Evidence map›Paper›PMID 30125673›Full record

ArticlePractical radiation oncology2019

Prospective Comparison of Toxicity and Cosmetic Outcome After Accelerated Partial Breast Irradiation With Conformal External Beam Radiotherapy or Single-Entry Multilumen Intracavitary Brachytherapy.

Shane R Stecklein, Simona F Shaitelman, Gildy V Babiera, Isabelle Bedrosian, Dalliah M Black, Matthew T Ballo, Isadora Arzu, Eric A Strom, Valerie K Reed, Tomas Dvorak and 10 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Practical radiation oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 3 institutions in 1 country.

Shane R SteckleinDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Simona F ShaitelmanDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Gildy V BabieraDepartment of Breast Surgical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Isabelle BedrosianDepartment of Breast Surgical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Dalliah M BlackDepartment of Breast Surgical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Matthew T BalloDepartment of Radiation Oncology, University of Tennessee Health Science Center, Memphis, Tennessee.
Isadora ArzuDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Eric A StromDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Valerie K ReedDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Tomas DvorakDepartment of Radiation Oncology, UFHealth Cancer Center/Orlando Health, Orlando, Florida.
Benjamin D SmithDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Wendy A WoodwardDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Karen E HoffmanDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Pamela J SchlembachDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Steve M KirsnerDepartment of Radiation Physics, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Christopher L NelsonDepartment of Radiation Physics, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Jinzhong YangDepartment of Radiation Physics, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
William GuerraDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Shiva DibajDepartment of Biostatistics, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
Elizabeth S BloomDepartment of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas. Electronic address: ebloom@mdanderson.org.
The University of Texas MD Anderson Cancer Center · USOrlando Health · USUniversity of Tennessee Health Science Center · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

purposeThis study aimed to prospectively characterize toxicity and cosmesis after accelerated partial breast irradiation (APBI) with 3-dimensional conformal radiation therapy (CRT) or single-entry, multilumen, intracavitary brachytherapy. METHODS AND MATERIALS: A total of 281 patients with pTis, pT1N0, or pT2N0 (≤3.0 cm) breast cancer treated with segmental mastectomy were prospectively enrolled from December 2008 through August 2014. APBI was delivered using 3-dimensional CRT (n = 29) or with SAVI (n = 176), Contura (n = 56), or MammoSite (n = 20) brachytherapy catheters. Patients were evaluated at protocol-specified intervals, at which time the radiation oncologist scored cosmetic outcome, toxicities, and recurrence status using a standardized template.

resultsThe median follow-up time is 41 months. Grade 1 seroma and fibrosis were more common with brachytherapy than with 3-dimensional CRT (50.4% vs 3.4% for seroma; P < .0001 and 66.3% vs 44.8% for fibrosis; P = .02), but grade 1 edema was more common with 3-dimensional CRT than with brachytherapy (17.2% vs 5.6%; P = .04). Grade 2 to 3 pain was more common with 3-dimensional CRT (17.2% vs 5.2%; P = .03). Actuarial 5-year rates of fair or poor radiation oncologist-reported cosmetic outcome were 9% for 3-dimensional CRT and 24% for brachytherapy (P = .13). Brachytherapy was significantly associated with inferior cosmesis on mixed model analysis (P = .003). Significant predictors of reduced risk of adverse cosmetic outcome after brachytherapy were D0.1cc (skin) ≤102%, minimum skin distance >5.1 mm, dose homogeneity index >0.54, and volume of nonconformance ≤0.89 cc. The 5-year ipsilateral breast recurrence was 4.3% for brachytherapy and 4.2% for 3-dimensional CRT APBI patients (P = .95).

conclusionsBrachytherapy APBI is associated with higher rates of grade 1 fibrosis and seroma than 3-dimensional CRT but lower rates of grade 1 edema and grade 2 to 3 pain than 3-dimensional CRT. Rates of radiation oncologist-reported fair or poor cosmetic outcomes are higher with brachytherapy. We identified dosimetric parameters that predict reduced risk of adverse cosmetic outcome after brachytherapy-based APBI. Ipsilateral breast recurrence was equivalent for brachytherapy and 3-dimensional CRT.

Indexed as

CosmeticsAgedAged, 80 and overBrachytherapyBreast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, LobularEdemaFemaleFibrosisFollow-Up StudiesHumansMiddle AgedNeoplasm Recurrence, LocalPainPrognosisCosmetics

Identifiers

PMID30125673
PMCPMC6321793
OpenAlexW2885945364

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.