WBRT Vs. APBI: an Interim Report of Patient Satisfaction and Outcomes

Overview

Journal J Contemp Brachytherapy

Date 2016 Mar 18

PMID 26985193

Citations 11

Authors

Samantha M Bitter

Patricia Heffron-Cartwright

Christopher Wennerstrom

Jared Weatherford

Douglas Einstein

Louis C Keiler

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine differences in patient's reported quality of life and self-reported breast cosmesis between whole breast radiation therapy (WBRT) and accelerated partial breast irradiation (APBI) via single and multi-lumen high-dose-rate (HDR) brachytherapy for women with early stage breast cancer.

Material And Methods: Patient information was retrospectively reviewed and survey data were prospectively collected for women treated between 2004 to 2014 (APBI) and 2012 to 2014 (WBRT). Criteria for APBI treatments were ER+ (after 2010), N0 (after 2010), T < 3 cm, and post-menopausal. All patients were given a survey with modified FACIT (Functional Assessment of Chronic Illness Therapy) breast quality of life questions to rate their amount of pain, self-consciousness, low energy, presence of lymphedema, and breast cosmesis.

Results: 242 APBI patients and 59 WBRT patients were identified. In the WBRT cohort, 34 women met departmental criteria for APBI treatment (WBRT who were APBI eligible). The FACIT survey was completed by 80 women treated with APBI (33%; mean follow-up time of 14 months), and 26 women treated with WBRT who were APBI eligible (76%; mean follow-up time of 26 months). During the first year post-treatment, low energy (p = 0.009), self-consciousness (p = 0.0004), and lymphedema (p = 0.0002) scores were significantly lower in the APBI cohort when compared to women treated with WBRT who were APBI eligible. During the second year post-treatment, women treated with APBI reported significantly better breast cosmesis (p = 0.04). The single-lumen balloon (score = 6.3/10) was found to be associated with worse cosmesis compared to the multi-lumen balloons (Mammosite ML and Contura; score = 8.2/10; p = 0.002). There were no significant differences in rates of recurrence between balloons or treatments (p > 0.05).

Conclusions: APBI treated patients reported higher cosmetic satisfaction than patients in the matched WBRT cohort. Quality of life scores tended to improve over time. Multi-lumen catheters provided superior cosmetic results compared to single-lumen catheters.

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References

Wadasadawala T, Budrukkar A, Chopra S, Badwe R, Hawaldar R, Parmar V . Quality of life after accelerated partial breast irradiation in early breast cancer: matched pair analysis with protracted whole breast radiotherapy. Clin Oncol (R Coll Radiol). 2009; 21(9):668-75. DOI: 10.1016/j.clon.2009.07.014. View

Antonucci J, Wallace M, Goldstein N, Kestin L, Chen P, Benitez P . Differences in patterns of failure in patients treated with accelerated partial breast irradiation versus whole-breast irradiation: a matched-pair analysis with 10-year follow-up. Int J Radiat Oncol Biol Phys. 2008; 74(2):447-52. DOI: 10.1016/j.ijrobp.2008.08.025. View

Dickler A, Kirk M, Chu J, Nguyen C . The MammoSite breast brachytherapy applicator: a review of technique and outcomes. Brachytherapy. 2005; 4(2):130-6. DOI: 10.1016/j.brachy.2004.12.003. View

Kini V . Balloon breast brachytherapy - review of current data. Brachytherapy. 2005; 4(3):181-2. DOI: 10.1016/j.brachy.2005.07.003. View

Tanaka E, Yamazaki H, Yoshida K, Takenaka T, Masuda N, Kotsuma T . Objective and longitudinal assessment of dermatitis after postoperative accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy in patients with breast cancer treated with breast conserving therapy: reduction of.... Int J Radiat Oncol Biol Phys. 2010; 81(4):1098-104. DOI: 10.1016/j.ijrobp.2010.07.035. View

White J . MammoSite and accelerated partial breast irradiation: Rethinking one-size-fits-all breast irradiation after lumpectomy. Brachytherapy. 2005; 4(3):183-5. DOI: 10.1016/j.brachy.2005.07.001. View

De La Rochefordiere A, Abner A, Silver B, Vicini F, Recht A, Harris J . Are cosmetic results following conservative surgery and radiation therapy for early breast cancer dependent on technique?. Int J Radiat Oncol Biol Phys. 1992; 23(5):925-31. DOI: 10.1016/0360-3016(92)90896-p. View

