SBRT IN WOMEN OVER 70 YEARS OLD WITH EARLY BREAST CANCER
PATRICIA ELENA MURINA,
Argentina
PO-1209
Abstract
SBRT IN WOMEN OVER 70 YEARS OLD WITH EARLY BREAST CANCER
Authors: PATRICIA ELENA MURINA1, Daniela Angel2, Oscar Muriano2, Agustin Giraudo2, Agostina Villegas2, Milla Galletto2, Silvia Zunino2
1Instituto Zunino, Radiotherapy, Córdoba , Argentina; 2Instituto Zunino, Radiotherapy, Córdoba, Argentina
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Purpose or Objective
Between August 2016 and August 2020, 50 patients (52 tumors) were treated, 2 patients with bilateral breast, average age 83.9 years (70-91) with a diagnosis of Tis, T1 and T2 breast cancer, all N0, M0; histology: invasive ductal / lobular carcinoma or ductal carcinoma in situ, irradiated in a single institution. Immobilization with vacuum bag and simulation with SIEMENS Spirit dedicated institutional tomograph and irradiated with Novalis accelerator (Varian BrainLab). Positioning both arms up from the head. ExacTrac image-guided intensity modulated technique (IMRT + IGRT) was used. Total breast volume was irradiated without boost. The prescription dose was 28 Gy (25-29), EQD2 48.9 Gy (42.5-51.0), BED 81.3 (66.6-85.1).
Toxicity was evaluated in person or by telephone survey.
Material and Methods
Between August 2016 and August 2020, 50 patients (52 tumors) were treated, 2 patients with bilateral breast, average age 83.9 years (70-91) with a diagnosis of Tis, T1 and T2 breast cancer, all N0, M0; histology: invasive ductal / lobular carcinoma or ductal carcinoma in situ, irradiated in a single institution. Immobilization with vacuum bag and simulation with SIEMENS Spirit dedicated institutional tomograph and irradiated with Novalis accelerator (Varian BrainLab). Positioning both arms up from the head. ExacTrac image-guided intensity modulated technique (IMRT + IGRT) was used. Total breast volume was irradiated without boost. The prescription dose was 28 Gy (25-29), EQD2 48.9 Gy (42.5-51.0), BED 81.3 (66.6-85.1).
Toxicity was evaluated in person or by telephone survey.
Results
50 patients (2 patients with bilateral SBRT) in total, 52 volumes irradiated and controlled.
Mean follow-up 30 months (8-57 months), 26 patients left breast, 26 right breast. All with quadrantectomy + - sentinel node, 49 luminal A patients and 1 triple-negative patient and 2 luminal B patients. Hormonal treatment managed at the discretion of the oncologist.
During treatment 1 patient with G2 epidermitis, 17 G1 epidermitis and 32 (56%) without toxicity.
At 2-3 weeks, 2 epidermitis G2 and 12 G1; 1 edema G2 and 4 G1; 1 mild pain.
At more than 8 months, 1 patient G2 edema and 1 G1; 1 fibrosis G2, 6 G1; 1 hyperchromia G1 patient, 2 mild pain patients, and 38 patients (76%) without toxicity. All patients expressed comfort and adherence to treatment
At 2-3 years 3/26 patients presented scattered telangiectasias
1/50 presented lymph node relapse (Triple negative), the rest free of disease
Conclusion
Despite the short follow-up time, the low toxicity suggests that this ultra-short treatment is feasible for women older than 70 years with low risk factors and could be considered for this age group for reasons of comfort and distance.