• Je něco špatně v tomto záznamu ?

Toxicity of external beam accelerated partial-breast irradiation (APBI) in adjuvant therapy of early-stage breast cancer: prospective randomized study

P. Burkon, I. Selingerova, M. Slavik, M. Holanek, M. Vrzal, O. Coufal, K. Polachova, P. Muller, P. Slampa, T. Kazda

. 2024 ; 19 (1) : 17. [pub] 20240203

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu randomizované kontrolované studie, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc24007206

Grantová podpora
MMCI 00209805 Ministerstvo Zdravotnictví Ceské Republiky
MMCI 00209805 Ministerstvo Zdravotnictví Ceské Republiky
MMCI 00209805 Ministerstvo Zdravotnictví Ceské Republiky
MMCI 00209805 Ministerstvo Zdravotnictví Ceské Republiky
MMCI 00209805 Ministerstvo Zdravotnictví Ceské Republiky
MMCI 00209805 Ministerstvo Zdravotnictví Ceské Republiky
MMCI 00209805 Ministerstvo Zdravotnictví Ceské Republiky
MMCI 00209805 Ministerstvo Zdravotnictví Ceské Republiky
MMCI 00209805 Ministerstvo Zdravotnictví Ceské Republiky
MMCI 00209805 Ministerstvo Zdravotnictví Ceské Republiky
LM2023049 Ministerstvo Školství, Mládeže a Tělovýchovy
CZ.02.1.01/0.0/0.0/16_013/0001674 Ministerstvo Školství, Mládeže a Tělovýchovy

