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Late side-effects and cosmetic results of accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: 5-year results of a randomised, controlled, phase 3 trial
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BACKGROUND: We previously confirmed the non-inferiority of accelerated partial breast irradiation (APBI) with interstitial brachytherapy in terms of local control and overall survival compared with whole-breast irradiation for patients with early-stage breast cancer who underwent breast-conserving surgery in a phase 3 randomised trial. Here, we present the 5-year late side-effects and cosmetic results of the trial. METHODS: We did this randomised, controlled, phase 3 trial at 16 centres in seven European countries. Women aged 40 years or older with stage 0-IIA breast cancer who underwent breast-conserving surgery with microscopically clear resection margins of at least 2 mm were randomly assigned 1:1, via an online interface, to receive either whole-breast irradiation of 50 Gy with a tumour-bed boost of 10 Gy or APBI with interstitial brachytherapy. Randomisation was stratified by study centre, menopausal status, and tumour type (invasive carcinoma vs ductal carcinoma in situ), with a block size of ten, according to an automated dynamic algorithm. Patients and investigators were not masked to treatment allocation. The primary endpoint of our initial analysis was ipsilateral local recurrence; here, we report the secondary endpoints of late side-effects and cosmesis. We analysed physician-scored late toxicities and patient-scored and physician-scored cosmetic results from the date of breast-conserving surgery to the date of onset of event. Analysis was done according to treatment received (as-treated population). This trial is registered with ClinicalTrials.gov, number NCT00402519. FINDINGS: Between April 20, 2004, and July 30, 2009, we randomly assigned 1328 women to receive either whole-breast irradiation (n=673) or APBI with interstitial brachytherapy (n=655); 1184 patients comprised the as-treated population (551 in the whole-breast irradiation group and 633 in the APBI group). At a median follow-up of 6.6 years (IQR 5.8-7.6), no patients had any grade 4 toxities, and three (<1%) of 484 patients in the APBI group and seven (2%) of 393 in the whole-breast irradiation group had grade 3 late skin toxicity (p=0.16). No patients in the APBI group and two (<1%) in the whole-breast irradiation group developed grade 3 late subcutaneous tissue toxicity (p=0.10). The cumulative incidence of any late side-effect of grade 2 or worse at 5 years was 27.0% (95% CI 23.0-30.9) in the whole-breast irradiation group versus 23.3% (19.9-26.8) in the APBI group (p=0.12). The cumulative incidence of grade 2-3 late skin toxicity at 5 years was 10.7% (95% CI 8.0-13.4) in the whole-breast irradiation group versus 6.9% (4.8-9.0) in the APBI group (difference -3.8%, 95% CI -7.2 to 0.4; p=0.020). The cumulative risk of grade 2-3 late subcutaneous tissue side-effects at 5 years was 9.7% (95% CI 7.1-12.3) in the whole-breast irradiation group versus 12.0% (9.4-14.7) in the APBI group (difference 2.4%; 95% CI -1.4 to 6.1; p=0.28). The cumulative incidence of grade 2-3 breast pain was 11.9% (95% CI 9.0-14.7) after whole-breast irradiation versus 8.4% (6.1-10.6) after APBI (difference -3.5%; 95% CI -7.1 to 0.1; p=0.074). At 5 years' follow-up, according to the patients' view, 413 (91%) of 454 patients had excellent to good cosmetic results in the whole-breast irradiation group versus 498 (92%) of 541 patients in the APBI group (p=0.62); when judged by the physicians, 408 (90%) of 454 patients and 503 (93%) of 542 patients, respectively, had excellent to good cosmetic results (p=0.12). No treatment-related deaths occurred, but six (15%) of 41 patients (three in each group) died from breast cancer, and 35 (85%) deaths (21 in the whole-breast irradiation group and 14 in the APBI group) were unrelated. INTERPRETATION: 5-year toxicity profiles and cosmetic results were similar in patients treated with breast-conserving surgery followed by either APBI with interstitial brachytherapy or conventional whole-breast irradiation, with significantly fewer grade 2-3 late skin side-effects after APBI with interstitial brachytherapy. These findings provide further clinical evidence for the routine use of interstitial multicatheter brachytherapy-based APBI in the treatment of patients with low-risk breast cancer who opt for breast conservation. FUNDING: German Cancer Aid.
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<div class="JournalArticle Publication short-list"> <div class="authors"> <span class="author-name" mtid="10013383"> <a href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Polgar, C ✉</a> </span> <span class="author-type"> </span> ; <span class="author-name" > Ott, OJ </span> <span class="author-type"> </span> ; <span class="author-name" > Hildebrandt, G </span> <span class="author-type"> </span> ; <span class="author-name" > Kauer-Dorner, D </span> <span class="author-type"> </span> ; <span class="author-name" > Knauerhase, H </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10044386"> <a href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Major, T</a> </span> <span class="author-type"> </span> ; <span class="author-name" > Lyczek, J </span> <span class="author-type"> </span> ; <span class="author-name" > Guinot, JL </span> <span class="author-type"> </span> ; <span class="author-name" > Dunst, J </span> <span class="author-type"> </span> ; <span class="author-name" > Miguelez, CG </span> <span class="author-type"> </span> et al. </div ><div class="title"><a href="/gui2/?mode=browse¶ms=publication;3173126" mtid="3173126" target="_blank">Late side-effects and cosmetic results of accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: 5-year results of a randomised, controlled, phase 3 trial</a></div> <div class="pub-info"> <span class="journal-title">LANCET ONCOLOGY</span> <span class="journal-volume">18</span> : <span class="journal-issue">2</span> <span class="page"> pp. 259-268. , 10 p. </span> <span class="year">(2017)</span> </div> <div class="pub-end"><div class="identifier-list"> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1016/S1470-2045(17)30011-6" target="_blank" href="https://doi.org/10.1016/S1470-2045%2817%2930011-6"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000396343000052" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000396343000052"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="85009384686" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-85009384686"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="28094198" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=28094198&dopt=Abstract"> PubMed </a> </span> </span> </div> <div class="short-pub-prop-list"> <span class="deleted-record">Zárolt</span> <span class="short-pub-mtid"> Közlemény:3173126 </span> <span class="status-holder"><span class="status-data status-ADMIN_APPROVED"> Admin láttamozott </span></span> <span class="pub-core">Forrás Idéző </span> <span class="pub-type">Folyóiratcikk (Sokszerzős vagy csoportos szerzőségű szakcikk ) </span> <!