Study Shows Accelerated Partial Breast Irradiation Can Be Used to Treat Early Stage Breast Cancer

The results of a new prospective brachytherapy clinical study have been released at the annual meeting of the American Society for Therapeutic Radiation and Oncology (ASTRO; San Antonio, USA), October 18–21, 2015.

The randomized, multicenter phase III study evaluated 1,184 patients aged 40 years and older with a median age of 62, and compared treatment using Accelerated Partial Breast Irradiation (APBI) combined with interstitial multi-catheter brachytherapy to treatment using Whole Breast Irradiation (WBI). The study took place at 16 medical centers in six European countries—Austria, the Czech Republic, Germany, Hungary, Poland, Spain, and Switzerland.

The study results were announced by the Groupe Européen de Curiethérapie—European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) and showed that overall survival, local and regional cancer control rates using APBI brachytherapy, after breast conserving surgery for those patients with early stage breast cancers, were equivalent to those using WBI.

The researchers randomized the patients either to a standardized treatment arm (WBI, n=551), or an investigational treatment arm (APBI, n=633). Follow-up exams were made for the patients every three months in the first 60 months, and then annually, with a median follow up of 6.6 years.

Nine patients were treated with APBI, and five patients with WBI. All had a local recurrence after five years, equivalent to cumulative recurrence rates of 1.44% and 0.92% (p=0.42) respectively. There was no significant difference in regional recurrence between the groups. The five-year overall survival was 97.27% for APBI and 95.55% for patients treated with WBI, with no observed difference in breast-cancer related deaths.

Prof. Vratislav Strnad, MD, PhD, Department of Radiation Oncology, University Hospital, Erlangen, Germany, said, "GEC-ESTRO is the most comprehensive clinical study to date evaluating the efficacy of APBI brachytherapy alone versus traditional external whole breast irradiation. APBI brachytherapy is an attractive treatment approach with a high level of precision, versatility and flexibility. The benefits of APBI brachytherapy include an at least four-fold reduction in total radiation exposure to healthy surrounding tissue and nearby structures including the chest wall, heart, lungs or skin; preservation of future treatment options; and a notably shorter course of therapy—four or five days, compared to three or up to seven weeks for whole breast irradiation."

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