Fat necrosis after partial-breast irradiation with brachytherapy or electron irradiation versus standard whole-breast radiotherapy--4-year results of a randomized trial.

Lovey, K; Fodor, J [Fodor, János (Orvosi tudomány), szerző] Országos Onkológiai Intézet; Major, T [Major, Tibor (klinikai sugárfizika), szerző] Országos Onkológiai Intézet; Szabo, E; Orosz, Z [Orosz, Zsolt (Pathológia), szerző] Országos Onkológiai Intézet; Sulyok, Z; Janvary, L [Jánváry, Zsolt Levente (Sugárterápiás onk...), szerző]; Frohlich, G [Fröhlich, Georgina (Sugárfizika), szerző] Országos Onkológiai Intézet; Kasler, M [Kásler, Miklós (Klinikai onkológia), szerző] Országos Onkológiai Intézet; Polgar, C [Polgár, Csaba (Sugárterápia, kli...), szerző] Országos Onkológiai Intézet

Angol nyelvű Szakcikk (Folyóiratcikk) Tudományos
  • SJR Scopus - Oncology: D1
  • Fizika
PURPOSE: To examine the incidence and clinical relevance of fat necrosis after accelerated partial-breast irradiation (PBI) using interstitial high-dose-rate brachytherapy (HDR-BT) in comparison with partial-breast electron irradiation (ELE) and whole-breast irradiation (WBI). METHODS AND MATERIALS: Between 1998 and 2004, 258 early-stage breast cancer patients were randomized to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 x 5.2 Gy HDR-BT (n = 88) or 50 Gy ELE (n = 40). The incidence of fat necrosis, its impact on cosmetic outcome, accompanying radiologic features, and clinical symptoms were evaluated. RESULTS: The 4-year actuarial rate of fat necrosis was 31.1% for all patients, and 31.9%, 36.5%, and 17.7% after WBI, HDR-BT and ELE, respectively (p(WBI/HDR-BT) = 0.26; p(WBI/ELE) = 0.11; p(ELE/HDR-BT) = 0.025). The respective rate of asymptomatic fat necrosis was 20.2%, 25.3%, and 10% of patients. The incidence of symptomatic fat necrosis was not significantly different after WBI (8.5%), HDR-BT (11.4%), and ELE (7.5%). Symptomatic fat necrosis was significantly associated with a worse cosmetic outcome, whereas asymptomatic fat necrosis was not. Fat necrosis was detectable with mammography and/or ultrasound in each case. Additional imaging examinations were required in 21% of cases and aspiration cytology in 42%. CONCLUSIONS: Asymptomatic fat necrosis is a common adverse event of breast-conserving therapy, having no significant clinical relevance in the majority of the cases. The incidence of both symptomatic and asymptomatic fat necrosis is similar after conventional WBI and accelerated partial-breast HDR-BT.
Hivatkozás stílusok: IEEEACMAPAChicagoHarvardCSLMásolásNyomtatás
2022-12-08 08:02