-- && !record.category.scientific --> <span class="pub-category">Tudományos</span> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 237</span> | Független: 206 | Függő: 31 | Nem jelölt: 0 | WoS jelölt: 197 | Scopus jelölt: 209 | WoS/Scopus jelölt: 218 | DOI jelölt: 224 </div> </div> </div> </div><div class="JournalArticle Publication long-list"> <div class="authors"> <img title="Forrásközlemény" style="float: left" src="/frontend/resources/grid/publication-core-icon.png"> <img title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png"> <div class="autype autype0"> <span class="author-name" mtid="10013383"><a href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Polgar C ✉ (<span class="authorship-author-name">Polgár Csaba</span> <span class="authorAux-mtmt"> Sugárterápia, klinikai onkológia</span>) </a> </span> <span class="author-affil">Országos Onkológiai Intézet</span> ; <span class="author-name" >Ott OJ </span> ; <span class="author-name" >Hildebrandt G </span> ; <span class="author-name" >Kauer-Dorner D </span> ; <span class="author-name" >Knauerhase H </span> ; <span class="author-name" mtid="10044386"><a href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Major T (<span class="authorship-author-name">Major Tibor</span> <span class="authorAux-mtmt"> klinikai sugárfizika</span>) </a> </span> <span class="author-affil">Országos Onkológiai Intézet</span> ; <span class="author-name" >Lyczek J </span> ; <span class="author-name" >Guinot JL </span> ; <span class="author-name" >Dunst J </span> ; <span class="author-name" >Miguelez CG </span> ; <span class="author-name" >Slampa P </span> ; <span class="author-name" >Allgauer M </span> ; <span class="author-name" >Lossl K </span> ; <span class="author-name" >Polat B </span> ; <span class="author-name" >Kovacs G </span> ; <span class="author-name" >Fischedick AR </span> ; <span class="author-name" >Fietkau R </span> ; <span class="author-name" >Resch A </span> ; <span class="author-name" >Kulik A </span> ; <span class="author-name" >Arribas L </span> ; <span class="author-name" >Niehoff P </span> ; <span class="author-name" >Guedea F </span> ; <span class="author-name" >Schlamann A </span> ; <span class="author-name" >Potter R </span> ; <span class="author-name" >Gall C </span> ; <span class="author-name" >Uter W </span> ; <span class="author-name" >Strnad V </span> </div> <div class="autype autype-29"> Kollaborációs szervezet: <span class="author-name" >Groupe Europeen de Curietherapie of European Society for Radiotherapy and Oncology (GEC-ESTRO) </span> </div> </div> <div class="title"><a href="/gui2/?mode=browse¶ms=publication;3173126" target="_blank">Late side-effects and cosmetic results of accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: 5-year results of a randomised, controlled, phase 3 trial</a></div> <div> <span class="journal-title">LANCET ONCOLOGY</span> <span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/1470-2045">1470-2045</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/1474-5488">1474-5488</a>)</span>: <span class="journal-volume">18</span> <span class="journal-issue">2</span> <span class="page"> pp 259-268 </span> <span class="year">(2017)</span> </div> <div class="pub-footer"> <span class="language" xmlns="http://www.w3.org/1999/html">Nyelv: Angol | </span> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1016/S1470-2045(17)30011-6" target="_blank" href="https://doi.org/10.1016/S1470-2045%2817%2930011-6"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000396343000052" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000396343000052"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="85009384686" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-85009384686"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="28094198" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=28094198&dopt=Abstract"> PubMed </a> </span> </span> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 237</span> | Független: 206 | Függő: 31 | Nem jelölt: 0 | WoS jelölt: 197 | Scopus jelölt: 209 | WoS/Scopus jelölt: 218 | DOI jelölt: 224 </div> <div class="publication-citation"> <a target="_blank" href="/api/publication?cond=citations.related;eq;3173126&sort=publishedYear,desc&sort=title"> Idézett közlemények száma: 7 </a> </div> <div class="mtid"><span class="long-pub-mtid">Közlemény: 3173126</span> | <span class="status-data status-ADMIN_APPROVED"> Admin láttamozott </span> <span class="oldId">Régi azonosító: 3173126</span> | Forrás Idéző | <span class="type-subtype">Folyóiratcikk ( Sokszerzős vagy csoportos szerzőségű szakcikk ) </span> | <span class="pub-category">Tudományos</span> | <span class="publication-sourceOfData">MEDLINE</span> </div> <div class="lastModified">Utolsó módosítás: 2023.01.26. 00:56 Pécsi Éva (MTMT Közp 3, admin) </div> <div class="lockedBy">Ideiglenesen zárolva 2023.01.20. 10:55 Pécsi Éva (MTMT Közp 3, admin) </div> </div></div>
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5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial
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BACKGROUND: In a phase 3, randomised, non-inferiority trial, accelerated partial breast irradiation (APBI) for patients with stage 0, I, and IIA breast cancer who underwent breast-conserving treatment was compared with whole-breast irradiation. Here, we present 5-year follow-up results. METHODS: We did a phase 3, randomised, non-inferiority trial at 16 hospitals and medical centres in seven European countries. 1184 patients with low-risk invasive and ductal carcinoma in situ treated with breast-conserving surgery were centrally randomised to either whole-breast irradiation or APBI using multicatheter brachytherapy. The primary endpoint was local recurrence. Analysis was done according to treatment received. This trial is registered with ClinicalTrials.gov, number NCT00402519. FINDINGS: Between April 20, 2004, and July 30, 2009, 551 patients had whole-breast irradiation with tumour-bed boost and 633 patients received APBI using interstitial multicatheter brachytherapy. At 5-year follow-up, nine patients treated with APBI and five patients receiving whole-breast irradiation had a local recurrence; the cumulative incidence of local recurrence was 1.44% (95% CI 0.51-2.38) with APBI and 0.92% (0.12-1.73) with whole-breast irradiation (difference 0.52%, 95% CI -0.72 to 1.75; p=0.42). No grade 4 late side-effects were reported. The 5-year risk of grade 2-3 late side-effects to the skin was 3.2% with APBI versus 5.7% with whole-breast irradiation (p=0.08), and 5-year risk of grade 2-3 subcutaneous tissue late side-effects was 7.6% versus 6.3% (p=0.53). The risk of severe (grade 3) fibrosis at 5 years was 0.2% with whole-breast irradiation and 0% with APBI (p=0.46). INTERPRETATION: The difference between treatments was below the relevance margin of 3 percentage points. Therefore, adjuvant APBI using multicatheter brachytherapy after breast-conserving surgery in patients with early breast cancer is not inferior to adjuvant whole-breast irradiation with respect to 5-year local control, disease-free survival, and overall survival. FUNDING: German Cancer Aid.
