Accelerated partial breast irradiation with multi-catheter brachytherapy: Local control, side effects and cosmetic outcome for 274 patients. Results of the German–Austrian multi-centre trial

• Published in: Radiotherapy and oncology Vol. 82; no. 3; pp. 281 - 286
• Main Authors: Ott, Oliver J, Hildebrandt, Guido, Pötter, Richard, Hammer, Josef, Lotter, Michael, Resch, Alexandra, Sauer, Rolf, Strnad, Vratislav
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.03.2007
• Subjects: Accelerated partial breast irradiation; Adult; Aged; Aged, 80 and over; Brachytherapy - adverse effects; Brachytherapy - methods; Breast Neoplasms - mortality; Breast Neoplasms - radiotherapy; Breast Neoplasms - surgery; Combined Modality Therapy; Female; Follow-Up Studies; HDR; Hematology, Oncology and Palliative Medicine; Humans; Kaplan-Meier Estimate; Mastectomy, Segmental; Middle Aged; Multi-catheter brachytherapy; Neoplasm Recurrence, Local - prevention & control; PDR; Prognosis; Survival Rate; Treatment Outcome; Accelerated partial breast irradiation; Multi-catheter brachytherapy; HDR; PDR
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2006.08.028

Abstract Background and purpose To evaluate the safety and effectiveness of accelerated partial breast irradiation (APBI) with multi-catheter brachytherapy. Patients and methods Between 11/2000 and 04/2005, 274 patients participated. Patients were eligible for APBI if they had histologically confirmed breast cancer, a tumour diameter ⩽3 cm, complete resection with clear margins ⩾2 mm, negative axillary lymph nodes or singular nodal micro-metastasis, no distant metastases, hormone receptor-positive tumours, and were ⩾35 years. Patients were excluded if mammographically they showed a multicentric invasive growth pattern, poorly differentiated tumours, residual diffuse micro-calcifications, extensive intraductal component, or vessel invasion. Median follow-up was 32 months (range; 8–68). Results The local control rate was 99.3% (272/274), the 3 year-local-recurrence-free survival probability, 99.6%. Peri-operative complications occurred in 5.5% (15/274): 9 (3.3%) experienced implant infection and 6 (2.2%) hematoma. Acute toxicity (Grade 1/2 radio-dermatitis) was seen in 6.6% (18/274). Late side effects ⩾ Grade 3 (fibrosis, telangiectasia) occurred in 1.8% (4/274). Cosmetic results were excellent/good in 94% (253/274). Conclusions This analysis underlined the safety and effectiveness of APBI in a carefully selected subgroup with favourable disease characteristics. Of course, longer follow-up and randomised trials are necessary to conclusively assess the potential of APBI.