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Clinical Trial
. 2008 Oct 1;72(2):467-73.
doi: 10.1016/j.ijrobp.2007.12.056. Epub 2008 Mar 4.

A Phase II trial of brachytherapy alone after lumpectomy for select breast cancer: tumor control and survival outcomes of RTOG 95-17

Douglas W Arthur  1 , Kathryn Winter, Robert R Kuske, John Bolton, Rachel Rabinovitch, Julia White, William F Hanson, Raymond M Wilenzick, Beryl McCormick
Affiliations
Clinical Trial

A Phase II trial of brachytherapy alone after lumpectomy for select breast cancer: tumor control and survival outcomes of RTOG 95-17

Douglas W Arthur et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: Radiation Therapy Oncology Group 95-17 is a prospective Phase II cooperative group trial of accelerated partial breast irradiation (APBI) alone using multicatheter brachytherapy after lumpectomy in select early-stage breast cancers. Tumor control and survival outcomes are reported.

Methods and materials: Eligibility criteria included Stage I/II breast carcinoma confirmed to be <3 cm, unifocal, invasive nonlobular histology with zero to three positive axillary nodes without extracapsular extension. APBI treatment was delivered with either low-dose-rate (LDR) (45 Gy in 3.5-5 days) or high-dose-rate (HDR) brachytherapy (34 Gy in 10 twice-daily fractions over 5 days). End points evaluated included in-breast control, regional control, mastectomy-free rate, mastectomy-free survival, disease-free survival, and overall survival. The study was designed to analyze the HDR and LDR groups separately and without comparison.

Results: Between 1997 and 2000, 100 patients were accrued and 99 were eligible; 66 treated with HDR brachytherapy and 33 treated with LDR brachytherapy. Eighty-seven patients had T1 lesions and 12 had T2 lesions. Seventy-nine were pathologically N0 and 20 were N1. Median follow-up in the HDR group is 6.14 years with the 5-year estimates of in-breast, regional, and contralateral failure rates of 3%, 5%, and 2%, respectively. The LDR group experienced similar results with a median follow-up of 6.22 years. The 5-year estimates of in-breast, regional, and contralateral failure rates of 6%, 0%, and 6%, respectively.

Conclusion: Patients treated with multicatheter partial breast brachytherapy in this trial experienced excellent in-breast control rates and overall outcome that compare with reports from APBI studies with similar extended follow-up.

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Figures

Figure 1
Figure 1
Orthogonal film based implant evaluation. Surgical clips identified for cavity delineation and dummy sources were placed in catheters for subsequent position digitization.
Figure 2
Figure 2
Central plane view of 2-dimensional brachytherapy implant dosimetric plan
See this image and copyright information in PMC

References

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