Three-Fraction Accelerated Partial Breast Irradiation (APBI) Delivered With Brachytherapy Applicators Is Feasible and Safe: First Results From the TRIUMPH-T Trial

Peter Y. Chen, Catheryn Yashar, Matthew M. Poppe, Linna Li, Zeinab Abou Yehia, Frank A. Vicini, Dirk Moore, Roger Dale, Doug Arthur, Chirag Shah, Bruce G. Haffty, Robert Kuske

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: Shorter courses of accelerated partial-breast irradiation delivered as single-fraction intraoperative therapy are now offered as an alternative to 4 to 6 weeks of whole-breast irradiation after lumpectomy. However, this approach has potential shortcomings in patient selection and target volume definition and in dosimetric, radiobiological, and logistical issues. We designed a prospective, phase 2, multi-institution clinical trial to study 2- or 3-day accelerated partial breast irradiation delivered with brachytherapy applicators. Methods and Materials: This trial treats select breast cancers after breast-conserving surgery with brachytherapy applicators that deliver 22.5 Gy in 3 fractions of 7.5 Gy. The planning treatment volume was 1 to 1.5 cm beyond the surgical cavity. Eligible women were aged ≥45 years with unicentric invasive or in situ tumors ≤3.0 cm with positive estrogen or progesterone receptors and no metastasis to axillary nodes that have been excised with negative margins. Strict dosimetric parameters were required to be met before acceptance into the trial. Results: A group of 200 patients was prospectively enrolled and followed for a minimum of 6 months. Two- or 3-day brachytherapy was associated with low acute or subacute toxicity, 97.25% excellent or good cosmetic outcomes, and excellent local control in select breast cancers. Conclusions: Ultrashort breast brachytherapy is dosimetrically feasible and can be delivered with excellent short-term tolerance and low toxicity.

Original languageEnglish (US)
Pages (from-to)67-74
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume104
Issue number1
DOIs
StatePublished - May 1 2019

Fingerprint

Brachytherapy
breast
Breast
irradiation
Segmental Mastectomy
Breast Neoplasms
toxicity
Progesterone Receptors
Cosmetics
Estrogen Receptors
Patient Selection
cancer
estrogens
Clinical Trials
Neoplasm Metastasis
metastasis
surgery
acceptability
Therapeutics
planning

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Chen, Peter Y. ; Yashar, Catheryn ; Poppe, Matthew M. ; Li, Linna ; Abou Yehia, Zeinab ; Vicini, Frank A. ; Moore, Dirk ; Dale, Roger ; Arthur, Doug ; Shah, Chirag ; Haffty, Bruce G. ; Kuske, Robert. / Three-Fraction Accelerated Partial Breast Irradiation (APBI) Delivered With Brachytherapy Applicators Is Feasible and Safe : First Results From the TRIUMPH-T Trial. In: International Journal of Radiation Oncology Biology Physics. 2019 ; Vol. 104, No. 1. pp. 67-74.
@article{65ec10c3ae55421188b8deb2b2a09903,
title = "Three-Fraction Accelerated Partial Breast Irradiation (APBI) Delivered With Brachytherapy Applicators Is Feasible and Safe: First Results From the TRIUMPH-T Trial",
abstract = "Purpose: Shorter courses of accelerated partial-breast irradiation delivered as single-fraction intraoperative therapy are now offered as an alternative to 4 to 6 weeks of whole-breast irradiation after lumpectomy. However, this approach has potential shortcomings in patient selection and target volume definition and in dosimetric, radiobiological, and logistical issues. We designed a prospective, phase 2, multi-institution clinical trial to study 2- or 3-day accelerated partial breast irradiation delivered with brachytherapy applicators. Methods and Materials: This trial treats select breast cancers after breast-conserving surgery with brachytherapy applicators that deliver 22.5 Gy in 3 fractions of 7.5 Gy. The planning treatment volume was 1 to 1.5 cm beyond the surgical cavity. Eligible women were aged ≥45 years with unicentric invasive or in situ tumors ≤3.0 cm with positive estrogen or progesterone receptors and no metastasis to axillary nodes that have been excised with negative margins. Strict dosimetric parameters were required to be met before acceptance into the trial. Results: A group of 200 patients was prospectively enrolled and followed for a minimum of 6 months. Two- or 3-day brachytherapy was associated with low acute or subacute toxicity, 97.25{\%} excellent or good cosmetic outcomes, and excellent local control in select breast cancers. Conclusions: Ultrashort breast brachytherapy is dosimetrically feasible and can be delivered with excellent short-term tolerance and low toxicity.",
author = "Chen, {Peter Y.} and Catheryn Yashar and Poppe, {Matthew M.} and Linna Li and {Abou Yehia}, Zeinab and Vicini, {Frank A.} and Dirk Moore and Roger Dale and Doug Arthur and Chirag Shah and Haffty, {Bruce G.} and Robert Kuske",
year = "2019",
month = "5",
day = "1",
doi = "https://doi.org/10.1016/j.ijrobp.2018.12.050",
language = "English (US)",
volume = "104",
pages = "67--74",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "1",