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<div class="JournalArticle Publication short-list"> <div class="authors"> <span class="author-name" > Vratislav, Strnad ✉ </span> <span class="author-type"> </span> ; <span class="author-name" > Oliver, J Ott </span> <span class="author-type"> </span> ; <span class="author-name" > Guido, Hildebrandt </span> <span class="author-type"> </span> ; <span class="author-name" > Daniela, Kauer-Dorner </span> <span class="author-type"> </span> ; <span class="author-name" > Hellen, Knauerhase </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10044386"> <a href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Tibor, Major</a> </span> <span class="author-type"> </span> ; <span class="author-name" > Jaroslaw, Lyczek </span> <span class="author-type"> </span> ; <span class="author-name" > Jose, Luis Guinot </span> <span class="author-type"> </span> ; <span class="author-name" > Jürgen, Dunst </span> <span class="author-type"> </span> ; <span class="author-name" > Cristina, Gutierrez Miguelez </span> <span class="author-type"> </span> et al. </div ><div class="title"><a href="/gui2/?mode=browse¶ms=publication;2971909" mtid="2971909" target="_blank">5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial</a></div> <div class="pub-info"> <span class="journal-title">LANCET</span> <span class="journal-volume">387</span> : <span class="journal-issue">10015</span> <span class="page"> pp. 229-238. , 10 p. </span> <span class="year">(2016)</span> </div> <div class="pub-end"><div class="identifier-list"> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1016/S0140-6736(15)00471-7" target="_blank" href="https://doi.org/10.1016/S0140-6736%2815%2900471-7"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000368130700030" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000368130700030"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="84954403299" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-84954403299"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="26494415" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=26494415&dopt=Abstract"> PubMed </a> </span> </span> </div> <div class="short-pub-prop-list"> <span class="short-pub-mtid"> Közlemény:2971909 </span> <span class="status-holder"><span class="status-data status-VALIDATED"> Egyeztetett </span></span> <span class="pub-core">Forrás Idéző </span> <span class="pub-type">Folyóiratcikk (Sokszerzős vagy csoportos szerzőségű szakcikk ) </span> <!-- && !record.category.scientific --> <span class="pub-category">Tudományos</span> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 634</span> | Független: 576 | Függő: 58 | Nem jelölt: 0 | WoS jelölt: 507 | Scopus jelölt: 533 | WoS/Scopus jelölt: 564 | DOI jelölt: 585 </div> </div> </div> </div><div class="JournalArticle Publication long-list">
<div class="authors">
<img title="Forrásközlemény" style="float: left" src="/frontend/resources/grid/publication-core-icon.png">
<img title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png">
<div class="autype autype0"> <span class="author-name" >Vratislav Strnad ✉
</span>
;
<span class="author-name" >Oliver J Ott
</span>
;
<span class="author-name" >Guido Hildebrandt
</span>
;
<span class="author-name" >Daniela Kauer-Dorner
</span>
;
<span class="author-name" >Hellen Knauerhase
</span>
;
<span class="author-name" mtid="10044386"><a
href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Tibor Major
(<span class="authorship-author-name">Major Tibor</span>
<span class="authorAux-mtmt"> klinikai sugárfizika</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" >Jaroslaw Lyczek
</span>
;
<span class="author-name" >Jose Luis Guinot
</span>
;
<span class="author-name" >Jürgen Dunst
</span>
;
<span class="author-name" >Cristina Gutierrez Miguelez
</span>
;
<span class="author-name" >Pavel Slampa
</span>
;
<span class="author-name" >Michael Allgäuer
</span>
;
<span class="author-name" >Kristina Lössl
</span>
;
<span class="author-name" >Bülent Polat
</span>
;
<span class="author-name" >György Kovács
</span>
;
<span class="author-name" >Arnt-René Fischedick
</span>
;
<span class="author-name" >Thomas G Wendt
</span>
;
<span class="author-name" >Rainer Fietkau
</span>
;
<span class="author-name" >Marion Hindemith
</span>
;
<span class="author-name" >Alexandra Resch
</span>
;
<span class="author-name" >Anna Kulik
</span>
;
<span class="author-name" >Leo Arribas
</span>
;
<span class="author-name" >Peter Niehoff
</span>
;
<span class="author-name" >Fernando Guedea
</span>
;
<span class="author-name" >Annika Schlamann
</span>
;
<span class="author-name" >Richard Pötter
</span>
;
<span class="author-name" >Christine Gall
</span>
;
<span class="author-name" >Martina Malzer
</span>
;
<span class="author-name" >Wolfgang Uter
</span>
;
<span class="author-name" mtid="10013383"><a
href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Csaba Polgár
(<span class="authorship-author-name">Polgár Csaba</span>
<span class="authorAux-mtmt"> Sugárterápia, klinikai onkológia</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
</div>
<div class="autype autype-29"> Kollaborációs szervezet:
<span class="author-affil">the Groupe Européen de Curiethérapie of European Society for Radiotherapy Oncology (GEC-ESTRO)</span>
</div>
</div>
<div class="title"><a href="/gui2/?mode=browse¶ms=publication;2971909" target="_blank">5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial</a></div> <div> <span class="journal-title">LANCET</span>
<span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/0140-6736">0140-6736</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/1474-547X">1474-547X</a>)</span>:
<span class="journal-volume">387</span> <span class="journal-issue">10015</span>
<span class="page">
pp 229-238
</span> <span class="year">(2016)</span>
</div>
<div class="pub-footer">
<span class="language" xmlns="http://www.w3.org/1999/html">Nyelv:
Angol
| </span>
<span class="identifiers">
<span class="id identifier oa_none" title="none">
<a style="color:blue" title="10.1016/S0140-6736(15)00471-7" target="_blank" href="https://doi.org/10.1016/S0140-6736%2815%2900471-7">
DOI
</a>
</span>
<span class="id identifier oa_none" title="none">
<a style="color:blue" title="000368130700030" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000368130700030">
WoS
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<span class="id identifier oa_none" title="none">
<a style="color:blue" title="84954403299" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-84954403299">
Scopus
</a>
</span>
<span class="id identifier oa_none" title="none">
<a style="color:blue" title="26494415" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=26494415&dopt=Abstract">
PubMed
</a>
</span>
</span>
<div class="publication-citation" style="margin-left: 0.5cm;">
<span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 634</span>
| Független: 576
| Függő: 58
| Nem jelölt: 0
| WoS jelölt: 507
| Scopus jelölt: 533
| WoS/Scopus jelölt: 564
| DOI jelölt: 585
</div>
<div class="publication-citation">
<a target="_blank" href="/api/publication?cond=citations.related;eq;2971909&sort=publishedYear,desc&sort=title">
Idézett közlemények száma: 3
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<div class="mtid"><span class="long-pub-mtid">Közlemény: 2971909</span>
| <span class="status-data status-VALIDATED"> Egyeztetett
</span>
<span class="oldId">Régi azonosító: 2971909</span> |
Forrás Idéző
| <span class="type-subtype">Folyóiratcikk
( Sokszerzős vagy csoportos szerzőségű szakcikk
)
</span>
| <span class="pub-category">Tudományos</span>
| <span class="publication-sourceOfData">MEDLINE</span>
</div>
<div class="lastModified">Utolsó módosítás: 2023.01.09. 09:43 Szalóky-Siki Ágnes (SE_KK_Admin5_SZSA, admin)
</div>
<pre class="comment" style="margin-top: 0; margin-bottom: 0;"><u>Megjegyzés</u>: Polgár Csaba hozzájárulása a közleményhez: szerző, a vizsgálat ötletadója, a vizsgálat egyik vezetője, a vizsgálati protokoll szerkesztője, részt vett az adatok statisztikai értékelésében és a kézirat megírásában is.</pre>
</div></div>
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BACKGROUND AND PURPOSE: To report the 12-year updated results of accelerated partial-breast irradiation (APBI) using multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT). PATIENTS AND METHODS: Forty-five prospectively selected patients with T1N0-N1mi, nonlobular breast cancer without the presence of an extensive intraductal component and with negative surgical margins were treated with APBI after breast-conserving surgery (BCS) using interstitial HDR BT. A total dose of 30.3Gy (n=8) and 36.4Gy (n=37) in seven fractions within 4days was delivered to the tumour bed plus a 1-2cm margin. The median follow-up time was 133months for surviving patients. Local and regional control, disease-free (DFS), cancer-specific (CSS), and overall survival (OS), as well as late side effects, and cosmetic results were assessed. RESULTS: Four (8.9%) ipsilateral breast tumour recurrences were observed, for a 5-, 10-, and 12-year actuarial rate of 4.4%, 9.3%, and 9.3%, respectively. A total of two regional nodal failures were observed for a 12-year actuarial rate of 4.4%. The 12-year DFS, CSS, and OS was 75.3%, 91.1%, and 88.9%, respectively. Grade 3 fibrosis was observed in one patient (2.2%). No patient developed grade 3 teleangiectasia. Fat necrosis requiring surgical intervention occurred in one woman (2.2%). Cosmetic results were rated excellent or good in 35 patients (77.8%). CONCLUSIONS: Twelve-year results with APBI using HDR multicatheter interstitial implants continue to demonstrate excellent long-term local tumour control, survival, and cosmetic results with a low-rate of late side effects.
