Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer
Abstract Background Local recurrences after breast conserving treatment are mainly close to the original tumor site, and as such shorter fractionation strategies focused on and nearest mammary gland, i.e. accelerated partial breast irradiation (APBI), have been developed. Stereotactic APBI has been...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-03-01
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| Series: | Radiation Oncology |
| Online Access: | http://link.springer.com/article/10.1186/s13014-018-0991-4 |
| _version_ | 1828916543167135744 |
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| author | Laura Lozza Laura Fariselli Marco Sandri Mario Rampa Valentina Pinzi Maria Carmen De Santis Marzia Franceschini Giovanna Trecate Ilaria Maugeri Luisa Fumagalli Francesca Bonfantini Giulia Bianchi Emanuele Pignoli Elena De Martin Roberto Agresti |
| author_facet | Laura Lozza Laura Fariselli Marco Sandri Mario Rampa Valentina Pinzi Maria Carmen De Santis Marzia Franceschini Giovanna Trecate Ilaria Maugeri Luisa Fumagalli Francesca Bonfantini Giulia Bianchi Emanuele Pignoli Elena De Martin Roberto Agresti |
| author_sort | Laura Lozza |
| collection | DOAJ |
| description | Abstract Background Local recurrences after breast conserving treatment are mainly close to the original tumor site, and as such shorter fractionation strategies focused on and nearest mammary gland, i.e. accelerated partial breast irradiation (APBI), have been developed. Stereotactic APBI has been attempted, although there is little experience using CyberKnife (CK) for early breast cancer. Methods This pilot study was designed to assess the feasibility of CK-APBI on 20 evaluable patients of 29 eligible, followed for 2 years. The primary endpoint was acute/sub-acute toxicity; secondary endpoints were late toxicity and the cosmetic result. Results Mean pathological tumor size was 10.5 mm (±4.3, range 3–18), 8 of these patients were classified as LumA-like, 11 as LumB-like, and 1 as LumB-HER2-enriched. Using CK-APBI with Iris, the treatment time was approximately 60 min (range~ 35 to ~ 120). All patients received 30 Gy in five fractions delivered to the PTV. The median number of beams was 180 (IQR 107–213; range:56–325) with a median PTV isodose prescription of 86.0% (IQR 85.0–88.5; range:82–94). The median PTV was 88.1 cm3 (IQR 63.8–108.6; range:32.3–238.8). The median breast V100 and V50 was 0.6 (IQR 0.1–1.5; range:0–13) and 18.6 (IQR 13.1–21.7; range:7.5–37), respectively. The median PTV minimum dose was 26.2 Gy (IQR 24.7–27.6; range 22.3–29.3). Mild side effects were recorded during the period of observation. Cosmetic evaluations were performed by three observers from the start of radiotherapy up to 2 years. Patients’ evaluation progressively increase from 60% to 85% of excellent rating; this trend was similar to that of external observer. Conclusions These preliminary results showed the safe feasibility of CK-APBI in early breast cancer, with mild acute and late toxicity and very good cosmetic results. Trial registration The present study is registered at Clinicaltrial.gov (NCT02896322). Retrospectively egistered August 4, 2016. |
| first_indexed | 2024-12-13T20:35:53Z |
| format | Article |
| id | doaj.art-375ce51746ac45ef84f22a63f4d06a5f |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-13T20:35:53Z |
