Cosmetic Outcomes Found Worse after Accelerated Partial-Breast than Whole-Breast Irradiation; ASTRO Says Results Important, Will Be Considered in Possible Update of APBI GuidelineCosmetic outcomes were significantly worse and low-grade late toxicities were slightly more prevalent among women who underwent accelerated partial breast irradiation (APBI) than among those treated with more traditional whole-breast irradiation (WBI), according to interim findings from the first large randomized study comparing the two treatments.
Researchers with the Randomized Trial of Accelerated Partial Breast Irradiation (RAPID) trial compared the two techniques in 2,135 women over age 40 who first underwent breast-conserving surgery for invasive ductal carcinoma or ductal carcinoma in situ, of 3 cm or less, before being randomized to receive either three-dimensional conformal radiation therapy (3D-CRT) APBI or WBI.
The multi-institution study is evaluating cosmesis, late toxicity, and cancer recurrence in the patients over a 10-year period. The interim findings, available online ahead of print in the Journal of Clinical Oncology(doi: 10.1200/JCO.2013.50.5511), were based on a median follow-up of three years.
Women in the APBI group had more adverse cosmetic outcomes as assessed by separate panels of nurses and physicians, and by the patients themselves. Trained nurses found cosmesis problems in 29 percent of the APBI group compared with 17 percent in the WBI cohort at three months, and 32 percent versus 13 percent after five years.
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