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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EA single-center randomized study of 520 patients with early breast cancer compared accelerated partial breast irradiation using intensity modulated radiotherapy to whole breast irradiation. No differences were seen in the 5-year rate ipsilateral breast tumor recurrence rate and significantly less skin toxicity was observed with partial breast irradiation.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eaccelerated partial breast irradiation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eintensity modulated radiotherapy\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eradiation therapy\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Esurvival\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Erecurrence\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EAccelerated Partial Breast Irradiation Using Intensity Modulated Radiotherapy Versus Whole Breast Irradiation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENCT02104895\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EAccelerated partial breast irradiation (APBI) using intensity-modulated radiotherapy (IMRT) is an alternative technique to whole-breast irradiation (WBI) in early stage breast cancer (BC). Lorenzo Livi, MD, Florence University Hospital, Florence, Italy, presented the 5-year survival results from the Accelerated Partial Breast Irradiation Using Intensity Modulated Radiotherapy Versus Whole Breast Irradiation trial [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT02104895\u0026amp;atom=%2Fspmdc%2F14%2F56%2F10.atom\u0022\u003ENCT02104895\u003C\/a\u003E]. In this single-center phase 3 randomized equivalence trial that compared IMRT with WBI in patients with early stage BC, the hypothesis was that APBI-IMRT would be advantageous by increasing dose conformity while minimizing normal tissue exposure.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EEligible patients were women aged\u2009\u0026gt;\u200940 years, had a maximum tumor diameter of 25 mm, were considered appropriate candidates for breast-conserving surgery, and had surgical margins \u0026gt;\u20095 mm [Livi L et al. \u003Cem\u003EInt J Radiat Oncol Biol Phys.\u003C\/em\u003E 2010; Livi L et al. \u003Cem\u003EEur J Cancer\u003C\/em\u003E. 2015]. Surgical clips were mandatory in all patients. The clinical target volume in patients in the APBI arm was defined as a 1-cm 3-D margin around the surgical clips. The planning target volume was a 1-cm margin added to the clinical target volume, limited to 3 mm from skin and to 4-mm intrusion in the homolateral lung.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EPatients were randomized 1:1 to receive either external APBI using the IMRT technique or WBI. Patients in the APBI arm received a total dose of 30 Gy in 5 fractions (6 Gy\/fr in 2 weeks) to the tumor bed and those randomized to WBI received 50 Gy plus a boost 10 Gy in 30 fractions (2 Gy\/fr in 6 weeks). The primary end point was ipsilateral breast tumor recurrence (IBTR). Treatment toxicity and overall survival (OS) were secondary end points. Tolerance was evaluated using Radiation Therapy Oncology Group, the European Organization for Research and Treatment of Cancer, and the Harvard Breast Cosmesis scales.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EA total of 520 patients were randomized from 2005 to 2013, with 260 in each arm [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT02104895\u0026amp;atom=%2Fspmdc%2F14%2F56%2F10.atom\u0022\u003ENCT02104895\u003C\/a\u003E]. The majority of patients had a pT1b or pT1c tumor stage (about 75%) and negative axillary lymph nodes (about 86%). The most common molecular subtype was luminal A (169 patients in the APBI group and 151 in the WBI group). After a median follow-up of 5 years (range, 0.6 to 9.0), the 5-year IBTR rate was 1.5% (3 cases) compared with 1.4% (3 cases) in the WBI group (\u003Cem\u003EP\u003C\/em\u003E\u2009=\u2009.86; \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). The 5-year OS rate was 99.4% in the APBI group and 96.6% in the WBI group (HR, 0.17; 95% CI, 0.02 to 1.36; \u003Cem\u003EP\u003C\/em\u003E\u2009=\u2009.057).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11603\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11603\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11603\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EFive-Year Event Rates by Treatment (ITT Population)\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-10\u0022\u003ENo grade 3 toxicity was observed in either treatment group. In terms of acute adverse events, the APBI group was significantly better considering any grade of skin toxicity (\u003Cem\u003EP\u003C\/em\u003E\u2009=\u2009.0001). In early late side effects, 2 cases of grade 2 skin fibrosis occurred in the WBI group (0.8%). A total of 337 patients (65%) had a cosmetic evaluation with a minimum follow-up of 48 months, \u0026gt;\u200990% of patients in both groups had cosmetic results rated as excellent or good, and APBI patients were considered to have a better outcome compared with patients in the WBI arm (\u003Cem\u003EP\u003C\/em\u003E\u2009=\u2009.045). Dr Livi was encouraged by the findings but noted that the interpretation of the study is limited by the small sample size and low IBRT event rate.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/56\/10.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzo7oe\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzo7oe\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}