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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Monday, October 14, 2024
A study presented at the 2024 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 240) highlighted the use of adjuvant single-fraction, high-gradient partial-breast irradiation for early-stage, hormone-sensitive breast cancer. David Lakomy, MD, of Washington University in St. Louis, and colleagues assessed long-term cancer control, cosmesis, and toxicity with this strategy. They found that after treatment, ipsilateral breast recurrence-free survival rates at 2 and 5 years were 98% and 96%, and regional and distant metastasis recurrence-free survival rates were 100% and 98% at 2 and 5 years, respectively.
A total of 50 patients with stage 0 to 1, hormone-sensitive, node-negative breast cancer were included in this study. Patients were treated with adjuvant single-fraction, partial-breast irradiation (20 Gy to the surgical bed, decreasing with a sharp gradient to 5 Gy at 1 cm from the surgical bed). Patients were routinely followed for ipsilateral breast, regional, and distant recurrences.
In addition to the survival outcomes previously mentioned, radiation-associated acute toxicity was observed in 40% of patients and largely consisted of grade 1 skin erythema (26%) or other grade 1 soft-tissue changes (10%). Additionally, acute breast and/or chest wall pain was seen in 8% of patients, and radiation-associated late toxicity was seen in 68% of patients. Further, late toxicity was predominated by grade 1 or 2 fibrosis of the deep connective tissue (50%) and skin hyperpigmentation (36%). The median percent breast retraction assessment at baseline measured 6.8% and improved to 4.7% at 5-year follow-up. Finally, physician and patient cosmesis ratings were deemed good to excellent in more than 93% of patients across all timepoints.
Disclosure: Dr. Lakomy reported no conflicts of interest.
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