TY - JOUR AU - Polgár, Csaba AU - Fodor, János AU - Major, Tibor AU - Sulyok, Z AU - Kásler, Miklós TI - Breast-conserving therapy with partial or whole breast irradiation: ten-year results of the Budapest randomized trial. JF - RADIOTHERAPY AND ONCOLOGY J2 - RADIOTHER ONCOL VL - 108 PY - 2013 IS - 2 SP - 197 EP - 202 PG - 6 SN - 0167-8140 DO - 10.1016/j.radonc.2013.05.008 UR - https://m2.mtmt.hu/api/publication/2557678 ID - 2557678 N1 - Center of Radiotherapy, National Institute of Oncology, Ráth György u. 7-9, Budapest H-1122, Hungary Center of Surgery, National Institute of Oncology, Budapest, Hungary National Institute of Oncology, Budapest, Hungary Cited By :296 Export Date: 14 June 2023 CODEN: RAOND Correspondence Address: Polgár, C.; Center of Radiotherapy, Ráth György u. 7-9, Budapest H-1122, Hungary; email: polgar@oncol.hu Chemicals/CAS: goserelin, 65807-02-5; tamoxifen, 10540-29-1; trastuzumab, 180288-69-1 AB - BACKGROUND AND PURPOSE: To report the long-term results of a single-institution randomized study comparing the results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). PATIENTS AND METHODS: Between 1998 and 2004, 258 selected women with pT1 pN0-1mi M0, grade 1-2, non-lobular breast cancer without the presence of extensive intraductal component and resected with negative margins were randomized after BCS to receive 50 Gy WBI (n=130) or PBI (n=128). The latter consisted of either 7 x 5.2 Gy high-dose-rate (HDR) multi-catheter brachytherapy (BT; n=88) or 50 Gy electron beam (EB) irradiation (n=40). Primary endpoint was local recurrence (LR) as a first event. Secondary endpoints were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and cosmetic results. RESULTS: After a median follow up of 10.2 years, the ten-year actuarial rate of LR was 5.9% and 5.1% in PBI and WBI arms, respectively (p=0.77). There was no significant difference in the ten-year probability of OS (80% vs 82%), CSS (94% vs 92%), and DFS (85% vs 84%), either. The rate of excellent-good cosmetic result was 81% in the PBI, and 63% in the control group (p<0.01). CONCLUSIONS: Partial breast irradiation delivered by interstitial HDR BT or EB for a selected group of early-stage breast cancer patients produces similar ten-year results to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with HDR BT implants compared with the outcome after WBI. LA - English DB - MTMT ER - TY - JOUR AU - Polgár, Csaba AU - Van, Limbergen E AU - Potter, R AU - Kovacs, G AU - Polo, A AU - Lyczek, J AU - Hildebrandt, G AU - Niehoff, P AU - Guinot, JL AU - Guedea, F AU - Johansson, B AU - Ott, OJ AU - Major, Tibor AU - Strnad, V AU - the, GEC-ESTRO breast cancer working group TI - Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery. recommendations of the Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009) TS - recommendations of the Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009) JF - RADIOTHERAPY AND ONCOLOGY J2 - RADIOTHER ONCOL VL - 94 PY - 2010 IS - 3 SP - 264 EP - 273 PG - 10 SN - 0167-8140 DO - 10.1016/j.radonc.2010.01.014 UR - https://m2.mtmt.hu/api/publication/2571279 ID - 2571279 AB - PURPOSE: To give recommendations on patient selection criteria for the use of accelerated partial-breast irradiation (APBI) based on available clinical evidence complemented by expert opinion. METHODS AND MATERIALS: Overall, 340 articles were identified by a systematic search of the PubMed database using the keywords "partial-breast irradiation" and "APBI". This search was complemented by searches of reference lists of articles and handsearching of relevant conference abstracts and book chapters. Of these, 3 randomized and 19 prospective non-randomized studies with a minimum median follow-up time of 4 years were identified. The authors reviewed the published clinical evidence on APBI, complemented by relevant clinical and pathological studies of standard breast-conserving therapy and, through a series of personal communications, formulated the recommendations presented in this article. RESULTS: The GEC-ESTRO Breast Cancer Working Group recommends three categories guiding patient selection for APBI: (1) a low-risk group for whom APBI outside the context of a clinical trial is an acceptable treatment option; including patients ageing at least 50 years with unicentric, unifocal, pT1-2 (30 mm) tumours, and/or EIC positive or LVI positive tumours, and/or 4 or more positive lymph nodes or unknown axillary status (pNx), and (3) an intermediate-risk group, for whom APBI is considered acceptable only in the context of prospective clinical trials. CONCLUSIONS: These recommendations will provide a clinical guidance regarding the use of APBI outside the context of a clinical trial before large-scale randomized clinical trial outcome data become available. Furthermore they should promote further clinical research focusing on controversial issues in the treatment of early-stage breast carcinoma. LA - English DB - MTMT ER -