Brachytherapy | 2019
Accelerated partial breast irradiation in the elderly: 5-Year results of the single fraction elderly breast irradiation (SiFEBI) phase I/II trial.
Abstract
PURPOSE\nTo evaluate the clinical outcomes of a very-accelerated partial breast irradiation (vAPBI) in the elderly based on a single fraction of multicatheter interstitial high-dose rate brachytherapy (MIB). Mature results with a median follow-up of 5\xa0years.\n\n\nMETHODS AND MATERIALS\nFrom November 2012 to September 2014, 26 patients (pts) (≥70) with early breast cancer were enrolled in a prospective phase II trial (NCT01727011). After lumpectomy, intraoperative catheter implant was performed for postoperative APBI (single fraction 16\xa0Gy). Surveillance was performed twice a year after APBI. Oncologic outcome (local [LRFS], metastasis-free survival, cancer-specific survival, and overall survival [OS]) as well as late toxicity and cosmetic outcome were investigated.\n\n\nRESULTS\nMedian age was 77\xa0years [69-89]. After a median follow-up of 63\xa0months [60-68], 5-year LRFS, metastasis-free survival, cancer-specific survival, and overall survival rates were 100%, 95.5%, 100%, and 88.5%, respectively. Late toxicity was observed in 5\xa0pts (19.2%) with a total of five events: 3\xa0pts G1 (60%); and 2\xa0pts G2 (40%). The observed late side effects were breast pain in 1\xa0pt (G2 cytosteatonecrosis with occasional acetaminophen consumption), hypopigmentation (puncture site) in 2\xa0pts (G1) and breast fibrosis in 2\xa0pts (G1: 1\xa0pt; G2: 1\xa0pt). Cosmetic evaluation was excellent for 21\xa0pts (81%) and good for 2\xa0pts (19%).\n\n\nCONCLUSION\nFor elderly with early breast cancer, a vAPBI using a single fraction of postoperative MIB (16\xa0Gy) provides excellent oncologic results, mainly in terms of local control and cancer death. Late toxicity and cosmetic profile are acceptable.