• Int. J. Radiat. Oncol. Biol. Phys. · Dec 2011

    Early side effects of three-dimensional conformal external beam accelerated partial breast irradiation to a total dose of 40 Gy in one week (a phase II trial).

    • Céline Bourgier, Charlotte Pichenot, Rodolfe Verstraet, Mohamed El Nemr, Steve Heymann, Bruno Biron, Suzette Delaloge, Marie-Christine Mathieu, Jean-Rémy Garbay, Jean Bourhis, Alphonse G Taghian, and Hugo Marsiglia.
    • Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France. bourgier@igr.fr
    • Int. J. Radiat. Oncol. Biol. Phys. 2011 Dec 1; 81 (5): 1228-35.

    PurposeSeveral accelerated partial breast irradiation (APBI) techniques are described in the literature, and apparently, the three-dimensional (3D)-conformal technique is being used increasingly. Nonetheless, the optimal radiation dose is not yet known. Here, we report feasibility and early toxicities of APBI delivering 40 Gy over 5 days, in a phase II trial.Methods And MaterialsFrom October 2007 to September 2008, 25 patients with pT1N0 cancer received 3D-conformal APBI. The prescribed radiation dose was 40 Gy in 4-Gy fractions given twice daily. This technique used two minitangents and an "en face" electron field. Toxicities were systematically assessed at 1, 2, and 6 months and then once every 6 months.ResultsThe planning tumor volume for evaluation (PTV_EVAL) coverage was adequate: the mean dose to the PTV_EVAL was 41.8 Gy (range, 41-42.4 Gy). Mean doses to the ipsilateral lung and heart were 1.6 Gy (range, 1.0-2.3 Gy) and 1.2 Gy (range, 1.0-1.6 Gy), respectively. One and two months after completion of APBI, most patients had no or mild erythema (n=16 patients at 1 month; n=25 patients at 2 months); none of these patients developed moist desquamation. After a median follow-up of 12 months, only 1 patient had a significant moderate field contracture (grade 2). Other reported late toxicities were grade 1.Conclusions3D-conformal APBI (with two minitangents and an "en face" electron field) using a total dose of 40 Gy in 10 fractions twice daily over 5 days achieved appropriate PTV_EVAL coverage and offered significant sparing of normal tissue. Early tolerance was excellent.Copyright © 2011 Elsevier Inc. All rights reserved.

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