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Breast Cancer Research and Treatment

, Volume 153, Issue 3, pp 539–547 | Cite as

Accelerated partial breast irradiation using intensity-modulated radiotherapy technique compared to whole breast irradiation for patients aged 70 years or older: subgroup analysis from a randomized phase 3 trial

  • Icro Meattini
  • Calogero Saieva
  • Livia Marrazzo
  • Lucia Di Brina
  • Stefania Pallotta
  • Monica Mangoni
  • Fiammetta Meacci
  • Benedetta Bendinelli
  • Giulio Francolini
  • Isacco Desideri
  • Carla De Luca Cardillo
  • Vieri Scotti
  • Ilaria Francesca Furfaro
  • Francesca Rossi
  • Daniela Greto
  • Pierluigi Bonomo
  • Donato Casella
  • Marco Bernini
  • Luis Sanchez
  • Lorenzo Orzalesi
  • Roberta Simoncini
  • Jacopo Nori
  • Simonetta Bianchi
  • Lorenzo Livi
Clinical trial

Abstract

The purpose of this study was to report the efficacy and the safety profile on the subset of selected early breast cancer (BC) patients aged 70 years or older from a single-center phase 3 trial comparing whole breast irradiation (WBI) to accelerated partial breast irradiation (APBI) using intensity-modulated radiation therapy technique. Between 2005 and 2013, 520 patients aged more than 40 years old were enrolled and randomly assigned to receive either WBI or APBI in a 1:1 ratio. Eligible patients were women with early BC (maximum diameter 2.5 cm) suitable for breast conserving surgery. This study is registered with ClinicalTrials.gov, NCT02104895. A total of 117 patients aged 70 years or more were analyzed (58 in the WBI arm, 59 in the APBI arm). At a median follow-up of 5-years (range 3.4–7.0), the ipsilateral breast tumor recurrence (IBTR) rate was 1.9 % in both groups. No significant difference between the two groups was identified (log-rank test p = 0.96). The 5-year disease-free survival (DFS) rates in the WBI group and APBI group were 6.1 and 1.9 %, respectively (p = 0.33). The APBI group presented significantly better results in terms of acute skin toxicity, considering both any grade (p = 0.0001) and grade 2 or higher (p = 0.0001). Our subgroup analyses showed a very low rate and no significant difference in terms of IBTR, using both WBI and APBI. A significant impact on patients compliance in terms of acute and early late toxicity was shown, which could translate in a consistent improvement of overall quality of life.

Keywords

Elderly IMRT Partial breast irradiation Endocrine therapy Breast cancer Phase 3 trial 

Notes

Acknowledgments

Partial data of present study have been presented during 3rd European Society for Radiotherapy and Oncology (ESTRO) Forum, 24–28 April 2015, Barcelona. We would like to thank Mrs. Chiara Rocha for English revision of this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Icro Meattini
    • 1
  • Calogero Saieva
    • 2
  • Livia Marrazzo
    • 3
  • Lucia Di Brina
    • 1
  • Stefania Pallotta
    • 3
  • Monica Mangoni
    • 1
  • Fiammetta Meacci
    • 1
  • Benedetta Bendinelli
    • 2
  • Giulio Francolini
    • 1
  • Isacco Desideri
    • 1
  • Carla De Luca Cardillo
    • 1
  • Vieri Scotti
    • 1
  • Ilaria Francesca Furfaro
    • 1
  • Francesca Rossi
    • 4
  • Daniela Greto
    • 1
  • Pierluigi Bonomo
    • 1
  • Donato Casella
    • 5
  • Marco Bernini
    • 5
  • Luis Sanchez
    • 5
  • Lorenzo Orzalesi
    • 5
  • Roberta Simoncini
    • 5
  • Jacopo Nori
    • 6
  • Simonetta Bianchi
    • 7
  • Lorenzo Livi
    • 1
  1. 1.Department of Radiation OncologyUniversity of Florence, Azienda Ospedaliero-Universitaria CareggiFlorenceItaly
  2. 2.Molecular and Nutritional Epidemiology UnitISPO (Cancer Research and Prevention Institute)FlorenceItaly
  3. 3.Medical Physics UnitUniversity of Florence, Azienda Ospedaliero-Universitaria CareggiFlorenceItaly
  4. 4.Radiotehrapy UnitAzienda Sanitaria 10FlorenceItaly
  5. 5.Department of SurgeryUniversity of FlorenceFlorenceItaly
  6. 6.Diagnostic Senology UnitAzienda Ospedaliero-Universitaria CareggiFlorenceItaly
  7. 7.Division of Pathological AnatomyUniversity of FlorenceFlorenceItaly

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