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Par$al breast radia$on therapy with proton beam: 5-year results with cosme$c outcomes.
Bush DA, Slater JD, Loma Linda, Int. J Radiat Oncol Biol Phys, 2014; 90(3):501-5
METHODS AND MATERIALS:
➢
100 paJents. Mean age 63 yrs.
➢
Invasive nonlobular carcinoma with a maximal dimension of 3 cm (average 1.3cm)
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ParJal mastectomy with negaJve margins; Axillary LN sampling negaJve.
➢
PostoperaJve proton beam radiaJon therapy to
40 Gy in 10 frac$ons, once daily over 2
weeks. Mul$ple fields were treated daily, and skin-sparing techniques were used.
RESULTS:
➢
The median follow-up 60 months.
➢
Actuarial 5-yr. ipsilateral recurrence-free survival 97%, DFS 94%; OS 95%.
➢
No cases of grade 3 or higher acute skin reacJons
➢
Late skin reac$ons: 7 cases of grade 1 telangiectasia.
PaJent- and physician-reported
cosmesis was good to excellent in 90% of responses, was not changed from baseline
measurements, and was well maintained throughout the enJre 5-year follow-up period.
CONCLUSIONS:
Proton beam radiaJon therapy for PBI produced excellent ipsilateral breast recurrence-free
survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and
lumpectomy cavity configuraJons. CosmeJc results appear to be excellent and unchanged
from baseline out to 5 years following treatment.
Note:
Loma Linda has not experienced skin problems. (Bush et al.)
MGH did not report high grade skin toxicities in Stage III Breast CA
Pilot Study (Sh. MacDonald, )
No excessive acut high grade toxicity at NJ ProCure center (Cuaron
t al, Int. J Radiat Oncol, 2015)
…but long term cosmeiss and QoL data still not available