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Cosmetic Outcome and Toxicity After Stereotactic Accelerated Partial Breast Irradiation in Early Breast Cancer: A Prospective Observational Cohort Study

Authors
 Hwa Kyung Byun  ;  Jee Suk Chang  ;  Hojin Kim  ;  Jihun Kim  ;  Min Cheol Han  ;  Se Young Kim  ;  Ryeong Hwang Park  ;  Claire Jieun Kim  ;  Yong Bae Kim 
Citation
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.117(3) : 690-700, 2023-11 
Journal Title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
ISSN
 0360-3016 
Issue Date
2023-11
MeSH
Breast / radiation effects ; Breast Neoplasms* / pathology ; Breast Neoplasms* / radiotherapy ; Breast Neoplasms* / surgery ; Carcinoma in Situ* / surgery ; Female ; Fibrosis ; Humans ; Mastectomy, Segmental ; Prospective Studies ; Treatment Outcome
Abstract
Purpose: The aim of this work was to prospectively evaluate the toxicity and cosmetic outcomes of 5-fraction, stereotactic, accelerated partial breast irradiation (APBI).

Methods and materials: This prospective observational cohort study enrolled women who underwent APBI for invasive carcinoma or carcinoma in situ of the breast. APBI was delivered using a CyberKnife M6 robotic radiosurgery system at 30 Gy in 5 nonconsecutive, once-daily fractions. Women undergoing whole breast irradiation (WBI) were also enrolled for comparison. Patient-reported and physician-assessed adverse events were recorded. Breast fibrosis was measured using a tissue compliance meter, and breast cosmesis was assessed using BCCT.core (an automatic, computer-based software). Outcomes were collected until 24 months posttreatment according to the study protocol.

Results: In total, 204 patients (APBI, n = 103; WBI, n = 101) were enrolled. Regarding patient-reported outcomes, the APBI group reported significantly less skin dryness (6.9% vs 18.3%; P = .015), radiation skin reaction (9.9% vs 23.5%; P = .010), and breast hardness (8.0% vs 20.4%; P = .011) at 6 months than the WBI group. On physician assessment, the APBI group had significantly less dermatitis at 12 months (1.0% vs 7.2%; P = .027) than the WBI group. Any severe toxicities after APBI were rare in patient-reported outcomes (score ≥3, 3.0%) and physician assessments (grade ≥3, 2.0%). In the uninvolved quadrants, measured fibrosis in the APBI group was significantly lower than that in the WBI group at 6 (P = .001) and 12 (P = .029) months but not at 24 months. In the involved quadrant, measured fibrosis in the APBI group was not significantly different from that in the WBI group at any time. Cosmetic outcomes in the APBI group were mostly excellent or good (77.6%) at 24 months, and there was no significant cosmetic detriment from the baseline.

Conclusions: Stereotactic APBI was associated with less fibrosis in the uninvolved breast quadrants than WBI. Patients showed minimal toxicity and no detrimental effects on cosmesis after APBI.
Full Text
https://www.sciencedirect.com/science/article/pii/S0360301623004649
DOI
10.1016/j.ijrobp.2023.05.018
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Kim, Jihun(김지훈) ORCID logo https://orcid.org/0000-0003-4856-6305
Kim, Hojin(김호진) ORCID logo https://orcid.org/0000-0002-4652-8682
Byun, Hwa Kyung(변화경) ORCID logo https://orcid.org/0000-0002-8964-6275
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Han, Min Cheol(한민철)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/197402
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