Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer : Preliminary Results of a Prospective Phase II Trial
Mené sur 27 patientes atteintes d'un carcinome canalaire infiltrant du sein de stade précoce (durée médiane de suivi : 3,6 ans), cet essai de phase II évalue, du point de vue de l'échec local ou régional, de la réponse pathologique complète et des résultats esthétiques, la faisabilité d'une irradiation partielle accélérée du sein par radiothérapie conformationnelle 3D avant une lumpectomie
Introduction : Assess the feasibility of utilizing 3D conformal APBI in the pre-operative setting followed by standard breast conserving therapy. Methods and Materials : This is a prospective trial testing the feasibility of pre-operative APBI followed by lumpectomy for patients with early stage invasive ductal breast cancer. Eligible patients had T1-T2 (< 3 cm), N0 tumors Patients received 38.5 Gray (Gy) in 3.85 Gy fractions delivered twice daily. Surgery was performed > 21 days after radiotherapy. Adjuvant therapy was given as per standard of care. Results : Twenty-seven patients completed treatment. With a median follow up of 3.6 years (range: 0.5 - 5 years), there have been no local or regional failures. A complete pathologic response based on hematoxylin and eosin stains was seen in 4 patients (15%). There were four grade 3 seromas. Patient reported cosmetic outcome was rated as good to excellent in 79% of patients following treatment. Discussion : Pre-operative 3DCRT-APBI is feasible and well tolerated in select patients with early stage breast cancer with no reported local recurrences and good-excellent cosmetic results. Conclusion : The pathologic response rates associated with this non-ablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.