AI Article Synopsis
- IMPORT LOW study shows that partial-breast and reduced-dose radiotherapy are as effective as whole-breast radiotherapy in preventing local relapse for low-risk breast cancer patients, with similar or lower toxicity after 5 years.
- The study involved 1,333 consenting participants and assessed various patient-reported outcomes using quality of life questionnaires at multiple intervals, focusing on adverse effects related to treatments.
- Results indicated that while issues like breast appearance changes persisted, other adverse effects like pain and edema decreased over time; partial-breast and reduced-dose treatments had significantly lower average adverse effects compared to whole-breast radiotherapy.
Article Abstract
Purpose: IMPORT LOW demonstrated noninferiority of partial-breast and reduced-dose radiotherapy versus whole-breast radiotherapy for local relapse and similar or reduced toxicity at 5 years. Comprehensive patient-reported outcome measures collected at serial time points are now reported.
Patients And Methods: IMPORT LOW recruited women with low-risk breast cancer after breast-conserving surgery. Patients were randomly assigned to 40 Gy whole-breast radiotherapy (control), 36 Gy whole-breast and 40 Gy partial-breast radiotherapy (reduced-dose), or 40 Gy partial-breast radiotherapy only (partial-breast) in 15 fractions. European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires Core 30 and Breast Cancer-Specific Module, Body Image Scale, protocol-specific items, and the Hospital Anxiety and Depression Scale were administered at baseline, 6 months, and 1, 2, and 5 years. Patterns of moderate/marked adverse effects (AEs) were assessed using longitudinal regression models, and baseline predictors were investigated.
Results: A total of 41 of 71 centers participated in the patient-reported outcome measures substudy; 1,265 (95%) of 1,333 patients consented, and 557 (58%) of 962 reported no moderate/marked AEs at 5 years. Breast appearance change was most prevalent and persisted over time (approximately 20% at each time point). Prevalence of breast hardness, pain, oversensitivity, edema, and skin changes reduced over time ( P < .001 for each), whereas breast shrinkage increased ( P < .001). Analysis by treatment group showed average number of AEs per person was lower in partial-breast (incidence rate ratio, 0.77; 95% CI, 0.71 to 0.84; P < .001) and reduced-dose (incidence rate ratio, 0.83; 95% CI, 0.76 to 0.90; P < .001) versus whole-breast group and decreased over time in all groups. Younger age, larger breast size/surgical deficit, lymph node positivity, and higher levels of anxiety/depression were baseline predictors of subsequent AE reporting.
Conclusion: Most AEs reduced over time, with fewer AEs in the partial-breast and reduced-dose groups. Baseline predictors for AE reporting were identified. These findings will facilitate informed discussion and shared decision making for future patients receiving moderately hypofractionated breast radiotherapy.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357225 | PMC |
| http://dx.doi.org/10.1200/JCO.18.00982 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intraoperative radiotherapy versus whole breast radiotherapy in early-stage breast cancer: a retrospective outcome analysis based on ASTRO guidelines on PBI.
Breast Cancer Res
December 2024
Department of Radiation Oncology, China Medial University Hospital, No. 2, Yude Rd., North Dist., Taichung City, 404327, Taiwan.
Background: Intraoperative radiotherapy (IORT) is a convenient treatment techniques for patients with early-stage breast cancer. We aimed to compare the outcome of IORT to that of whole-breast external beam radiotherapy (EBRT) in highly selected breast cancer patients based on the 2023 American Society for Radiation Oncology (ASTRO) Clinical Practice Guideline for Partial Breast Irradiation (PBI).
Patients And Methods: We reviewed patients who underwent breast-conserving surgery (BCS) and received either IORT or EBRT for early-stage breast cancer between 2014 and 2019.
Single-modality endocrine therapy versus radiotherapy after breast-conserving surgery in women aged 70 years and older with luminal A-like early breast cancer (EUROPA): a preplanned interim analysis of a phase 3, non-inferiority, randomised trial.
Lancet Oncol
December 2024
Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
Background: Optimal therapy following breast-conserving surgery in older adults with low-risk, early-stage breast cancer remains uncertain. The EUROPA trial aims to compare the effects of radiotherapy and endocrine therapy as single-modality treatments on health-related quality of life (HRQOL) and ipsilateral breast tumour recurrence (IBTR) outcomes in this population.
Methods: This non-inferiority, phase 3, randomised study was conducted at 18 academic hospitals across Italy (17 centres) and Slovenia (one centre).
Prospective study of once-daily accelerated partial breast irradiation using 3-dimensional conformal external beam radiotherapy for Japanese women: 12-year outcomes, toxicity, and cosmesis.
Breast Cancer
December 2024
Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Background: To analyze in a prospective study the long-term safety and efficacy of 3-dimensional conformal radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI) for Japanese women with early breast cancer.
Methods: Breast cancer patients with pathological tumor size ≤ 3 cm, age ≥ 20 years, lumpectomy with at least a 5 mm margin, and ≤ 3 positive axillary nodes were eligible. APBI was delivered by 3D-CRT at a dose of 38.
"When Less is More": Paradigm Shifts in Radiation Treatment for Early-Stage Breast Cancer.
Curr Treat Options Oncol
December 2024
Department of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Recent advancements in the treatment of early-stage breast cancer have significantly shifted the radiotherapy landscape. Traditionally, the standard of care included lumpectomy followed by endocrine therapy and 3-5 weeks of adjuvant radiation targeting the entire unilateral breast. This review summaries modern trials, emphasizing data reported since 2019 that have changed radiation treatment paradigms.
View Article and Find Full Text PDFBilobed lateral artery perforator-based flap for partial breast reconstruction - Technique description and results from a ten-year cohort.
Surg Oncol
December 2024
Gynecology and Breast Unit, Araújo Jorge Cancer Hospital, Brazil; Mastology Program, Federal University of Goias, Brazil.
Introduction: We present a new technique, the bilobed lateral artery perforator-based flap, for breast-conserving surgery of large central tumors or nearby, combining Zymany's bilobed flap and a Lateral Intercostal Perforator (LICAP) flap, and its 10-year outcomes.
Materials And Methods: We studied 37 patients with malignant breast tumors near or involving the central skin, without ptosis or desire to correct it, who avoided mastectomy with this modified bilobed flap from 2013 to 2022. The same surgeon operated on them in different institutions.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!