Very accelerated partial breast irradiation in 1 or 2 days: Late toxicity and early oncological outcome of the GEC-ESTRO VAPBI cohort

Hannoun-Levi JM, Gimeno Morales M, Gal J, Anchuelo J, Guinot JL, Gastanaga M, Meszaros N, Polgar C, Strnad V, Schiappa R, Gutierrez C (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Radiotherapy and Oncology Elsevier

Book Volume: 194

Article Number: 110217

DOI: 10.1016/j.radonc.2024.110217

Abstract

Purpose: To analyze late toxicity after very accelerated partial breast irradiation (VAPBI) for low-risk breast cancer. Materials: Methods: In this retrospective, observational, international multicenter study (HDH F20220713143949), patients with low-risk breast cancer underwent lumpectomy + vAPBI (high-dose rate multicatheter interstitial brachytherapy-MIBT). VAPBI was performed with 4(4x6.2 Gy/2d), 3(3x7.45 Gy/2d) or 1 fraction (1x16Gy or 1x18Gy/1d). Primary endpoint was late toxicity. Secondary endpoints were cumulative incidence of breast cancer local relapse (LR) and distant metastatic relapse (DMR) and specific (SS) and overall (OS) survivals. Prognostic factors for late toxicity were analyzed. Results: From 01/2012 to 06/2022, 516 pts with early breast cancer were enrolled. Median follow-up was 44 months [95 %CI 39–46]. Median age was 71 years [40–100]. Median tumor size was 12 mm [1–35]. VAPBI delivered 1, 3 and 4 fractions for 205pts (39.7 %), 167pts (32.4 %) and 144pts (28 %) respectively. 221 late toxicity events were observed in 168pts (32.6 %) (Fibrosis, dyschromia, pain and telangiectasia). Grade 2 and 3 late toxicities were observed in 7.2 and 0.6 % respectively (no G4) with no difference between 1 and ≥ 2 treatment days. CTV > 50 cc (p = 0.007) and V150 > 40 % (p = 0.027) were prognostic factors for G ≥ 2 late toxicity. Four-year cumulative incidence rates of LR and DMR were 2 % [95 %CI 0–3] and 1 % [95 %CI 0–2] respectively. Conclusions: VAPBI based on 1 or ≥ 2 days of MIBT represents an attractive de-escalation of irradiation approach for low-risk breast cancer. Late toxicity profile appears acceptable while early oncological outcome shows encouraging local control. Longer follow-up is warranted in order to confirm these preliminary results.

Authors with CRIS profile

Vratislav Strnad Department of Radiation Oncology

Involved external institutions

University of Côte d'Azur / Université Côte d'Azur FR France (FR) Universidad de Navarra ES Spain (ES) Marqués de Valdecilla University Hospital / Hospital Universitario de Marqués de Valdecilla (HUMV) ES Spain (ES) Valencia Oncology Institute Foundation / Fundación Instituto Valenciano de Oncología / Fundació Institut Valencià d’Oncologia (IVO) ES Spain (ES) Hospital Clínico San Carlos ES Spain (ES) Semmelweis University / Semmelweis Egyetem HU Hungary (HU) Országos Onkológiai Intézet / National Institute of Oncology HU Hungary (HU) Catalan Institute of Oncology / Institut Català d'Oncologia (ICO) ES Spain (ES)

How to cite

APA:

Hannoun-Levi, J.M., Gimeno Morales, M., Gal, J., Anchuelo, J., Guinot, J.L., Gastanaga, M.,... Gutierrez, C. (2024). Very accelerated partial breast irradiation in 1 or 2 days: Late toxicity and early oncological outcome of the GEC-ESTRO VAPBI cohort. Radiotherapy and Oncology, 194. https://dx.doi.org/10.1016/j.radonc.2024.110217

MLA:

Hannoun-Levi, Jean Michel, et al. "Very accelerated partial breast irradiation in 1 or 2 days: Late toxicity and early oncological outcome of the GEC-ESTRO VAPBI cohort." Radiotherapy and Oncology 194 (2024).

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