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@article{Thiruchelvam:2022:10.1016/S1470-2045(22)00145-0,
author = {Thiruchelvam, PTR and Leff, DR and Godden, AR and Cleator, S and Wood, SH and Kirby, AM and Jallali, N and Somaiah, N and Hunter, JE and Henry, FP and Micha, A and O'Connell, RL and Mohammed, K and Patani, N and Tan, MLH and Gujral, D and Ross, G and James, SE and Khan, AA and Rusby, JE and Hadjiminas, DJ and MacNeill, FA and PRADA, Trial Management Group},
doi = {10.1016/S1470-2045(22)00145-0},
journal = {The Lancet Oncology},
pages = {682--690},
title = {Primary radiotherapy and deep inferior epigastric perforator flap reconstruction for patients with breast cancer (PRADA): a multicentre, prospective, non-randomised, feasibility study},
url = {http://dx.doi.org/10.1016/S1470-2045(22)00145-0},
volume = {23},
year = {2022}
}

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TY  - JOUR
AB  - BACKGROUND: Radiotherapy before mastectomy and autologous free-flap breast reconstruction can avoid adverse radiation effects on healthy donor tissues and delays to adjuvant radiotherapy. However, evidence for this treatment sequence is sparse. We aimed to explore the feasibility of preoperative radiotherapy followed by skin-sparing mastectomy and deep inferior epigastric perforator (DIEP) flap reconstruction in patients with breast cancer requiring mastectomy. METHODS: We conducted a prospective, non-randomised, feasibility study at two National Health Service trusts in the UK. Eligible patients were women aged older than 18 years with a laboratory diagnosis of primary breast cancer requiring mastectomy and post-mastectomy radiotherapy, who were suitable for DIEP flap reconstruction. Preoperative radiotherapy started 3-4 weeks after neoadjuvant chemotherapy and was delivered to the breast, plus regional nodes as required, at 40 Gy in 15 fractions (over 3 weeks) or 42·72 Gy in 16 fractions (over 3·2 weeks). Adverse skin radiation toxicity was assessed preoperatively using the Radiation Therapy Oncology Group toxicity grading system. Skin-sparing mastectomy and DIEP flap reconstruction were planned for 2-6 weeks after completion of preoperative radiotherapy. The primary endpoint was the proportion of open breast wounds greater than 1 cm width requiring a dressing at 4 weeks after surgery, assessed in all participants. This study is registered with ClinicalTrials.gov, NCT02771938, and is closed to recruitment. FINDINGS: Between Jan 25, 2016, and Dec 11, 2017, 33 patients were enrolled. At 4 weeks after surgery, four (12·1%, 95% CI 3·4-28·2) of 33 patients had an open breast wound greater than 1 cm. One (3%) patient had confluent moist desquamation (grade 3). There were no serious treatment-related adverse events and no treatment-related deaths. INTERPRETATION: Preoperative radiotherapy followed by skin-sparing mastectomy and immediat
AU  - Thiruchelvam,PTR
AU  - Leff,DR
AU  - Godden,AR
AU  - Cleator,S
AU  - Wood,SH
AU  - Kirby,AM
AU  - Jallali,N
AU  - Somaiah,N
AU  - Hunter,JE
AU  - Henry,FP
AU  - Micha,A
AU  - O'Connell,RL
AU  - Mohammed,K
AU  - Patani,N
AU  - Tan,MLH
AU  - Gujral,D
AU  - Ross,G
AU  - James,SE
AU  - Khan,AA
AU  - Rusby,JE
AU  - Hadjiminas,DJ
AU  - MacNeill,FA
AU  - PRADA,Trial Management Group
DO  - 10.1016/S1470-2045(22)00145-0
EP  - 690
PY  - 2022///
SN  - 1213-9432
SP  - 682
TI  - Primary radiotherapy and deep inferior epigastric perforator flap reconstruction for patients with breast cancer (PRADA): a multicentre, prospective, non-randomised, feasibility study
T2  - The Lancet Oncology
UR  - http://dx.doi.org/10.1016/S1470-2045(22)00145-0
UR  - https://www.ncbi.nlm.nih.gov/pubmed/35397804
UR  - http://hdl.handle.net/10044/1/96513
VL  - 23
ER  -

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