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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2017

01-10-2017 | Breast Oncology

A Single Institution Retrospective Comparison Study of Locoregional Recurrence After Accelerated Partial Breast Irradiation Using External Beam Fractionation Compared with Whole Breast Irradiation with 8 Years of Follow-Up

Authors: Shalin Shah, MD, Alexandra Kyrillos, BS, Kristine Kuchta, MS, Hussain Habib, BS, Megan Tobias, BS, Vathsala Raghavan, MD, Arif Shaikh, MD, William Bloomer, MD, Catherine Pesce, MD, Katharine Yao, MD

Published in: Annals of Surgical Oncology | Issue 10/2017

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Abstract

Background

Accelerated partial breast irradiation (APBI) was developed to address disadvantages of overall treatment time and potentially unnecessary radiation associated with whole breast irradiation (WBI). We report updated results of our single institution study using an external beam APBI regimen with a median follow-up of 8 years.

Methods

A total of 290 APBI patients with AJCC Stage 0–II breast cancer were compared with 290 WBI patients with matched tumor characteristics. Toxicities were scored based on the Common Terminology Criteria for Adverse Events (CTCAE v3.0). Cox regression models were used to predict likelihood of freedom from ipsilateral failure.

Results

Median follow-up was 8 years in the APBI group and 7.5 years in the WBI group. In the APBI group, there were 18 (6.2%) ipsilateral breast tumor recurrence (IBTR), 13 (72%) had elsewhere failures (EF), and 5 (28%) had local failures (LF) with a median time to failure of 64.1 months. In the WBI group, there were three (1.0%) IBTR; one (33%) was an EF and two (67%) were LF with a median time to failure of 91 months. APBI was 4.6 times more likely (hazard ratio 4.57, 95% confidence interval 1.3–16.2, p = 0.02) to have an IBTR than WBI after adjusting for age, tumor size, histology, grade, and estrogen receptor status. Fatigue, erythema, and desquamation toxicities were significantly less in the APBI group then the WBI group.

Conclusions

IBTR rates were higher in external beam APBI group compared with WBI, but APBI had fewer toxicities. Clinicians must weigh the risks and benefits of APBI when making a recommendation for partial breast irradiation after lumpectomy.
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Metadata
Title
A Single Institution Retrospective Comparison Study of Locoregional Recurrence After Accelerated Partial Breast Irradiation Using External Beam Fractionation Compared with Whole Breast Irradiation with 8 Years of Follow-Up
Authors
Shalin Shah, MD
Alexandra Kyrillos, BS
Kristine Kuchta, MS
Hussain Habib, BS
Megan Tobias, BS
Vathsala Raghavan, MD
Arif Shaikh, MD
William Bloomer, MD
Catherine Pesce, MD
Katharine Yao, MD
Publication date
01-10-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 10/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-5953-9

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