Cosmetic Outcomes of a Phase 1 Dose Escalation Study of 5-Fraction Stereotactic Partial Breast Irradiation for Early Stage Breast Cancer

PurposeOur purpose was to evaluate cosmetic changes after 5-fraction adjuvant stereotactic partial breast irradiation (S-PBI).Methods and MaterialsSeventy-five women with in situ or invasive cancer stage 0, I, II, tumor size ?3 cm, were enrolled lumpectomy a phase 1 dose escalation trial of S-PBI into cohorts receiving 30, 32.5, 35, 37.5, 40 Gy 5 fractions. Before S-PBI, 3 4 gold fiducial markers placed the cavity for tracking Synchrony respiratory system. delivered CyberKnife robotic radiosurgery Patients physicians evaluated global cosmesis using Harvard Breast Cosmesis Scale. Eight independent panelists digital photography 10 subdomains at baseline follow-up. McNemar tests used change cosmesis, graded as excellent/good fair/poor, from year 3. Wilcoxon signed rank subdomains. Cohen’s kappa (?) statistic estimate interobserver agreement (IOA) between raters, Fleiss’ ? IOA panelists.ResultsMedian follow-up 5, 4, years cohorts. Most patients reported both (86.3%) (89.8%). No cohort had significantly worsened by on analysis. subdomain significant worsening fair patient-physician (? = 0.300, P < .001), patient-panel 0.295, physician-panel 0.256, individual (Fleiss 0.327, .001).ConclusionsDose 30 fractions early not associated detectable is promising modality treatment cancer. Our (S-PBI). Seventy-five panelists. Median .001). Dose