Kirk M, Hsi W, Dickler A, Chu J, Dowlatshahi K, Francescatti D . Surface optimization technique for MammoSite breast brachytherapy applicator. Int J Radiat Oncol Biol Phys. 2005; 62(2):366-72. DOI: 10.1016/j.ijrobp.2004.10.038. View

Ott O, Schulz-Wendtland R, Uter W, Pfahlberg A, Beckmann M, Sauer R . Fat necrosis after conserving surgery and interstitial brachytherapy and/or external-beam irradiation in women with breast cancer. Strahlenther Onkol. 2005; 181(10):638-44. DOI: 10.1007/s00066-005-1439-y. View

10.

Keisch M, Arthur D . Current perspective on the MammoSite Radiation Therapy System - a balloon breast brachytherapy applicator. Brachytherapy. 2005; 4(3):177-80. DOI: 10.1016/j.brachy.2005.07.002. View

11.

Cella D, Tulsky D, Gray G, Sarafian B, Linn E, Bonomi A . The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol. 1993; 11(3):570-9. DOI: 10.1200/JCO.1993.11.3.570. View

12.

Wadasadawala T, Sarin R, Budrukkar A, Jalali R, Munshi A, Badwe R . Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: a case-control study of disease control, cosmesis, and complications. J Cancer Res Ther. 2009; 5(2):93-101. DOI: 10.4103/0973-1482.52794. View

13.

Lee K, Quillo A, Dillon D, Sowards K, Hatmaker A, Dragun A . Acute toxicity and early cosmetic outcome in patients treated with multilumen balloon brachytherapy with skin spacing ≤ 7.0 millimeters. J Contemp Brachytherapy. 2013; 4(1):8-13. PMC: 3551367. DOI: 10.5114/jcb.2012.27946. View

14.

Wazer D, Kaufman S, Cuttino L, DiPetrillo T, Arthur D . Accelerated partial breast irradiation: an analysis of variables associated with late toxicity and long-term cosmetic outcome after high-dose-rate interstitial brachytherapy. Int J Radiat Oncol Biol Phys. 2005; 64(2):489-95. DOI: 10.1016/j.ijrobp.2005.06.028. View

15.

Perera F, Chisela F, Engel J, Venkatesan V . Method of localization and implantation of the lumpectomy site for high dose rate brachytherapy after conservative surgery for T1 and T2 breast cancer. Int J Radiat Oncol Biol Phys. 1995; 31(4):959-65. DOI: 10.1016/0360-3016(94)00576-1. View

16.

Livi L, Banci Buonamici F, Simontacchi G, Scotti V, Fambrini M, Compagnucci A . Accelerated partial breast irradiation with IMRT: new technical approach and interim analysis of acute toxicity in a phase III randomized clinical trial. Int J Radiat Oncol Biol Phys. 2009; 77(2):509-15. DOI: 10.1016/j.ijrobp.2009.04.070. View

17.

Vicini F, Chen P, Wallace M, Mitchell C, Hasan Y, Grills I . Interim cosmetic results and toxicity using 3D conformal external beam radiotherapy to deliver accelerated partial breast irradiation in patients with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys. 2007; 69(4):1124-30. DOI: 10.1016/j.ijrobp.2007.04.033. View

18.

Weed D, Edmundson G, Vicini F, Chen P, Martinez A . Accelerated partial breast irradiation: a dosimetric comparison of three different techniques. Brachytherapy. 2005; 4(2):121-9. DOI: 10.1016/j.brachy.2004.12.005. View

19.

Vicini F, Winter K, Wong J, Pass H, Rabinovitch R, Chafe S . Initial efficacy results of RTOG 0319: three-dimensional conformal radiation therapy (3D-CRT) confined to the region of the lumpectomy cavity for stage I/ II breast carcinoma. Int J Radiat Oncol Biol Phys. 2009; 77(4):1120-7. PMC: 3365530. DOI: 10.1016/j.ijrobp.2009.06.067. View

20.

Skowronek J, Wawrzyniak-Hojczyk M, Ambrochowicz K . Brachytherapy in accelerated partial breast irradiation (APBI) - review of treatment methods. J Contemp Brachytherapy. 2013; 4(3):152-64. PMC: 3551377. DOI: 10.5114/jcb.2012.30682. View