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<div class="JournalArticle Publication short-list"> <div class="authors"> <span class="author-name" mtid="10013383"> <a href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Polgar, C</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10044386"> <a href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Major, T</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10003193"> <a href="/gui2/?type=authors&mode=browse&sel=10003193" target="_blank">Fodor, J</a> </span> <span class="author-type"> </span> ; <span class="author-name" > Sulyok, Z </span> <span class="author-type"> </span> ; <span class="author-name" > Somogyi, A </span> <span class="author-type"> </span> ; <span class="author-name" > Lovey, K </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10003241"> <a href="/gui2/?type=authors&mode=browse&sel=10003241" target="_blank">Nemeth, G</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10024576"> <a href="/gui2/?type=authors&mode=browse&sel=10024576" target="_blank">Kasler, M</a> </span> <span class="author-type"> </span> </div ><div class="title"><a href="/gui2/?mode=browse¶ms=publication;1323093" mtid="1323093" target="_blank">Accelerated partial-breast irradiation using high-dose-rate interstitial brachytherapy: 12-year update of a prospective clinical study.</a></div> <div class="pub-info"> <span class="journal-title">RADIOTHERAPY AND ONCOLOGY</span> <span class="journal-volume">94</span> : <span class="journal-issue">3</span> <span class="page"> pp. 274-279. , 6 p. </span> <span class="year">(2010)</span> </div> <div class="pub-end"><div class="identifier-list"> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1016/j.radonc.2010.01.019" target="_blank" href="https://doi.org/10.1016/j.radonc.2010.01.019"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000276619500003" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000276619500003"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="77949285102" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-77949285102"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="20181401" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=20181401&dopt=Abstract"> PubMed </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:black" title="http://www.sciencedirect.com/science/article/pii/S016781401000071X" target="_blank" href="http://www.sciencedirect.com/science/article/pii/S016781401000071X"> Teljes dokumentum </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:black" title="12452558384747273393" target="_blank" href="http://scholar.Google.com/scholar?hl=en&lr=&cluster=12452558384747273393"> Google scholar </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:black" title="sVys299f0KwJ" target="_blank" href="http://scholar.Google.com/scholar?hl=en&lr=&cluster=sVys299f0KwJ"> Google scholar hash </a> </span> </span> </div> <div class="short-pub-prop-list"> <span class="deleted-record">Zárolt</span> <span class="short-pub-mtid"> Közlemény:1323093 </span> <span class="status-holder"><span class="status-data status-ADMIN_APPROVED"> Admin láttamozott </span></span> <span class="pub-core">Forrás Idéző </span> <span class="pub-type">Folyóiratcikk (Szakcikk ) </span> <!-- && !record.category.scientific --> <span class="pub-category">Tudományos</span> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 207</span> | Független: 178 | Függő: 29 | Nem jelölt: 0 | WoS jelölt: 160 | Scopus jelölt: 182 | WoS/Scopus jelölt: 185 | DOI jelölt: 181 </div> </div> </div> </div><div class="JournalArticle Publication long-list"> <div class="authors"> <img title="Forrásközlemény" style="float: left" src="/frontend/resources/grid/publication-core-icon.png"> <img title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png"> <div class="autype autype0"> <span class="author-name" mtid="10013383"><a href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Polgar C (<span class="authorship-author-name">Polgár Csaba</span> <span class="authorAux-mtmt"> Sugárterápia, klinikai onkológia</span>) </a> </span> <span class="author-affil">Országos Onkológiai Intézet</span> ; <span class="author-name" mtid="10044386"><a href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Major T (<span class="authorship-author-name">Major Tibor</span> <span class="authorAux-mtmt"> klinikai sugárfizika</span>) </a> </span> <span class="author-affil">Országos Onkológiai Intézet</span> ; <span class="author-name" mtid="10003193"><a href="/gui2/?type=authors&mode=browse&sel=10003193" target="_blank">Fodor J (<span class="authorship-author-name">Fodor János</span> <span class="authorAux-mtmt"> Orvosi tudomány</span>) </a> </span> <span class="author-affil">Országos Onkológiai Intézet</span> ; <span class="author-name" >Sulyok Z </span> ; <span class="author-name" >Somogyi A </span> ; <span class="author-name" >Lovey K </span> ; <span class="author-name" mtid="10003241"><a href="/gui2/?type=authors&mode=browse&sel=10003241" target="_blank">Nemeth G (<span class="authorship-author-name">Németh György</span> <span class="authorAux-mtmt"> sugárterápia</span>) </a> </span> <span class="author-affil">Országos Onkológiai Intézet</span> ; <span class="author-name" mtid="10024576"><a href="/gui2/?type=authors&mode=browse&sel=10024576" target="_blank">Kasler M (<span class="authorship-author-name">Kásler Miklós</span> <span class="authorAux-mtmt"> Klinikai onkológia</span>) </a> </span> <span class="author-affil">Országos Onkológiai Intézet</span> </div> </div> <div class="title"><a href="/gui2/?mode=browse¶ms=publication;1323093" target="_blank">Accelerated partial-breast irradiation using high-dose-rate interstitial brachytherapy: 12-year update of a prospective clinical study.</a></div> <div> <span class="journal-title">RADIOTHERAPY AND ONCOLOGY</span> <span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/0167-8140">0167-8140</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/1879-0887">1879-0887</a>)</span>: <span class="journal-volume">94</span> <span class="journal-issue">3</span> <span class="page"> pp 274-279 </span> <span class="year">(2010)</span> </div> <div class="pub-footer"> <span class="language" xmlns="http://www.w3.org/1999/html">Nyelv: Angol | </span> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1016/j.radonc.2010.01.019" target="_blank" href="https://doi.org/10.1016/j.radonc.2010.01.019"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000276619500003" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000276619500003"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="77949285102" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-77949285102"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="20181401" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=20181401&dopt=Abstract"> PubMed </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:black" title="http://www.sciencedirect.com/science/article/pii/S016781401000071X" target="_blank" href="http://www.sciencedirect.com/science/article/pii/S016781401000071X"> Teljes dokumentum </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:black" title="12452558384747273393" target="_blank" href="http://scholar.Google.com/scholar?hl=en&lr=&cluster=12452558384747273393"> Google scholar </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:black" title="sVys299f0KwJ" target="_blank" href="http://scholar.Google.com/scholar?hl=en&lr=&cluster=sVys299f0KwJ"> Google scholar hash </a> </span> </span> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 207</span> | Független: 178 | Függő: 29 | Nem jelölt: 0 | WoS jelölt: 160 | Scopus jelölt: 182 | WoS/Scopus jelölt: 185 | DOI jelölt: 181 </div> <div class="publication-citation"> <a target="_blank" href="/api/publication?cond=citations.related;eq;1323093&sort=publishedYear,desc&sort=title"> Idézett közlemények száma: 9 </a> </div> <div class="mtid"><span class="long-pub-mtid">Közlemény: 1323093</span> | <span class="status-data status-ADMIN_APPROVED"> Admin láttamozott </span> <span class="oldId">Régi azonosító: 1323093</span> | Forrás Idéző | <span class="type-subtype">Folyóiratcikk ( Szakcikk ) </span> | <span class="pub-category">Tudományos</span> | <span class="publication-sourceOfData">MEDLINE</span> </div> <div class="lastModified">Utolsó módosítás: 2023.01.26. 00:54 Pécsi Éva (MTMT Közp 3, admin) </div> <div class="lockedBy">Ideiglenesen zárolva 2023.01.20. 10:55 Pécsi Éva (MTMT Közp 3, admin) </div> </div></div>
