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Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2016 08 01;95(5):1460-1465

Date

08/02/2016

Pubmed ID

27479725

Pubmed Central ID

PMC5088493

DOI

10.1016/j.ijrobp.2016.03.037

Scopus ID

2-s2.0-84990841036   33 Citations

Abstract

PURPOSE: To examine 10-year rates of local, regional, and distant recurrences, patterns of recurrence, and survival rates for breast cancer patients enrolled on Study NRG Oncology/Radiation Therapy Oncology Group 9517, a multi-institutional prospective trial that studied one of the earliest methods of accelerated partial breast irradiation (APBI), multicatheter brachytherapy (MCT).

METHODS AND MATERIALS: Eligibility included stage I/II unifocal breast cancer <3 cm in size after lumpectomy with negative surgical margins and 0 to 3 positive axillary nodes without extracapsular extension. The APBI dose delivered was 34 Gy in 10 twice-daily fractions over 5 days for high-dose-rate (HDR); and 45 Gy in 3.5 to 5 days for low-dose-rate (LDR) brachytherapy. The primary endpoint was HDR and LDR MCT reproducibility. This analysis focuses on long-term ipsilateral breast recurrence (IBR), contralateral breast cancer events (CBE), regional recurrence (RR), and distant metastases (DM), disease-free, and overall survival.

RESULTS: The median follow-up was 12.1 years. One hundred patients were accrued from 1997 to 2000; 98 were evaluable; 65 underwent HDR and 33 LDR MCT. Median age was 62 years; 88% had T1 tumors; 81% were pN0. Seventy-seven percent were estrogen receptor and/or progesterone receptor positive; 33% received adjuvant chemotherapy and 64% antiendocrine therapy. There have been 4 isolated IBRs and 1 IBR with RR, for 5.2% 10-year IBR without DM. There was 1 isolated RR, 1 with IBR, and 1 with a CBE, for 3.1% 10-year RR without DM. The 10-year CBE rate was 4.2%, with 5 total events. Eleven patients have developed DM, 8 have died of breast cancer, and 22 have died from other causes. The 10-year DFS and OS rates are 69.8% and 78.0%, respectively.

CONCLUSION: This multi-institutional, phase 2 trial studying MCT-APBI continues to report durable in-breast cancer control rates with long-term follow-up.

Author List

White J, Winter K, Kuske RR, Bolton JS, Arthur DW, Scroggins T, Rabinovitch RA, Kelly T, Toonkel LM, Vicini FA, McCormick B

Author

Tracy R. Kelly MD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Brachytherapy
Breast Neoplasms
Catheterization, Peripheral
Combined Modality Therapy
Female
Humans
Longitudinal Studies
Mastectomy, Segmental
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Prevalence
Risk Factors
Survival Rate
Treatment Outcome
United States
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0