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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