Study compares two radiation therapy techniques available to women with breast cancer
May 04, 2017
The researchers analyzed for effectiveness of radiation (defined as the need for a later mastectomy), post-operative complications (infectious and non-infectious), and post-radiation complications (breast pain, fat necrosis and rib fracture).
At five years, the incidence of mastectomy was statistically significantly higher in the APBI brachytherapy-treatment group compared to that of the WBI, 4 percent and 2.2 percent, respectively. APBI brachytherapy was also found to be associated with a higher incidence of acute and late toxicities, compared to those of WBI - infectious complications, 16 and 10 percent, respectively; non-infectious complications, 16 percent and 8 percent, respectively; - and post-radiation complications - five-year incidence of rib fracture, 4 and 4 percent, respectively; fat necrosis, 9 and 4 percent, respectively; and breast pain, 15 percent and 12 percent, respectively.
The researchers note the study's limits, including that it was not randomized, the relatively-short follow up of patients and limited details regarding tumor characteristics were available.
Given the findings, communication between the patient and her physician is paramount so that a woman with breast cancer can make an informed, personalized decision, said Thomas A. Buchholz, M.D., professor and head of the Division of Radiation Oncology at MD Anderson.
"This is a very important, well-designed study in a large cohort of patients and provides the first comparison of these two popular radiation techniques after breast-conserving surgery," said Buchholz, also an author on the study. "It's important to note that in both groups, we found a relatively low risk of recurrence. Still, we have a responsibility to discuss potential risks and benefits with our patients, while we await definitive results from randomized trials."
National randomized trials comparing APBI brachytherapy to WBI are ongoing. MD Anderson will continue offering APBI to interested patients in the context of ongoing institutional and multi-institutional clinical protocols, says Buchholz.
Source: The University of Texas MD Anderson Cancer Center in Houston