Accelerated Partial Breast Irradiation Versus Traditional Whole Breast Ir-radiation in Early Stage (I and II) Breast Carcinoma

BackgroundThe goal of accelerated partial breast ir-radiation (APBI) is both to reduce the duration of radiation therapy treatment to less than a week and to improve local control by increasing the dose to tumor bed. Many randomized trials had repoted between 75 % and 90 % of local recurrence are in the quaderant of original tumor, and therefore, it is anticipated that important residual cancer will be in the APBI fields. The aim of this study was the assessment of treatment outcomes and toxicities, the primary end points were disease free survival (DFS) and overall survival (OAS) in both groups. Secondary end point was radiation toxicities. PATIENTS & METHODS70 patients of early breast carcinoma randomized into two groupsgroup A (35 patients treated with 3D conformal RT using photons, radiation dose38.5 Gy /3.85 Gy/Fx. delivered BID over 5-7 days with an interfraction interval of 6 hours or more (APBI)), and group B (35 patients with 3 D conformal RT in convevtional dose 40 Gy /2.5 Gy /Fx/ 5 Fx per week/15 days WBI). Results Median age was 44 years. , the majority of patients with stage II disease (64.3 %), and 77 % of patients had hormonal receptor positive disease. After a median follow up of 30 months, DFS & OS rates for the whole group (70 patients) were 79 % and 83 %, respectively. DFS was 86 % in group A versus 80 % in group B and OS was 90 % & 88 % in group A & B respectively without statistical significance difference (P greater than0.05) Regarding late radiation toxicities no difference between groups although late toxicity was higher in group B. Conclusion In early stage invasive breast carcinoma (T1, T2 N0-N1 M0) after breast conserving therapy (BCT), using of APBI technique compared to conventional WBI, after a median follow up 30 months, showed comparable results regarding (DFS, OAS & cosmotic results). These results suggest that APBI technique could achieved the goal of adjuvant radiation therapy in BCT without inferiority in DFS & OAS with comparable cosmotic results.