{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:38:16Z","timestamp":1747147096655,"version":"3.40.5"},"reference-count":41,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose\/Objective<\/jats:title><jats:p>The primary objective is to examine patient self\u2010assessment of breast pain and cosmesis between three\u2010dimensional (3D\u2010CRT) versus intensity\u2010modulated radiotherapy (IMRT). The secondary objective is to evaluate any relationship of treatment planning conformality of both cohorts to patient\u2010assessed pain. Assessments were performed at interim 12, 24, 36, and 48\u00a0months with a final 5\u2010year assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials\/Methods<\/jats:title><jats:p>In total, 656 patients (3D\u2010CRT <jats:italic>n<\/jats:italic>\u00a0=\u00a0328; IMRT <jats:italic>n<\/jats:italic>\u00a0=\u00a0328) were randomly assigned to either IMRT or 3D\u2010CRT accelerated partial breast radiotherapy to 38.5\u00a0Gy in 10 BID 3.85\u00a0Gy fractions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median follow\u2010up was 3\u00a0years. Multivariate analysis showed that pain severity significantly decreased from baseline to the 12\u2010month follow\u2010up visit (&lt;0.001 for both 3D\u2010CRT and IMRT) in each cohort. There was significantly less pain at 2 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002) and 3\u00a0years (0.045) in the IMRT arm versus the 3D\u2010CRT arm when compared to the baseline pain level. There was no difference in patient\u2010assessed cosmesis at any follow\u2010up point; however, although MD\u2010assessed cosmesis showed no difference from years 1 to 4, there was significantly better cosmesis for 3D\u2010CRT versus IMRT (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.047) at 5\u00a0years. There was a significant correlation between a maximum pain score and an increase in the CI<jats:sub>100<\/jats:sub> (indicating less conformity) in the IMRT cohort (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) and in the IMRT subgroup when the CI<jats:sub>100<\/jats:sub> was \u22640.37 cohort arm (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the analysis of our primary objective we found that at 2\u00a0years, IMRT resulted in more interval improvement in breast pain after baseline when compared to patients treated with 3D\u2010CRT planning. As seen in our secondary analysis, this may be due to the ability of IMRT to achieve higher conformality (as evidenced by lower CI values) resulting in less fibrosis. There were no differences in patient\u2010assessed cosmesis or MD\u2010assessed cosmesis for years 1\u20134; however, physician\u2010assessed 5\u2010year cosmesis was better with 3D\u2010CRT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.4242","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T14:39:49Z","timestamp":1630507189000},"page":"7089-7100","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A prospective Phase III trial evaluating patient self\u2010reported pain and cosmesis in accelerated partial breast irradiation utilizing 3\u2010D versus intensity\u2010modulated radiotherapy"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2250-9329","authenticated-orcid":false,"given":"Charles E.","family":"Leonard","sequence":"first","affiliation":[{"name":"Rocky Mountain Cancer Centers Littleton Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunfei","family":"Wang","sequence":"additional","affiliation":[{"name":"Linasmar Consulting Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Asmar","sequence":"additional","affiliation":[{"name":"Linasmar Consulting Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel Y.","family":"Lei","sequence":"additional","affiliation":[{"name":"Rocky Mountain Cancer Centers Littleton Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn T.","family":"Howell","sequence":"additional","affiliation":[{"name":"Rocky Mountain Cancer Centers Littleton Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phyllis L.","family":"Henkenberns","sequence":"additional","affiliation":[{"name":"Rocky Mountain Cancer Centers Littleton Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy K.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Rocky Mountain Cancer Centers Littleton Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy L.","family":"Hobart","sequence":"additional","affiliation":[{"name":"Rocky Mountain Cancer Centers Littleton Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon P.","family":"Tole","sequence":"additional","affiliation":[{"name":"Rocky Mountain Cancer Centers Littleton Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane M.","family":"Kercher","sequence":"additional","affiliation":[{"name":"SurgOne Greenwood Village Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodi L.","family":"Widner","sequence":"additional","affiliation":[{"name":"SurgOne Greenwood Village Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lora","family":"Barke","sequence":"additional","affiliation":[{"name":"Sally Jobe Diagnostic Breast Center Greenwood Village Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terese","family":"Kaske","sequence":"additional","affiliation":[{"name":"Sally Jobe Diagnostic Breast Center Greenwood Village Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis L.","family":"Carter","sequence":"additional","affiliation":[{"name":"Rocky Mountain Cancer Centers Littleton Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020989"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022152"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.1366"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20886"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30932-6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200203000-00002"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/93.17.1344"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02757-4"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2008.08.005"},{"key":"e_1_2_8_11_1","unstructured":"NSABP B\u201039\/RTOG 0413 protocol.https:\/\/members.nsabp.pitt.edu\/B39_Protocol.pdf. 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