POST-MASTECTOMY EXTERNAL BEAM RADIATION FOLLOWED BY HDR SURFACE MOULD BRACHYTHERAPY BOOST VS. EXTERNAL BEAM RADIOTHERAPY ALONE IN HIGH-RISK CASESA RANDOMISED CONTROLLED TRIAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 43
Abstract
BACKGROUND Post-mastectomy radiotherapy (phase III) results in excellent local control and better survival in patients with higher risk pathological scenario. Involved or closed surgical margins were not regarded as high risk, but surprisingly, they were susceptible to local failure. Boost dose followed by chest wall radiation, however, is the modality of choice in this hospital setting. MATERIALS AND METHODS Between 2007 and 2012, 60 high-risk post-mastectomy patients were identified and were randomly assigned into study and control arms (30 each). The study arm was given Post-Operative Radiotherapy (PORT) with chest wall dose of 50 Gy/25# fractions followed by Brachytherapy boost dose of 7.5 Gy/3#. Patients in control arm were treated with PORT alone. RESULTS A continuous follow-up of 36.3 months (median), 7 were alive with recurrent disease (1 in study and 6 in control arm) and 3 had died (1 in study and 2 in control arm). There was comparable grade 3 skin toxicity between the two arms with no case of late lung toxicity at 12 months in either arms. The 3-year local control (96.7% vs. 79.2%, p= 0.044) and Disease-Free Survival (DFS) of 3 years (93.3% vs. 73.3%, p= 0.041) were better in study arm, but 3-year overall (OS) survival (96.7% vs. 93.3%%, p= 0.55) was comparable. CONCLUSION Surface-mould HDR (High Dose Rate) brachytherapy boost after EBRT (External Beam Radiation Therapy) is safe and feasible for treating high-risk post-mastectomy cases with improved 3 years local control rates and DFS, but has no 3 years OS benefit.
Authors and Affiliations
Arkoprovo Halder, Partha Sarathi Halder, Anjan Das, Soumita Podder, Sandip Roy Basunia, Tapobrata Mitra, Hirak Biswas, Subrata Kumar Mandal
Keywords
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- EP ID EP548998
- DOI 10.14260/jemds/2018/1036
- Views 77
- Downloads 0
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