Long-term outcomes of three distinct once-daily schedules for accelerated partial breast irradiation
Background and purpose: To date, accelerated partial breast irradiation (APBI) regimens are highly heterogeneous. Twice-daily schedules show comparable local control to whole-breast radiotherapy but with worse toxicity and cosmesis profiles. Conversely, once-daily regimens are better tolerated, thou...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
|
| Series: | Breast |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S096097762500476X |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849321526601449472 |
|---|---|
| author | Lorenzo Vinante Michele Avanzo Angela Caroli Carlo Furlan Andrea Sacilotto Lorena Baboci Tiziana Perin Martina Urbani Alessandro Favero Simon Spazzapan Fabio Puglisi Maurizio Mascarin Samuele Massarut Marco Trovò |
| author_facet | Lorenzo Vinante Michele Avanzo Angela Caroli Carlo Furlan Andrea Sacilotto Lorena Baboci Tiziana Perin Martina Urbani Alessandro Favero Simon Spazzapan Fabio Puglisi Maurizio Mascarin Samuele Massarut Marco Trovò |
| author_sort | Lorenzo Vinante |
| collection | DOAJ |
| description | Background and purpose: To date, accelerated partial breast irradiation (APBI) regimens are highly heterogeneous. Twice-daily schedules show comparable local control to whole-breast radiotherapy but with worse toxicity and cosmesis profiles. Conversely, once-daily regimens are better tolerated, though dose and number of fractions are yet not standardized. Therefore, the aim of this study was to evaluate the efficacy and tolerability of three different once-daily APBI schedules. Materials and methods: Three consecutive phase-2 trials were conducted at a single national cancer center to assess three once-daily APBI schedules (40Gy in 10 fractions, 35Gy in 7 fractions, and 28Gy in 4 fractions) delivered with 3D-conformal radiotherapy. All patients were at least 60 years old and had early-stage breast cancer (pT1-2,pN0-N1mic). Toxicity and cosmesis were evaluated by physicians using the CTCAE 4.0 scale and the Harvard score, respectively. Recurrence rates and survival outcomes at 5 and 10 years were estimated using the Kaplan-Meier method. Results: A total of 189 patients were enrolled, with a median follow-up of 10.2 years. Patients treated with 40Gy in 10 fractions, 35Gy in 7 fractions and 28Gy in 4 fractions were 80 (42%), 73 (39%), and 36 (19%), respectively. Acute toxicity was low and comparable across schedules, whereas grade≥2 late toxicity and poor cosmesis were significantly worse with the shorter schedule. The 10-year estimated in-breast tumour recurrence rate was 5.5%, comparable to the limited literature reporting long-term outcomes. Conclusions: Once-daily APBI delivered with 3D-conformal radiotherapy was effective; however, regimens with fewer than 5 fractions may be associated with increased toxicity and worse cosmesis. |
| format | Article |
| id | doaj-art-c5d600faf4864d648038e115a3ced2b6 |
| institution | Kabale University |
| issn | 1532-3080 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj-art-c5d600faf4864d648038e115a3ced2b62025-08-20T03:49:44ZengElsevierBreast1532-30802025-06-018110445910.1016/j.breast.2025.104459Long-term outcomes of three distinct once-daily schedules for accelerated partial breast irradiationLorenzo Vinante0Michele Avanzo1Angela Caroli2Carlo Furlan3Andrea Sacilotto4Lorena Baboci5Tiziana Perin6Martina Urbani7Alessandro Favero8Simon Spazzapan9Fabio Puglisi10Maurizio Mascarin11Samuele Massarut12Marco Trovò13Department of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; Corresponding author. Via Gallini 2, Aviano, 33081, PN, Italy.Department of Medical Physics, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, ItalyDepartment of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, ItalyDepartment of Radiation Oncology, Ospedale di Belluno, Belluno, ItalyDepartment of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, ItalyDepartment of Immunophatology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; Corresponding author. Via Gallini 2, Aviano, 33081, PN, Italy.Department of Pathology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, ItalyDepartment of Radiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, ItalyDepartment of Surgery, Azienda Sanitaria Friuli Occidentale, Pordenone, ItalyDepartment of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, ItalyDepartment of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; Department of Medicine, University of Udine, Udine, ItalyDepartment of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, ItalyDepartment of Breast Surgery, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, ItalyDepartment of Radiation Oncology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, ItalyBackground and purpose: To date, accelerated partial breast irradiation (APBI) regimens are highly heterogeneous. Twice-daily schedules show comparable local control to whole-breast radiotherapy but with worse toxicity and cosmesis profiles. Conversely, once-daily regimens are better tolerated, though dose and number of fractions are yet not standardized. Therefore, the aim of this study was to evaluate the efficacy and tolerability of three different once-daily APBI schedules. Materials and methods: Three consecutive phase-2 trials were conducted at a single national cancer center to assess three once-daily APBI schedules (40Gy in 10 fractions, 35Gy in 7 fractions, and 28Gy in 4 fractions) delivered with 3D-conformal radiotherapy. All patients were at least 60 years old and had early-stage breast cancer (pT1-2,pN0-N1mic). Toxicity and cosmesis were evaluated by physicians using the CTCAE 4.0 scale and the Harvard score, respectively. Recurrence rates and survival outcomes at 5 and 10 years were estimated using the Kaplan-Meier method. Results: A total of 189 patients were enrolled, with a median follow-up of 10.2 years. Patients treated with 40Gy in 10 fractions, 35Gy in 7 fractions and 28Gy in 4 fractions were 80 (42%), 73 (39%), and 36 (19%), respectively. Acute toxicity was low and comparable across schedules, whereas grade≥2 late toxicity and poor cosmesis were significantly worse with the shorter schedule. The 10-year estimated in-breast tumour recurrence rate was 5.5%, comparable to the limited literature reporting long-term outcomes. Conclusions: Once-daily APBI delivered with 3D-conformal radiotherapy was effective; however, regimens with fewer than 5 fractions may be associated with increased toxicity and worse cosmesis.http://www.sciencedirect.com/science/article/pii/S096097762500476X |
| spellingShingle | Lorenzo Vinante Michele Avanzo Angela Caroli Carlo Furlan Andrea Sacilotto Lorena Baboci Tiziana Perin Martina Urbani Alessandro Favero Simon Spazzapan Fabio Puglisi Maurizio Mascarin Samuele Massarut Marco Trovò Long-term outcomes of three distinct once-daily schedules for accelerated partial breast irradiation Breast |
| title | Long-term outcomes of three distinct once-daily schedules for accelerated partial breast irradiation |
| title_full | Long-term outcomes of three distinct once-daily schedules for accelerated partial breast irradiation |
| title_fullStr | Long-term outcomes of three distinct once-daily schedules for accelerated partial breast irradiation |
| title_full_unstemmed | Long-term outcomes of three distinct once-daily schedules for accelerated partial breast irradiation |
| title_short | Long-term outcomes of three distinct once-daily schedules for accelerated partial breast irradiation |
| title_sort | long term outcomes of three distinct once daily schedules for accelerated partial breast irradiation |
| url | http://www.sciencedirect.com/science/article/pii/S096097762500476X |
| work_keys_str_mv | AT lorenzovinante longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT micheleavanzo longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT angelacaroli longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT carlofurlan longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT andreasacilotto longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT lorenababoci longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT tizianaperin longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT martinaurbani longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT alessandrofavero longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT simonspazzapan longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT fabiopuglisi longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT mauriziomascarin longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT samuelemassarut longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation AT marcotrovo longtermoutcomesofthreedistinctoncedailyschedulesforacceleratedpartialbreastirradiation |