Once Daily Versus Twice Daily External Beam Accelerated Partial Breast Irradiation: A Randomized Prospective Study

Boutrus, Rimoun; Sherif, Sara El; Abdelazim, Yasser; Bayomy, Mohammed; Gaber, Ayman S.; Farahat, Ahmed; Hashem, Tarek; Sebaie, Medhat El

doi:10.1016/j.ijrobp.2020.11.044

Cited by 12 publications

(6 citation statements)

References 19 publications

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“…The present study had very low late toxicity and 91% of the patients had excellent to good cosmesis. This is probably due to once-daily fractionation as seen in other once-daily fractionation schedules as in IMPORT LOW, FLORENCE, and Boutrus et al 16 , 17 , 18 Fifteen patients (44%) fell into the cautionary category as per the updated ASTRO guidelines; however, the long-term clinical outcomes were acceptable overall.…”

Section: Discussionmentioning

confidence: 99%

“…Hoopes et al 15 showed that 70% of women preferred once-daily radiation over 10 days to the breast compared with twice-daily radiation over 5 days. Once-daily verses twice-daily fractionation with EBRT APBI (38.5 Gy in 10 fractions) was explored in a randomized trial of 113 patients by Boutrus et al 16 Once-daily fractionation had similar local control and acute toxicities with statistically significant reduction in late skin toxicity (3.8% vs 11.7%; P = .001). The 2-year fair/poor cosmesis was lower with once-daily fractionation (7.5% vs 26.7%) compared with twice-daily fractionation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Clinical and Cosmetic Outcomes of Once-Daily Accelerated Partial Breast Irradiation in Early Breast Cancer

Kumar

Krupa

Yehia

et al. 2024

Advances in Radiation Oncology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-Term Clinical and Cosmetic Outcomes of Once-Daily Accelerated Partial Breast Irradiation in Early Breast Cancer

Kumar

Krupa

Yehia

et al. 2024

Advances in Radiation Oncology

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“…Similar results were observed for cosmetic outcomes. Recently, Boutrus et al, 22 in a prospective randomized single institutional trial, compared patients treated with a once-daily versus a twice-daily APBI schedule. All patients received 38.5 Gy in 10 Fr.…”

Section: Discussionmentioning

confidence: 99%

Cosmetic Results and Side Effects of Accelerated Partial-Breast Irradiation Versus Whole-Breast Irradiation for Low-Risk Invasive Carcinoma of the Breast: The Randomized Phase III IRMA Trial

Meduri

Baldissera

Iotti

et al. 2023

JCO

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PURPOSE The results in terms of side effects vary among the published accelerated partial-breast irradiation (APBI) studies. Here, we report the 5-year results for cosmetic outcomes and toxicity of the IRMA trial. METHODS We ran this randomized phase III trial in 35 centers. Women with stage I-IIA breast cancer treated with breast-conserving surgery, age ≥ 49 years, were randomly assigned 1:1 to receive either whole-breast irradiation (WBI) or external beam radiation therapy APBI (38.5 Gy/10 fraction twice daily). Patients and investigators were not masked to treatment allocation. The primary end point was ipsilateral breast tumor recurrence. We hereby present the analysis of the secondary outcomes, cosmesis, and normal tissue toxicity. All side effects were graded with the Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer Radiation Morbidity Scoring Schema. Analysis was performed with both intention-to-treat and as-treated approaches. RESULTS Between March 2007 and March 2019, 3,309 patients were randomly assigned to 1,657 WBI and 1,652 APBI; 3,225 patients comprised the intention-to-treat population (1,623 WBI and 1,602 APBI). At a median follow-up of 5.6 (interquartile range, 4.0-8.4) years, adverse cosmesis in the APBI patients was higher than that in the WBI patients at 3 years (12.7% v 9.2%; P = .009) and at 5 years (14% v 9.8%; P = .012). Late soft tissue toxicity (grade ≥ 3: 2.8% APBI v 1% WBI, P < .0001) and late bone toxicity (grade ≥ 3: 1.1% APBI v 0% WBI, P < .0001) were significantly higher in the APBI arm. There were no significant differences in late skin and lung toxicities. CONCLUSION External beam radiation therapy-APBI with a twice-daily IRMA schedule was associated with increased rates of late moderate soft tissue and bone toxicities, with a slight decrease in patient-reported cosmetic outcomes at 5 years when compared with WBI, although overall toxicity was in an acceptable range.

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“…A small RCT evaluated once versus twice daily APBI regimens (38.5 Gy/10 fractions) and found improved outcomes with once daily with respect to late skin toxicity, subcutaneous fibrosis, and adverse cosmesis when using 3D-CRT. 37 An alternative to 3D-CRT is IMRT, which allows for increased conformality. The University of Florence trial evaluated a regimen of 30 Gy in 5 fractions delivered every other day with IMRT compared with standard WBI in a randomized trial of 520 patients.…”

Section: Ultrashort Partial Breast Irradiationmentioning

confidence: 99%

Delivery of Adjuvant Radiation in 5 Days or Less After Lumpectomy for Breast Cancer: A Systematic Review

Vicini

Broughman

Halima

et al. 2022

International Journal of Radiation Oncology*Biology*Physics

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Once Daily Versus Twice Daily External Beam Accelerated Partial Breast Irradiation: A Randomized Prospective Study

Cited by 12 publications

References 19 publications

Long-Term Clinical and Cosmetic Outcomes of Once-Daily Accelerated Partial Breast Irradiation in Early Breast Cancer

Long-Term Clinical and Cosmetic Outcomes of Once-Daily Accelerated Partial Breast Irradiation in Early Breast Cancer

Cosmetic Results and Side Effects of Accelerated Partial-Breast Irradiation Versus Whole-Breast Irradiation for Low-Risk Invasive Carcinoma of the Breast: The Randomized Phase III IRMA Trial

Delivery of Adjuvant Radiation in 5 Days or Less After Lumpectomy for Breast Cancer: A Systematic Review

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