}

Three-Fraction Accelerated Partial Breast Irradiation (APBI) Delivered With Brachytherapy Applicators Is Feasible and Safe : First Results From the TRIUMPH-T Trial. / Chen, Peter Y.; Yashar, Catheryn; Poppe, Matthew M.; Li, Linna; Abou Yehia, Zeinab; Vicini, Frank A.; Moore, Dirk; Dale, Roger; Arthur, Doug; Shah, Chirag; Haffty, Bruce G.; Kuske, Robert.

In: International Journal of Radiation Oncology Biology Physics, Vol. 104, No. 1, 01.05.2019, p. 67-74.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Three-Fraction Accelerated Partial Breast Irradiation (APBI) Delivered With Brachytherapy Applicators Is Feasible and Safe

T2 - First Results From the TRIUMPH-T Trial

AU - Chen, Peter Y.

AU - Yashar, Catheryn

AU - Poppe, Matthew M.

AU - Li, Linna

AU - Abou Yehia, Zeinab

AU - Vicini, Frank A.

AU - Moore, Dirk

AU - Dale, Roger

AU - Arthur, Doug

AU - Shah, Chirag

AU - Haffty, Bruce G.

AU - Kuske, Robert

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Purpose: Shorter courses of accelerated partial-breast irradiation delivered as single-fraction intraoperative therapy are now offered as an alternative to 4 to 6 weeks of whole-breast irradiation after lumpectomy. However, this approach has potential shortcomings in patient selection and target volume definition and in dosimetric, radiobiological, and logistical issues. We designed a prospective, phase 2, multi-institution clinical trial to study 2- or 3-day accelerated partial breast irradiation delivered with brachytherapy applicators. Methods and Materials: This trial treats select breast cancers after breast-conserving surgery with brachytherapy applicators that deliver 22.5 Gy in 3 fractions of 7.5 Gy. The planning treatment volume was 1 to 1.5 cm beyond the surgical cavity. Eligible women were aged ≥45 years with unicentric invasive or in situ tumors ≤3.0 cm with positive estrogen or progesterone receptors and no metastasis to axillary nodes that have been excised with negative margins. Strict dosimetric parameters were required to be met before acceptance into the trial. Results: A group of 200 patients was prospectively enrolled and followed for a minimum of 6 months. Two- or 3-day brachytherapy was associated with low acute or subacute toxicity, 97.25% excellent or good cosmetic outcomes, and excellent local control in select breast cancers. Conclusions: Ultrashort breast brachytherapy is dosimetrically feasible and can be delivered with excellent short-term tolerance and low toxicity.

AB - Purpose: Shorter courses of accelerated partial-breast irradiation delivered as single-fraction intraoperative therapy are now offered as an alternative to 4 to 6 weeks of whole-breast irradiation after lumpectomy. However, this approach has potential shortcomings in patient selection and target volume definition and in dosimetric, radiobiological, and logistical issues. We designed a prospective, phase 2, multi-institution clinical trial to study 2- or 3-day accelerated partial breast irradiation delivered with brachytherapy applicators. Methods and Materials: This trial treats select breast cancers after breast-conserving surgery with brachytherapy applicators that deliver 22.5 Gy in 3 fractions of 7.5 Gy. The planning treatment volume was 1 to 1.5 cm beyond the surgical cavity. Eligible women were aged ≥45 years with unicentric invasive or in situ tumors ≤3.0 cm with positive estrogen or progesterone receptors and no metastasis to axillary nodes that have been excised with negative margins. Strict dosimetric parameters were required to be met before acceptance into the trial. Results: A group of 200 patients was prospectively enrolled and followed for a minimum of 6 months. Two- or 3-day brachytherapy was associated with low acute or subacute toxicity, 97.25% excellent or good cosmetic outcomes, and excellent local control in select breast cancers. Conclusions: Ultrashort breast brachytherapy is dosimetrically feasible and can be delivered with excellent short-term tolerance and low toxicity.

UR - http://www.scopus.com/inward/record.url?scp=85061692273&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061692273&partnerID=8YFLogxK

U2 - https://doi.org/10.1016/j.ijrobp.2018.12.050

DO - https://doi.org/10.1016/j.ijrobp.2018.12.050

M3 - Article

C2 - 30611839

VL - 104

SP - 67

EP - 74

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 1

ER -