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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)
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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 (<or=30 mm) pN0, non-lobular invasive breast cancer without the presence of an extensive intraductal component (EIC) and lympho-vascular invasion (LVI) and with negative surgical margins of at least 2mm, (2) a high-risk group, for whom APBI is considered contraindicated; including patients ageing <or=40 years; having positive margins, and/or multicentric or large (>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.
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<div class="JournalArticle Publication short-list"> <div class="authors"> <span class="author-name" mtid="10013383"> <a href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Polgar, C</a> </span> <span class="author-type"> </span> ; <span class="author-name" > Van, Limbergen E </span> <span class="author-type"> </span> ; <span class="author-name" > Potter, R </span> <span class="author-type"> </span> ; <span class="author-name" > Kovacs, G </span> <span class="author-type"> </span> ; <span class="author-name" > Polo, A </span> <span class="author-type"> </span> ; <span class="author-name" > Lyczek, J </span> <span class="author-type"> </span> ; <span class="author-name" > Hildebrandt, G </span> <span class="author-type"> </span> ; <span class="author-name" > Niehoff, P </span> <span class="author-type"> </span> ; <span class="author-name" > Guinot, JL </span> <span class="author-type"> </span> ; <span class="author-name" > Guedea, F </span> <span class="author-type"> </span> et al. </div ><div class="title"><a href="/gui2/?mode=browse¶ms=publication;2571279" mtid="2571279" target="_blank">Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery<span class="subTitle">: 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)</span></a></div> <div class="pub-info"> <span class="journal-title">RADIOTHERAPY AND ONCOLOGY</span> <span class="journal-volume">94</span> : <span class="journal-issue">3</span> <span class="page"> pp. 264-273. , 10 p. </span> <span class="year">(2010)</span> </div> <div class="pub-end"><div class="identifier-list"> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1016/j.radonc.2010.01.014" target="_blank" href="https://doi.org/10.1016/j.radonc.2010.01.014"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000276619500002" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000276619500002"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="77949283857" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-77949283857"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="20181402" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=20181402&dopt=Abstract"> PubMed </a> </span> </span> </div> <div class="short-pub-prop-list"> <span class="deleted-record">Zárolt</span> <span class="short-pub-mtid"> Közlemény:2571279 </span> <span class="status-holder"><span class="status-data status-ADMIN_APPROVED"> Admin láttamozott </span></span> <span class="pub-core">Forrás Idéző </span> <span class="pub-type">Folyóiratcikk (Jelentés ) </span> <!-- && !record.category.scientific --> <span class="pub-category">Tudományos</span> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 546</span> | Független: 490 | Függő: 56 | Nem jelölt: 0 | WoS jelölt: 471 | Scopus jelölt: 520 | WoS/Scopus jelölt: 544 | DOI jelölt: 506 </div> </div> </div> </div><div class="JournalArticle Publication long-list"> <div class="authors"> <img title="Forrásközlemény" style="float: left" src="/frontend/resources/grid/publication-core-icon.png"> <img title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png"> <div class="autype autype0"> <span class="author-name" mtid="10013383"><a href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Polgar C (<span class="authorship-author-name">Polgár Csaba</span> <span class="authorAux-mtmt"> Sugárterápia, klinikai onkológia</span>) </a> </span> <span class="author-affil">Országos Onkológiai Intézet</span> ; <span class="author-name" >Van Limbergen E </span> ; <span class="author-name" >Potter R </span> ; <span class="author-name" >Kovacs G </span> ; <span class="author-name" >Polo A </span> ; <span class="author-name" >Lyczek J </span> ; <span class="author-name" >Hildebrandt G </span> ; <span class="author-name" >Niehoff P </span> ; <span class="author-name" >Guinot JL </span> ; <span class="author-name" >Guedea F </span> ; <span class="author-name" >Johansson B </span> ; <span class="author-name" >Ott OJ </span> ; <span class="author-name" mtid="10044386"><a href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Major T (<span class="authorship-author-name">Major Tibor</span> <span class="authorAux-mtmt"> klinikai sugárfizika</span>) </a> </span> <span class="author-affil">Országos Onkológiai Intézet</span> ; <span class="author-name" >Strnad V </span> ; <span class="author-name" >the GEC-ESTRO breast cancer working group </span> </div> </div> <div class="title"><a href="/gui2/?mode=browse¶ms=publication;2571279" target="_blank">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).</a></div> <div> <span class="journal-title">RADIOTHERAPY AND ONCOLOGY</span> <span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/0167-8140">0167-8140</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/1879-0887">1879-0887</a>)</span>: <span class="journal-volume">94</span> <span class="journal-issue">3</span> <span class="page"> pp 264-273 </span> <span class="year">(2010)</span> </div> <div class="pub-footer"> <span class="language" xmlns="http://www.w3.org/1999/html">Nyelv: Angol | </span> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1016/j.radonc.2010.01.014" target="_blank" href="https://doi.org/10.1016/j.radonc.2010.01.014"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000276619500002" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000276619500002"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="77949283857" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-77949283857"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="20181402" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=20181402&dopt=Abstract"> PubMed </a> </span> </span> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 546</span> | Független: 490 | Függő: 56 | Nem jelölt: 0 | WoS jelölt: 471 | Scopus jelölt: 520 | WoS/Scopus jelölt: 544 | DOI jelölt: 506 </div> <div class="publication-citation"> <a target="_blank" href="/api/publication?cond=citations.related;eq;2571279&sort=publishedYear,desc&sort=title"> Idézett közlemények száma: 15 </a> </div> <div class="mtid"><span class="long-pub-mtid">Közlemény: 2571279</span> | <span class="status-data status-ADMIN_APPROVED"> Admin láttamozott </span> <span class="oldId">Régi azonosító: 2571279</span> | Forrás Idéző | <span class="type-subtype">Folyóiratcikk ( Jelentés ) </span> | <span class="pub-category">Tudományos</span> | <span class="publication-sourceOfData">MEDLINE</span> </div> <div class="lastModified">Utolsó módosítás: 2023.01.26. 00:55 Pécsi Éva (MTMT Közp 3, admin) </div> <div class="lockedBy">Ideiglenesen zárolva 2023.01.20. 10:55 Pécsi Éva (MTMT Közp 3, admin) </div> </div></div>
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Fat necrosis after partial-breast irradiation with brachytherapy or electron irradiation versus standard whole-breast radiotherapy--4-year results of a randomized trial.
