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Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: A case-control study of disease control, cosmesis, and complications
Journal of Cancer Research and Therapeutics, 06/19/09
Wadasadawala T et al. - In a study to compare disease control, cosmesis, and complications in pts with early breast cancer (EBC) undergoing accelerated partial-breast irradiation (APBI) using multicatheter interstitial brachytherapy vs those receiving conventional whole breast radiotherapy (WBRT), this study revealed equivalent locoregional and distant disease control in the 2 groups. APBI offered better overall cosmetic outcome, though at the cost of a slight increase in mild breast fibrosis and telangiectasias.
Methods- Women with EBC fulfilling the American Brachytherapy Society (ABS) criteria were selected as cases if treated with APBI or as controls if offered WBRT.
- APBI pts were treated with high-dose-rate brachytherapy (HDR) to a dose of 34 Gy/10#/6-8 days.
- WBRT was delivered to the whole breast to a dose of 45 Gy/25# followed by tumor bed boost, either with electrons (15 Gy/6#) or interstitial brachytherapy (HDR 10 Gy/1#).
- At median follow-up of 43.05 mos in APBI and 51.08 mos in WBRT, there was no difference in overall survival (OS), disease-free survival (DFS), late arm edema, and symptomatic fat necrosis between the 2 groups.
- APBI resulted in increase in mild breast fibrosis at the tumor bed.
- Telangiectasias were observed in 3 pnts of the APBI group.
- Cosmetic outcome was significantly better in the APBI group vs the WBRT group.
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