Accelerated partial breast irradiation: Association of dosimetric parameters with patient-reported outcomes Research Letter


Authors: Lapen, K.; Fiasconaro, M.; Zhang, Z.; Abaya, A.; McCormick, B.; Xu, A. J.; Cuaron, J.; Powell, S. N.; Kahn, A. J.; Gillespie, E. F.; Braunstein, L. Z.
Title: Accelerated partial breast irradiation: Association of dosimetric parameters with patient-reported outcomes
Abstract: Purpose: Accelerated partial breast irradiation (APBI) after breast-conserving surgery offers a well-tolerated adjuvant radiation therapy option for patients with breast cancer. We sought to describe patient-reported acute toxicity as a function of salient dosimetric parameters during and after an APBI regimen of 40 Gy in 10 once-daily fractions. Methods and Materials: From June 2019 to July 2020, patients undergoing APBI were assigned a weekly, response-adapted, patient reported outcomes-common terminology criteria for adverse events-based acute toxicity assessment. Patients reported acute toxicity during treatment and for up to 8 weeks after treatment. Dosimetric treatment parameters were collected. Descriptive statistics and univariable analyses were used to summarize patient-reported outcomes and their correlation to corresponding dosimetric measures, respectively. Results: Overall, 55 patients who received APBI completed a total of 351 assessments. Median planning target volume was 210 cc (range, 64-580 cc), and median planning target volume:ipsilateral breast volume ratio was 0.17 (range, 0.05-0.44). Overall, 22% of patients reported moderate breast enlargement and 27% reported maximum skin toxicity as severe or very severe. Furthermore, 35% of patients reported fatigue, and 44% of patients reported pain in the radiated area as moderate to very severe. Median time to first report of any moderate to very severe symptom was 10 days (interquartile range, 6-27 days). By 8 weeks after APBI, most patients reported resolution of symptoms, with 16% reporting residual moderate symptoms. Upon univariable analysis, none of the ascertained salient dosimetric parameters were associated with maximum symptoms or with the presence of moderate to very severe toxicity. Conclusions: Weekly assessments during and after APBI showed that patients experienced moderate to very severe toxicities, most commonly skin toxicity, but that these typically resolved by 8 weeks after radiation therapy. More comprehensive evaluations among larger cohorts are warranted to define the precise dosimetric parameters that correspond to outcomes of interest. © 2023 The Author(s)
Journal Title: Advances in Radiation Oncology
Volume: 8
Issue: 6
ISSN: 2452-1094
Publisher: Elsevier Inc.  
Date Published: 2023-11-01
Start Page: 101263
Language: English
DOI: 10.1016/j.adro.2023.101263
PROVIDER: scopus
PMCID: PMC10248091
PUBMED: 37305071
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Lior Z. Braunstein -- Source: Scopus
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MSK Authors
  1. Zhigang Zhang
    428 Zhang
  2. Simon Nicholas Powell
    331 Powell
  3. Beryl McCormick
    372 McCormick
  4. John Jacob Cuaron
    142 Cuaron
  5. Amy Jia Xu
    66 Xu
  6. Atif Jalees Khan
    153 Khan
  7. Erin Faye Gillespie
    149 Gillespie
  8. Kaitlyn Ann Lapen
    38 Lapen
  9. Anthony John Abaya
    2 Abaya