Details

Autor(en) / Beteiligte

• Meattini, Icro
• Marrazzo, Livia
• Saieva, Calogero
• Desideri, Isacco
• Scotti, Vieri
• Simontacchi, Gabriele
• Bonomo, Pierluigi
• Greto, Daniela
• Mangoni, Monica
• Scoccianti, Silvia
• Lucidi, Sara
• Paoletti, Lisa
• Fambrini, Massimiliano
• Bernini, Marco
• Sanchez, Luis
• Orzalesi, Lorenzo
• Nori, Jacopo
• Bianchi, Simonetta
• Pallotta, Stefania
• Livi, Lorenzo

Titel

Accelerated Partial-Breast Irradiation Compared With Whole-Breast Irradiation for Early Breast Cancer: Long-Term Results of the Randomized Phase III APBI-IMRT-Florence Trial

Ist Teil von

• Journal of clinical oncology, 2020-12, Vol.38 (35), p.4175-4183

Ort / Verlag

United States

Erscheinungsjahr

2020

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• To report the long-term results of external-beam accelerated partial-breast irradiation (APBI) intensity-modulated radiation therapy (IMRT) Florence phase III trial comparing whole-breast irradiation (WBI) to APBI in early-stage breast cancer. The primary end point was to determine the 5-year difference in ipsilateral breast tumor recurrence (IBTR) between 30 Gy in 5 once-daily fractions (APBI arm) and 50 Gy in 25 fractions with a tumor bed boost (WBI arm) after breast-conserving surgery. Five hundred twenty patients, more than 90% of whom had characteristics associated with low recurrence risk, were randomly assigned (WBI, n = 260; APBI, n = 260) between 2005 and 2013. Median follow-up was 10.7 years. The 10-year cumulative incidence of IBTR was 2.5% (n = 6) in the WBI and 3.7% (n = 9) in the APBI arm (hazard ratio [HR], 1.56; 95% CI, 0.55 to 4.37; = .40). Overall survival at 10 years was 91.9% in both arms (HR, 0.95; 95% CI, 0.50 to 1.79; = .86). Breast cancer-specific survival at 10 years was 96.7% in the WBI and 97.8% in the APBI arm (HR, 0.65; 95% CI, 0.21 to 1.99; = .45). The APBI arm showed significantly less acute toxicity ( = .0001) and late toxicity ( = .0001) and improved cosmetic outcome as evaluated by both physician ( = .0001) and patient ( = .0001). The 10-year cumulative IBTR incidence in early breast cancer treated with external APBI using IMRT technique in 5 once-daily fractions is low and not different from that after WBI. Acute and late treatment-related toxicity and cosmesis outcomes were significantly in favor of APBI.