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2007
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.
2008
(Kásler Miklós (Klinikai onkológia); 2011.09.12. 13:19:12)
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<div class="JournalArticle Publication short-list"> <div class="authors"> <span class="author-name" > Lovey, K ✉ </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10003193"> <a href="/gui2/?type=authors&mode=browse&sel=10003193" target="_blank">Fodor, J</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10044386"> <a href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Major, T</a> </span> <span class="author-type"> </span> ; <span class="author-name" > Szabo, E </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10001187"> <a href="/gui2/?type=authors&mode=browse&sel=10001187" target="_blank">Orosz, Z</a> </span> <span class="author-type"> </span> ; <span class="author-name" > Sulyok, Z </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10047664"> <a href="/gui2/?type=authors&mode=browse&sel=10047664" target="_blank">Janvary, L</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10016868"> <a href="/gui2/?type=authors&mode=browse&sel=10016868" target="_blank">Frohlich, G</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10024576"> <a href="/gui2/?type=authors&mode=browse&sel=10024576" target="_blank">Kasler, M</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10013383"> <a href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Polgar, C</a> </span> <span class="author-type"> </span> </div ><div class="title"><a href="/gui2/?mode=browse¶ms=publication;1118079" mtid="1118079" target="_blank">Fat necrosis after partial-breast irradiation with brachytherapy or electron irradiation versus standard whole-breast radiotherapy--4-year results of a randomized trial.</a></div> <div class="pub-info"> <span class="journal-title">INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS</span> <span class="journal-volume">69</span> : <span class="journal-issue">3</span> <span class="page"> pp. 724-731. , 8 p. </span> <span class="year">(2007)</span> </div> <div class="pub-end"><div class="identifier-list"> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1016/j.ijrobp.2007.03.055" target="_blank" href="https://doi.org/10.1016/j.ijrobp.2007.03.055"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000249943000011" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000249943000011"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="34548695438" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-34548695438"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="17524571" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17524571&dopt=Abstract"> PubMed </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:black" title="http://www.sciencedirect.com/science/article/pii/S0360301607006499" target="_blank" href="http://www.sciencedirect.com/science/article/pii/S0360301607006499"> Teljes dokumentum </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:black" title="12633215704252640009" target="_blank" href="http://scholar.Google.com/scholar?hl=en&lr=&cluster=12633215704252640009"> Google scholar </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:black" title="CWvd1r8yUq8J" target="_blank" href="http://scholar.Google.com/scholar?hl=en&lr=&cluster=CWvd1r8yUq8J"> Google scholar hash </a> </span> </span> </div> <div class="short-pub-prop-list"> <span class="deleted-record">Zárolt</span> <span class="short-pub-mtid"> Közlemény:1118079 </span> <span class="status-holder"><span class="status-data status-ADMIN_APPROVED"> Admin láttamozott </span></span> <span class="pub-core">Forrás Idéző </span> <span class="pub-type">Folyóiratcikk (Szakcikk ) </span> <!-- && !record.category.scientific --> <span class="pub-category">Tudományos</span> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 109</span> | Független: 95 | Függő: 14 | Nem jelölt: 0 | WoS jelölt: 81 | Scopus jelölt: 95 | WoS/Scopus jelölt: 96 | DOI jelölt: 94 </div> </div> </div> </div><div class="JournalArticle Publication long-list">
<div class="authors">
<img title="Forrásközlemény" style="float: left" src="/frontend/resources/grid/publication-core-icon.png">
<img title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png">
<div class="autype autype0"> <span class="author-name" >Lovey K ✉
</span>
;
<span class="author-name" mtid="10003193"><a
href="/gui2/?type=authors&mode=browse&sel=10003193" target="_blank">Fodor J
(<span class="authorship-author-name">Fodor János</span>
<span class="authorAux-mtmt"> Orvosi tudomány</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" mtid="10044386"><a
href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Major T
(<span class="authorship-author-name">Major Tibor</span>
<span class="authorAux-mtmt"> klinikai sugárfizika</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" >Szabo E
</span>
;
<span class="author-name" mtid="10001187"><a
href="/gui2/?type=authors&mode=browse&sel=10001187" target="_blank">Orosz Z
(<span class="authorship-author-name">Orosz Zsolt</span>
<span class="authorAux-mtmt"> Pathológia</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" >Sulyok Z
</span>
;
<span class="author-name" mtid="10047664"><a
href="/gui2/?type=authors&mode=browse&sel=10047664" target="_blank">Janvary L
(<span class="authorship-author-name">Jánváry Zsolt Levente</span>
<span class="authorAux-mtmt"> Sugárterápiás onkológia</span>)
</a>
</span>
;
<span class="author-name" mtid="10016868"><a
href="/gui2/?type=authors&mode=browse&sel=10016868" target="_blank">Frohlich G
(<span class="authorship-author-name">Fröhlich Georgina</span>
<span class="authorAux-mtmt"> Sugárfizika</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" mtid="10024576"><a
href="/gui2/?type=authors&mode=browse&sel=10024576" target="_blank">Kasler M
(<span class="authorship-author-name">Kásler Miklós</span>
<span class="authorAux-mtmt"> Klinikai onkológia</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" mtid="10013383"><a
href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Polgar C
(<span class="authorship-author-name">Polgár Csaba</span>
