italy.
Paola
P
Scavina
Department of Medical Oncology, San Giovanni-Addolorata Hospital, Rome, Italy.
Maria
M
Mauri
Department of Radiology, San Giovanni-Addolorata Hospital, Rome, Italy.
Elena
E
Santini
Department of Physical and Rehabilitation Medicine, San Giovanni-Addolorata Hospital, Rome, Italy.
Adriana
A
Antonaci
Breast Unit-Department of Surgery, San Giovanni-Addolorata Hospital, Rome, Italy.
Francesco
F
Cavaliere
Breast Unit-Department of Surgery, San Giovanni-Addolorata Hospital, Rome, Italy.
Massimo
M
LA Pinta
Department of Plastic Surgery, San Giovanni-Addolorata Hospital, Rome, Italy.
Andrea
A
Loreti
Breast Unit-Department of Surgery, San Giovanni-Addolorata Hospital, Rome, Italy.
Lucio
L
Fortunato
D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000528:radiation effects*; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D050397:Radiotherapy, Intensity-Modulated
APBI; Partial breast irradiation; TomoTherapy; breast cancer