Abstract
Purpose
According to ASTRO and ESTRO guidelines, external beam Partial Breast Irradiation (PBI) is a valid option for early-stage breast cancer patients. Nevertheless, there is lack of consensus about the best treatment schedule.
Methods
We retrospectively analysed data of female patients treated at our institution from 2013 to 2022 with adjuvant “one-week” partial breast irradiation. Clinical Target Volume (CTV) was an isotropic expansion of 15 mm from the tumour bed (identified as the breast tissue between surgical clips). The treatment schedule was 30 Gy delivered with Volumetric Modulated Arc Therapy in 5 daily fractions. The primary endpoint was Local Control (LC). Disease-Free Survival (DFS), Overall Survival (OS) and safety were secondary endpoints.
Results
Three hundred and forty-four patients with a median age of 69 (33–87) years were included in the study. After a median follow-up of 34 (7–105) months, 7 patients (2.0%) developed a local recurrence. Three-year LC, DFS and OS actuarial rates were 97.5% (95% CI 96.2%–98.8%), 95.7% (95% CI 94.2%–97.2%), and 96.9% (95% CI 95.7%–98.1%), respectively. Ten (2.9%) patients experienced grade 2 late toxicities. Five (1.5%) patients reported late cardiac major events. Three (0.9%) late pulmonary toxicities were detected. One hundred and five (30.5%) patients reported fat necrosis. Good or excellent cosmetic evaluation following the Harvard Scale was reported in 252 (96.9%) cases by the physicians, while in 241 (89.2%) cases by the patients.
Conclusion
“One-week” PBI is effective and safe, and this schedule is a valid option for highly selected early breast cancer patients.
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Availability of data and materials
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Abbreviations
- Fx:
-
Fractions
- WBI:
-
Whole breast irradiation
- RT:
-
Radiation therapy
- PBI:
-
Partial breast irradiation
- VMAT:
-
Volumetric modulated arc therapy
- CBCT:
-
Cone-beam computed tomography
- LC:
-
Local control
- IBTR:
-
Ipsilateral breast tumour recurrence
- OS:
-
Overall survival
- DFS:
-
Disease-free survival
- ET:
-
Endocrine therapy
- OTT:
-
Overall treatment time
- PTV:
-
Planning target volume
- V 95% :
-
Percentage of target volume receiving a dose equal to or higher than 95% of the prescribed dose
- MHD:
-
Mean heart dose
- OR:
-
Odds ratio
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RRC. The first draft of the manuscript was written by RRC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Colciago, R.R., La Rocca, E., Giandini, C. et al. One-week external beam partial breast irradiation: survival and toxicity outcomes. J Cancer Res Clin Oncol 149, 10965–10974 (2023). https://doi.org/10.1007/s00432-023-04973-y
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DOI: https://doi.org/10.1007/s00432-023-04973-y