Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2016 Aug 1;95(5):1460-1465.
doi: 10.1016/j.ijrobp.2016.03.037. Epub 2016 Apr 2.

Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer

Julia White  1 , Kathryn Winter  2 , Robert R Kuske  3 , John S Bolton  4 , Douglas W Arthur  5 , Troy Scroggins  4 , Rachel A Rabinovitch  6 , Tracy Kelly  7 , Leonard M Toonkel  8 , Frank A Vicini  9 , Beryl McCormick  10
Affiliations
Clinical Trial

Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer

Julia White et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: To examine 10-year rates of local, regional, and distant recurrences, patterns of recurrence, and survival rates for breast cancer patients enrolled on Study NRG Oncology/Radiation Therapy Oncology Group 9517, a multi-institutional prospective trial that studied one of the earliest methods of accelerated partial breast irradiation (APBI), multicatheter brachytherapy (MCT).

Methods and materials: Eligibility included stage I/II unifocal breast cancer <3 cm in size after lumpectomy with negative surgical margins and 0 to 3 positive axillary nodes without extracapsular extension. The APBI dose delivered was 34 Gy in 10 twice-daily fractions over 5 days for high-dose-rate (HDR); and 45 Gy in 3.5 to 5 days for low-dose-rate (LDR) brachytherapy. The primary endpoint was HDR and LDR MCT reproducibility. This analysis focuses on long-term ipsilateral breast recurrence (IBR), contralateral breast cancer events (CBE), regional recurrence (RR), and distant metastases (DM), disease-free, and overall survival.

Results: The median follow-up was 12.1 years. One hundred patients were accrued from 1997 to 2000; 98 were evaluable; 65 underwent HDR and 33 LDR MCT. Median age was 62 years; 88% had T1 tumors; 81% were pN0. Seventy-seven percent were estrogen receptor and/or progesterone receptor positive; 33% received adjuvant chemotherapy and 64% antiendocrine therapy. There have been 4 isolated IBRs and 1 IBR with RR, for 5.2% 10-year IBR without DM. There was 1 isolated RR, 1 with IBR, and 1 with a CBE, for 3.1% 10-year RR without DM. The 10-year CBE rate was 4.2%, with 5 total events. Eleven patients have developed DM, 8 have died of breast cancer, and 22 have died from other causes. The 10-year DFS and OS rates are 69.8% and 78.0%, respectively.

Conclusion: This multi-institutional, phase 2 trial studying MCT-APBI continues to report durable in-breast cancer control rates with long-term follow-up.

PubMed Disclaimer

Conflict of interest statement

R.R.K. reports other support from Cianna Medical, grants from Elekta, outside the submitted work.

Figures

Fig. 1
Fig. 1
NRG Oncology/RTOG 9517 study design. Abbreviations: HDR = high dose rate; LDR = low dose rate.
Fig. 2
Fig. 2
Patterns of failure in 13 women that experienced loco-regional events after treatment with multicatheter brachytherapy accelerated partial breast irradiation (APBI) after lumpectomy on Study NRG Oncology/RTOG 9517, with a median follow-up of 12.1 years. Patients can experience more than one site of failure.
See this image and copyright information in PMC

References

    1. Livi L, Meattini I, Marrazzo L, et al. Accelerated partial breast irradiation using intensity modulated radiotherapy versus whole breast irradiation: 5-year survival analysis of a phase 3 randomised controlled trial. Eur J Cancer. 2015;51:451–463. - PubMed
    1. Strnad V, Ott O, Hildebrandt G, et al. 5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: A randomised, phase 3, non-inferiority trial. Lancet. 2016;387:229–238. - PubMed
    1. Abbott AM, Habermann EB, Tuttle TM. Trends in the use of implantable accelerated partial breast irradiation therapy in early stage breast cancer in the United States. Cancer. 2011;117:3305–3310. - PubMed
    1. Smith B, Arthur D, Buchholz T, et al. Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO) Int J Radiat Oncol Biol Phys. 2009;74:987–1001. - PubMed
    1. Sauer R, Sautter-Bihl M, Budach W, et al. Accelerated partial breast irradiation. Consensus statement of 3 German oncology societies. Cancer. 2007;110:1187–1194. - PubMed

Publication types

MeSH terms