Study Supports Interstitial Brachytherapy-based APBI

Share this content:
Five-year toxicity profiles and cosmetic results were similar for patients with low-risk breast cancer who underwent breast-conserving surgery.
Five-year toxicity profiles and cosmetic results were similar for patients with low-risk breast cancer who underwent breast-conserving surgery.

Five-year toxicity profiles and cosmetic results were similar for patients with low-risk breast cancer who underwent breast-conserving surgery followed by either accelerated partial breast irradiation (APBI) with interstitial brachytherapy or conventional whole-breast irradiation, according to a study published in The Lancet Oncology.1

A previously reported phase 3 study confirmed the non-inferiority of APBI with interstitial brachytherapy compared with whole-breast irradiation for local control and overall survival among patients with early-stage breast cancer who underwent breast-conserving surgery. To further support these findings, researchers conducted an analysis of 5-year late side effects and cosmetic results of the study.

Median follow-up was 6.6 years. Less than 1% of the 484 evaluable patients who received APBI with interstitial multi-catheter brachytherapy and 2% of the 393 evaluable patients who underwent whole-breast irradiation had grade 3 late skin toxicity.

No patients in the APBI group and less than 1% of those in the whole-breast irradiation arm developed grade 3 late subcutaneous toxicity. No grade 4 toxicities were reported.

The cumulative incidence of any grade 2 or worse late side-effect at 5 years was 23.3% (19.9-26.8) in the APBI group vs 27.0% (95% CI, 23.0-30.9) in the whole-breast irradiation group.

Patients in the APBI group were less likely to develop grade 2 to 3 late dermatologic toxicity at 5 years. The cumulative incidence of grade 2 to 3 breast pain was not significantly different between the 2 groups.

Ninety-two percent of 541 patients in the APBI group and 91% of 454 patients in the whole-breast irradiation group reported excellent to good cosmetic results; similarly, 93% and 90%, respectively had excellent to good cosmetic results when judged by the physicians.

RELATED: Diarrhea Manageable With Pertuzumab Treatment for Breast Cancer

For the phase 3 trial (ClinicalTrials.gov Identifier: NCT00402519), investigators enrolled 1328 women aged 40 years or older with stage 0-IIA breast cancer who underwent breast-conserving surgery with microscopically clear resection margins of at least 2 mm. Participants were randomly assigned 1:1 to receive whole-breast irradiation of 50 Gy with a tumor-bed boost of 10 Gy or APBI with interstitial multi-catheter brachytherapy.

These findings support the routine use of APBI with interstitial brachytherapy after breast-conserving surgery in low-risk breast cancer.

Reference

  1. Polgar C, Ott OJ, Hildebrandt G, et al. Late side-effects and cosmetic results of accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: 5-year results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2017 Jan 13. doi: 10.1016/S1470-2045(17)30011-6 [Epub ahead of print]

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs

Sign Up for Free e-newsletters