<span class="authorAux-mtmt"> Sugárterápia, klinikai onkológia</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
</div>
</div>
<div class="title"><a href="/gui2/?mode=browse¶ms=publication;1118079" target="_blank">Fat necrosis after partial-breast irradiation with brachytherapy or electron irradiation versus standard whole-breast radiotherapy--4-year results of a randomized trial.</a></div> <div> <span class="journal-title">INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS</span>
<span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/0360-3016">0360-3016</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/1879-355X">1879-355X</a>)</span>:
<span class="journal-volume">69</span> <span class="journal-issue">3</span>
<span class="page">
pp 724-731
</span> <span class="year">(2007)</span>
</div>
<div class="pub-footer">
<span class="language" xmlns="http://www.w3.org/1999/html">Nyelv:
Angol
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<span class="identifiers">
<span class="id identifier oa_none" title="none">
<a style="color:blue" title="10.1016/j.ijrobp.2007.03.055" target="_blank" href="https://doi.org/10.1016/j.ijrobp.2007.03.055">
DOI
</a>
</span>
<span class="id identifier oa_none" title="none">
<a style="color:blue" title="000249943000011" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000249943000011">
WoS
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<a style="color:blue" title="34548695438" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-34548695438">
Scopus
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<span class="id identifier oa_none" title="none">
<a style="color:blue" title="17524571" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17524571&dopt=Abstract">
PubMed
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</span>
<span class="id identifier oa_none" title="none">
<a style="color:black" title="http://www.sciencedirect.com/science/article/pii/S0360301607006499" target="_blank" href="http://www.sciencedirect.com/science/article/pii/S0360301607006499">
Teljes dokumentum
</a>
</span>
<span class="id identifier oa_none" title="none">
<a style="color:black" title="12633215704252640009" target="_blank" href="http://scholar.Google.com/scholar?hl=en&lr=&cluster=12633215704252640009">
Google scholar
</a>
</span>
<span class="id identifier oa_none" title="none">
<a style="color:black" title="CWvd1r8yUq8J" target="_blank" href="http://scholar.Google.com/scholar?hl=en&lr=&cluster=CWvd1r8yUq8J">
Google scholar hash
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<div class="publication-citation" style="margin-left: 0.5cm;">
<span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 109</span>
| Független: 95
| Függő: 14
| Nem jelölt: 0
| WoS jelölt: 81
| Scopus jelölt: 95
| WoS/Scopus jelölt: 96
| DOI jelölt: 94
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<a target="_blank" href="/api/publication?cond=citations.related;eq;1118079&sort=publishedYear,desc&sort=title">
Idézett közlemények száma: 3
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<div class="mtid"><span class="long-pub-mtid">Közlemény: 1118079</span>
| <span class="status-data status-ADMIN_APPROVED"> Admin láttamozott
</span>
<span class="oldId">Régi azonosító: 1118079</span> |
Forrás Idéző
| <span class="type-subtype">Folyóiratcikk
( Szakcikk
)
</span>
| <span class="pub-category">Tudományos</span>
| <span class="publication-sourceOfData">MEDLINE</span>
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<div class="lastModified">Utolsó módosítás: 2023.01.20. 12:12 Pécsi Éva (MTMT Közp 3, admin)
</div>
<div class="lockedBy">Ideiglenesen zárolva 2024.02.12. 15:11 Pécsi Éva (MTMT Közp 3, admin)
</div>
<pre class="comment" style="margin-top: 0; margin-bottom: 0;"><u>Megjegyzés</u>: Megjegyzés-20317363
Cited By (since 1996): 1</pre>
</div></div>
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Department of Radiotherapy, National Institute of Oncology, Budapest, Hungary
Department of Human and Experimental Tumor Pathology, National Institute of Oncology, Budapest, Hungary
Department of General and Thoracic Surgery, National Institute of Oncology, Budapest, Hungary
Cited By :304
Export Date: 10 July 2023
CODEN: IOBPD
Correspondence Address: Polgár, C.; Department of Radiotherapy, , Budapest, Hungary; email: polgar@oncol.hu
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Breast-conserving treatment with partial or whole breast irradiation for low-risk invasive breast carcinoma--5-year results of a randomized trial.
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PURPOSE: To report the 5-year results of a randomized study comparing the
survival and cosmetic results of breast-conserving treatment with partial breast
irradiation (PBI) or conventional whole breast irradiation (WBI). METHODS AND
MATERIALS: Between 1998 and 2004, 258 selected patients with T1 N0-1mi, Grade
1-2, nonlobular breast cancer without presence of extensive intraductal component
and resected with negative margins were randomized after breast-conserving
surgery to receive 50 Gy/25 fractions WBI (n = 130) or PBI (n = 128). The latter
consisted of either 7 x 5.2 Gy high-dose-rate (HDR) multicatheter brachytherapy
(BT; n = 88) or 50 Gy/25 fractions electron beam (EB) irradiation (n = 40).
RESULTS: At a median follow-up of 66 months, the 5-year actuarial rate of local
recurrence was 4.7% and 3.4% in the PBI and WBI arms, respectively (p = 0.50).
There was no significant difference in the 5-year probability of overall survival
(94.6% vs. 91.8%), cancer-specific survival (98.3% vs. 96.0%), and disease-free
survival (88.3% vs. 90.3%). The rate of excellent to good cosmetic result was
77.6% in the PBI group (81.2% after HDR BT; 70.0% after EB) and 62.9% in the
control group (52.2% after telecobalt; 65.6% after 6-9-MV photons; p(WBI/PBI) =
0.009). CONCLUSIONS: Partial breast irradiation using interstitial HDR implants
or EB to deliver radiation to the tumor bed alone for a selected group of
early-stage breast cancer patients produces 5-year results similar to those
achieved with conventional WBI. Significantly better cosmetic outcome can be
achieved with carefully designed HDR multicatheter implants compared with the
outcome after WBI.
