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Long-term results of a randomized partial irradiation trial compared to whole breast irradiation in the early stage and low-risk breast cancer patients after conservative surgery

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Abstract

Purpose

To report long-term results of a randomized trial comparing accelerated partial breast irradiation (APBI) to whole-breast irradiation (WBI) in terms of efficacy, toxicity, and cosmesis.

Methods and materials

WBI group was treated with 3D conformal external irradiation, 2 Gy daily/fraction, 5 fractions/week, to a total dose of 50 Gy. APBI group was treated with 3D conformal external irradiation 3.75 Gy/fraction, twice a day, 5 fractions/week, to a total dose of 37.5 Gy in the APBI group. Patients were followed up every 6 months up to 5 years and yearly thereafter. During follow-up visits, the clinician evaluated chronic toxicity and scored cosmetic results with a four-scale system.

Results

After a median follow-up of 10.3 years, 43 patients in each group (84%) are alive without disease. One patient died after disease progression in the APBI arm, and there was no death in the WBI arm. The rest of the patients died from another disease different than breast cancer, similarly between groups. There was greater fibrosis in the APBI group (9 patients grade 1 and one grade 2) compared to WBI (3 patients grade 1 and one grade 2); p = 0.18. Regarding cosmesis, in APBI group, 19 and 21 (43.2 and 47%) patients had excellent or good results, similar to the WBI group with 18 patients (40.9%) in each cosmesis outcome. The WBI group did not have any patient with poor cosmesis but the APBI had 3 (6.8%; p = 0.24).

Conclusion

After a follow-up of 10 years, there were no differences in efficacy between the 2 treatment arms. Despite slight greater toxicity in the APBI group, the cosmesis was similar and satisfactory in both groups.

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Data availability

All data are avalaible for analysis and review in electronic records.

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Authors and Affiliations

  1. Universidad Autónoma de Barcelona, Barcelona, Spain

    X. Li, M. Zhao, Y. Huang & M. Algara

  2. Universitat Pompeu Fabra, Barcelona, Spain

    J. Sanz, P. Foro & N. Rodríguez

  3. Radiation Oncology Department, Hospital del Mar, Parc de Salut Mar, C/. Del Gas s/n Edificio B, sótano -2, 08003, Barcelona, Spain

    J. Sanz, P. Foro, A. Martínez, A. Reig, F. Liu, I. Membrive, M. Algara & N. Rodríguez

  4. Radiation Oncology Research Group, Institut Municipal d’InvestigacióMédica IMIM, Barcelona, Spain

    J. Sanz, P. Foro, A. Reig, I. Membrive, M. Algara & N. Rodríguez

Authors
  1. X. Li
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  2. J. Sanz
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  3. P. Foro
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  4. A. Martínez
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  5. M. Zhao
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  7. F. Liu
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  8. Y. Huang
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  10. M. Algara
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  11. N. Rodríguez
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Corresponding author

Correspondence to J. Sanz.

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Conflict of interest

All authors declare they have no conflict of interest excepte Dr Algara that has received consulting honoraria from Sysmex and Aristo and speaking honoraria from Siemens and Roche.

Ethical approval

This study obtained approval by ethic commitee of our hospital prior to the onset of patient inclusion in 2003.

Informed consent

All patients included signed informed consent to the participation in the study.

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Li, X., Sanz, J., Foro, P. et al. Long-term results of a randomized partial irradiation trial compared to whole breast irradiation in the early stage and low-risk breast cancer patients after conservative surgery. Clin Transl Oncol 23, 2127–2132 (2021). https://doi.org/10.1007/s12094-021-02618-5

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  • DOI: https://doi.org/10.1007/s12094-021-02618-5

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