BACKGROUND: Accelerated partial breast irradiation (APBI) is an alternative breast-conserving therapy approach where radiation is delivered in less time compared to whole breast irradiation (WBI), resulting in improved patient convenience, less toxicity, and cost savings. This prospective randomized study compares the external beam APBI with commonly used moderate hypofractionated WBI in terms of feasibility, safety, tolerance, and cosmetic effects. METHODS: Early breast cancer patients after partial mastectomy were equally randomized into two arms- external APBI and moderate hypofractionated WBI. External beam technique using available technical innovations commonly used in targeted hypofractionated radiotherapy to minimize irradiated volumes was used (cone beam computed tomography navigation to clips in the tumor bed, deep inspiration breath hold technique, volumetric modulated arc therapy dose application, using flattening filter free beams and the six degrees of freedom robotic treatment couch). Cosmetics results and toxicity were evaluated using questionnaires, CTCAE criteria, and photo documentation. RESULTS: The analysis of 84 patients with a median age of 64 years showed significantly fewer acute adverse events in the APBI arm regarding skin reactions, local and general symptoms during a median follow-up of 37 months (range 21-45 months). A significant difference in favor of the APBI arm in grade ≥ 2 late skin toxicity was observed (p = 0.026). Late toxicity in the breast area (deformation, edema, fibrosis, and pain), affecting the quality of life and cosmetic effect, occurred in 61% and 17% of patients in WBI and APBI arms, respectively. The cosmetic effect was more favorable in the APBI arm, especially 6 to 12 months after the radiotherapy. CONCLUSION: External APBI demonstrated better feasibility and less toxicity than the standard regimen in the adjuvant setting for treating early breast cancer patients. The presented study confirmed the level of evidence for establishing the external APBI in daily clinical practice. TRIAL REGISTRATION: NCT06007118.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc24007206
003      
CZ-PrNML
005      
20240423155805.0
007      
ta
008      
240412s2024 enk f 000 0|eng||
009      
AR
024    7_
$a 10.1186/s13014-024-02412-x $2 doi
035    __
$a (PubMed)38310249
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a enk
100    1_
$a Burkon, Petr $u Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic $u Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
245    10
$a Toxicity of external beam accelerated partial-breast irradiation (APBI) in adjuvant therapy of early-stage breast cancer: prospective randomized study / $c P. Burkon, I. Selingerova, M. Slavik, M. Holanek, M. Vrzal, O. Coufal, K. Polachova, P. Muller, P. Slampa, T. Kazda
520    9_
$a BACKGROUND: Accelerated partial breast irradiation (APBI) is an alternative breast-conserving therapy approach where radiation is delivered in less time compared to whole breast irradiation (WBI), resulting in improved patient convenience, less toxicity, and cost savings. This prospective randomized study compares the external beam APBI with commonly used moderate hypofractionated WBI in terms of feasibility, safety, tolerance, and cosmetic effects. METHODS: Early breast cancer patients after partial mastectomy were equally randomized into two arms- external APBI and moderate hypofractionated WBI. External beam technique using available technical innovations commonly used in targeted hypofractionated radiotherapy to minimize irradiated volumes was used (cone beam computed tomography navigation to clips in the tumor bed, deep inspiration breath hold technique, volumetric modulated arc therapy dose application, using flattening filter free beams and the six degrees of freedom robotic treatment couch). Cosmetics results and toxicity were evaluated using questionnaires, CTCAE criteria, and photo documentation. RESULTS: The analysis of 84 patients with a median age of 64 years showed significantly fewer acute adverse events in the APBI arm regarding skin reactions, local and general symptoms during a median follow-up of 37 months (range 21-45 months). A significant difference in favor of the APBI arm in grade ≥ 2 late skin toxicity was observed (p = 0.026). Late toxicity in the breast area (deformation, edema, fibrosis, and pain), affecting the quality of life and cosmetic effect, occurred in 61% and 17% of patients in WBI and APBI arms, respectively. The cosmetic effect was more favorable in the APBI arm, especially 6 to 12 months after the radiotherapy. CONCLUSION: External APBI demonstrated better feasibility and less toxicity than the standard regimen in the adjuvant setting for treating early breast cancer patients. The presented study confirmed the level of evidence for establishing the external APBI in daily clinical practice. TRIAL REGISTRATION: NCT06007118.
650    _2
$a lidé $7 D006801
650    _2
$a kojenec $7 D007223
650    _2
$a předškolní dítě $7 D002675
650    _2
$a ženské pohlaví $7 D005260
650    12
$a nádory prsu $x radioterapie $x chirurgie $x patologie $7 D001943
650    _2
$a kvalita života $7 D011788
650    _2
$a prospektivní studie $7 D011446
650    _2
$a mastektomie $7 D008408
650    _2
$a kombinovaná terapie $7 D003131
650    _2
$a segmentální mastektomie $7 D015412
655    _2
$a randomizované kontrolované studie $7 D016449
655    _2
$a časopisecké články $7 D016428
700    1_
$a Selingerova, Iveta $u Research Centre for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53, Brno, Czech Republic. iveta.selingerova@mou.cz $u Department of Mathematics and Statistics, Faculty of Science, Masaryk University, Brno, Czech Republic. iveta.selingerova@mou.cz
700    1_
$a Slavik, Marek $u Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic $u Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
700    1_
$a Holanek, Milos $u Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic $u Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
700    1_
$a Vrzal, Miroslav $u Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
700    1_
$a Coufal, Oldrich $u Department of Surgical Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic $u Department of Surgical Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
700    1_
$a Polachova, Katerina $u Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic $u Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
700    1_
$a Muller, Petr $u Research Centre for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53, Brno, Czech Republic
700    1_
$a Slampa, Pavel $u Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic $u Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
700    1_
$a Kazda, Tomas $u Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic $u Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic $u Research Centre for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53, Brno, Czech Republic
773    0_
$w MED00165460 $t Radiation oncology $x 1748-717X $g Roč. 19, č. 1 (2024), s. 17
856    41
$u https://pubmed.ncbi.nlm.nih.gov/38310249 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y - $z 0
990    __
$a 20240412 $b ABA008
991    __
$a 20240423155802 $b ABA008
999    __
$a ok $b bmc $g 2081285 $s 1216973
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2024 $b 19 $c 1 $d 17 $e 20240203 $i 1748-717X $m Radiation oncology $n Radiat. oncol. $x MED00165460
GRA    __
$a MMCI 00209805 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a MMCI 00209805 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a MMCI 00209805 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a MMCI 00209805 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a MMCI 00209805 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a MMCI 00209805 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a MMCI 00209805 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a MMCI 00209805 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a MMCI 00209805 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a MMCI 00209805 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a LM2023049 $p Ministerstvo Školství, Mládeže a Tělovýchovy
GRA    __
$a CZ.02.1.01/0.0/0.0/16_013/0001674 $p Ministerstvo Školství, Mládeže a Tělovýchovy
LZP    __
$a Pubmed-20240412

Najít záznam

Citační ukazatele

Možnosti archivace