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<div class="JournalArticle Publication short-list"> <div class="authors"> <span class="author-name" mtid="10013383"> <a href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Polgar, C</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10003193"> <a href="/gui2/?type=authors&mode=browse&sel=10003193" target="_blank">Fodor, J</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10044386"> <a href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Major, T</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10003241"> <a href="/gui2/?type=authors&mode=browse&sel=10003241" target="_blank">Nemeth, G</a> </span> <span class="author-type"> </span> ; <span class="author-name" > Lovey, K </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10001187"> <a href="/gui2/?type=authors&mode=browse&sel=10001187" target="_blank">Orosz, Z</a> </span> <span class="author-type"> </span> ; <span class="author-name" > Sulyok, Z </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10013883"> <a href="/gui2/?type=authors&mode=browse&sel=10013883" target="_blank">Takacsi-Nagy, Z</a> </span> <span class="author-type"> </span> ; <span class="author-name" mtid="10024576"> <a href="/gui2/?type=authors&mode=browse&sel=10024576" target="_blank">Kasler, M</a> </span> <span class="author-type"> </span> </div ><div class="title"><a href="/gui2/?mode=browse¶ms=publication;1118078" mtid="1118078" target="_blank">Breast-conserving treatment with partial or whole breast irradiation for low-risk invasive breast carcinoma--5-year results of a randomized trial.</a></div> <div class="pub-info"> <span class="journal-title">INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS</span> <span class="journal-volume">69</span> : <span class="journal-issue">3</span> <span class="page"> pp. 694-702. , 9 p. </span> <span class="year">(2007)</span> </div> <div class="pub-end"><div class="identifier-list"> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1016/j.ijrobp.2007.04.022" target="_blank" href="https://doi.org/10.1016/j.ijrobp.2007.04.022"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000249943000007" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000249943000007"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="34548697960" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-34548697960"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="17531400" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17531400&dopt=Abstract"> PubMed </a> </span> </span> </div> <div class="short-pub-prop-list"> <span class="short-pub-mtid"> Közlemény:1118078 </span> <span class="status-holder"><span class="status-data status-VALIDATED"> Egyeztetett </span></span> <span class="pub-core">Forrás Idéző </span> <span class="pub-type">Folyóiratcikk (Szakcikk ) </span> <!-- && !record.category.scientific --> <span class="pub-category">Tudományos</span> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 373</span> | Független: 356 | Függő: 17 | Nem jelölt: 0 | WoS jelölt: 278 | Scopus jelölt: 313 | WoS/Scopus jelölt: 325 | DOI jelölt: 320 </div> </div> </div> </div><div class="JournalArticle Publication long-list">
<div class="authors">
<img title="Forrásközlemény" style="float: left" src="/frontend/resources/grid/publication-core-icon.png">
<img title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png">
<div class="autype autype0"> <span class="author-name" mtid="10013383"><a
href="/gui2/?type=authors&mode=browse&sel=10013383" target="_blank">Polgar C
(<span class="authorship-author-name">Polgár Csaba</span>
<span class="authorAux-mtmt"> Sugárterápia, klinikai onkológia</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" mtid="10003193"><a
href="/gui2/?type=authors&mode=browse&sel=10003193" target="_blank">Fodor J
(<span class="authorship-author-name">Fodor János</span>
<span class="authorAux-mtmt"> Orvosi tudomány</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" mtid="10044386"><a
href="/gui2/?type=authors&mode=browse&sel=10044386" target="_blank">Major T
(<span class="authorship-author-name">Major Tibor</span>
<span class="authorAux-mtmt"> klinikai sugárfizika</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" mtid="10003241"><a
href="/gui2/?type=authors&mode=browse&sel=10003241" target="_blank">Nemeth G
(<span class="authorship-author-name">Németh György</span>
<span class="authorAux-mtmt"> sugárterápia</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" >Lovey K
</span>
;
<span class="author-name" mtid="10001187"><a
href="/gui2/?type=authors&mode=browse&sel=10001187" target="_blank">Orosz Z
(<span class="authorship-author-name">Orosz Zsolt</span>
<span class="authorAux-mtmt"> Pathológia</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" >Sulyok Z
</span>
;
<span class="author-name" mtid="10013883"><a
href="/gui2/?type=authors&mode=browse&sel=10013883" target="_blank">Takacsi-Nagy Z
(<span class="authorship-author-name">Takácsi-Nagy Zoltán</span>
<span class="authorAux-mtmt"> Sugárterápia</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
;
<span class="author-name" mtid="10024576"><a
href="/gui2/?type=authors&mode=browse&sel=10024576" target="_blank">Kasler M
(<span class="authorship-author-name">Kásler Miklós</span>
<span class="authorAux-mtmt"> Klinikai onkológia</span>)
</a>
</span>
<span class="author-affil">Országos Onkológiai Intézet</span>
</div>
</div>
<div class="title"><a href="/gui2/?mode=browse¶ms=publication;1118078" target="_blank">Breast-conserving treatment with partial or whole breast irradiation for low-risk invasive breast carcinoma--5-year results of a randomized trial.</a></div> <div> <span class="journal-title">INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS</span>
<span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/0360-3016">0360-3016</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/1879-355X">1879-355X</a>)</span>:
<span class="journal-volume">69</span> <span class="journal-issue">3</span>
<span class="page">
pp 694-702
</span> <span class="year">(2007)</span>
</div>
<div class="pub-footer">
<span class="language" xmlns="http://www.w3.org/1999/html">Nyelv:
Angol
| </span>
<span class="identifiers">
<span class="id identifier oa_none" title="none">
<a style="color:blue" title="10.1016/j.ijrobp.2007.04.022" target="_blank" href="https://doi.org/10.1016/j.ijrobp.2007.04.022">
DOI
</a>
</span>
<span class="id identifier oa_none" title="none">
<a style="color:blue" title="000249943000007" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000249943000007">
WoS
</a>
</span>
<span class="id identifier oa_none" title="none">
<a style="color:blue" title="34548697960" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-34548697960">
Scopus
</a>
</span>
<span class="id identifier oa_none" title="none">
<a style="color:blue" title="17531400" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17531400&dopt=Abstract">
PubMed
</a>
</span>
</span>
<div class="publication-citation" style="margin-left: 0.5cm;">
<span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 373</span>
| Független: 356
| Függő: 17
| Nem jelölt: 0
| WoS jelölt: 278
| Scopus jelölt: 313
| WoS/Scopus jelölt: 325
| DOI jelölt: 320
</div>
<div class="publication-citation">
<a target="_blank" href="/api/publication?cond=citations.related;eq;1118078&sort=publishedYear,desc&sort=title">
Idézett közlemények száma: 6
</a>
</div>
<div class="mtid"><span class="long-pub-mtid">Közlemény: 1118078</span>
| <span class="status-data status-VALIDATED"> Egyeztetett
</span>
<span class="oldId">Régi azonosító: 1118078</span> |
Forrás Idéző
| <span class="type-subtype">Folyóiratcikk
( Szakcikk
)
</span>
| <span class="pub-category">Tudományos</span>
| <span class="publication-sourceOfData">MEDLINE</span>
</div>
<div class="lastModified">Utolsó módosítás: 2022.03.07. 09:44 Csajbók Edit (SE_KK_Admin5_CSE, admin)
</div>
<pre class="comment" style="margin-top: 0; margin-bottom: 0;"><u>Megjegyzés</u>: Department of Radiotherapy, National Institute of Oncology, Budapest, Hungary
Department of Human and Experimental Tumor Pathology, National Institute of Oncology, Budapest, Hungary
Department of General and Thoracic Surgery, National Institute of Oncology, Budapest, Hungary
Cited By :304
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