| publishDate | 2018-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-375ce51746ac45ef84f22a63f4d06a5f2022-12-21T23:32:18ZengBMCRadiation Oncology1748-717X2018-03-0113111110.1186/s13014-018-0991-4Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancerLaura Lozza0Laura Fariselli1Marco Sandri2Mario Rampa3Valentina Pinzi4Maria Carmen De Santis5Marzia Franceschini6Giovanna Trecate7Ilaria Maugeri8Luisa Fumagalli9Francesca Bonfantini10Giulia Bianchi11Emanuele Pignoli12Elena De Martin13Roberto Agresti14Radiotherapy Unit, Fondazione IRCCS Istituto Nazionale dei TumoriHealth Department, Fondazione IRCCS Istituto Neurologico Carlo BestaMolecular Targeting Unit, Fondazione IRCCS Istituto Nazionale dei TumoriBreast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei TumoriHealth Department, Fondazione IRCCS Istituto Neurologico Carlo BestaRadiotherapy Unit, Fondazione IRCCS Istituto Nazionale dei TumoriRadiotherapy Unit, Fondazione IRCCS Istituto Nazionale dei TumoriRadiology Unit, Fondazione IRCCS Istituto Nazionale dei TumoriBreast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei TumoriHealth Department, Fondazione IRCCS Istituto Neurologico Carlo BestaMedical Physics Unit, Fondazione IRCCS Istituto Nazionale dei TumoriMedical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei TumoriMedical Physics Unit, Fondazione IRCCS Istituto Nazionale dei TumoriHealth Department, Fondazione IRCCS Istituto Neurologico Carlo BestaBreast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei TumoriAbstract Background Local recurrences after breast conserving treatment are mainly close to the original tumor site, and as such shorter fractionation strategies focused on and nearest mammary gland, i.e. accelerated partial breast irradiation (APBI), have been developed. Stereotactic APBI has been attempted, although there is little experience using CyberKnife (CK) for early breast cancer. Methods This pilot study was designed to assess the feasibility of CK-APBI on 20 evaluable patients of 29 eligible, followed for 2 years. The primary endpoint was acute/sub-acute toxicity; secondary endpoints were late toxicity and the cosmetic result. Results Mean pathological tumor size was 10.5 mm (±4.3, range 3–18), 8 of these patients were classified as LumA-like, 11 as LumB-like, and 1 as LumB-HER2-enriched. Using CK-APBI with Iris, the treatment time was approximately 60 min (range~ 35 to ~ 120). All patients received 30 Gy in five fractions delivered to the PTV. The median number of beams was 180 (IQR 107–213; range:56–325) with a median PTV isodose prescription of 86.0% (IQR 85.0–88.5; range:82–94). The median PTV was 88.1 cm3 (IQR 63.8–108.6; range:32.3–238.8). The median breast V100 and V50 was 0.6 (IQR 0.1–1.5; range:0–13) and 18.6 (IQR 13.1–21.7; range:7.5–37), respectively. The median PTV minimum dose was 26.2 Gy (IQR 24.7–27.6; range 22.3–29.3). Mild side effects were recorded during the period of observation. Cosmetic evaluations were performed by three observers from the start of radiotherapy up to 2 years. Patients’ evaluation progressively increase from 60% to 85% of excellent rating; this trend was similar to that of external observer. Conclusions These preliminary results showed the safe feasibility of CK-APBI in early breast cancer, with mild acute and late toxicity and very good cosmetic results. Trial registration The present study is registered at Clinicaltrial.gov (NCT02896322). Retrospectively egistered August 4, 2016.http://link.springer.com/article/10.1186/s13014-018-0991-4 |
| spellingShingle | Laura Lozza Laura Fariselli Marco Sandri Mario Rampa Valentina Pinzi Maria Carmen De Santis Marzia Franceschini Giovanna Trecate Ilaria Maugeri Luisa Fumagalli Francesca Bonfantini Giulia Bianchi Emanuele Pignoli Elena De Martin Roberto Agresti Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer Radiation Oncology |
| title | Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
| title_full | Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
| title_fullStr | Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
| title_full_unstemmed | Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
| title_short | Partial breast irradiation with CyberKnife after breast conserving surgery: a pilot study in early breast cancer |
| title_sort | partial breast irradiation with cyberknife after breast conserving surgery a pilot study in early breast cancer |
| url | http://link.springer.com/article/10.1186/s13014-018-0991-4 |
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