Accelerated partial-breast irradiation using high-dose-rate interstitial brachytherapy: 12-year update of a prospective clinical study

• Published in: Radiotherapy and oncology Vol. 94; no. 3; pp. 274 - 279
• Main Authors: Polgár, Csaba, Major, Tibor, Fodor, János, Sulyok, Zoltán, Somogyi, András, Lövey, Katalin, Németh, György, Kásler, Miklós
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.03.2010
• Subjects: Accelerated partial-breast irradiation; Adult; Aged; Brachytherapy; Breast Neoplasms - radiotherapy; Breast-conserving therapy; Female; Follow-Up Studies; Hematology, Oncology and Palliative Medicine; High-dose-rate brachytherapy; Humans; Mammaplasty - standards; Middle Aged; Neoplasm Staging; Radiotherapy Dosage; Time Factors; Treatment Outcome; Breast-conserving therapy; High-dose-rate brachytherapy; Accelerated partial-breast irradiation
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2010.01.019

Abstract Background and purpose To report the 12-year updated results of accelerated partial-breast irradiation (APBI) using multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT). Patients and methods Forty-five prospectively selected patients with T1N0-N1mi, nonlobular breast cancer without the presence of an extensive intraductal component and with negative surgical margins were treated with APBI after breast-conserving surgery (BCS) using interstitial HDR BT. A total dose of 30.3 Gy ( n = 8) and 36.4 Gy ( n = 37) in seven fractions within 4 days was delivered to the tumour bed plus a 1–2 cm margin. The median follow-up time was 133 months for surviving patients. Local and regional control, disease-free (DFS), cancer-specific (CSS), and overall survival (OS), as well as late side effects, and cosmetic results were assessed. Results Four (8.9%) ipsilateral breast tumour recurrences were observed, for a 5-, 10-, and 12-year actuarial rate of 4.4%, 9.3%, and 9.3%, respectively. A total of two regional nodal failures were observed for a 12-year actuarial rate of 4.4%. The 12-year DFS, CSS, and OS was 75.3%, 91.1%, and 88.9%, respectively. Grade 3 fibrosis was observed in one patient (2.2%). No patient developed grade 3 teleangiectasia. Fat necrosis requiring surgical intervention occurred in one woman (2.2%). Cosmetic results were rated excellent or good in 35 patients (77.8%). Conclusions Twelve-year results with APBI using HDR multicatheter interstitial implants continue to demonstrate excellent long-term local tumour control, survival, and cosmetic results with a low-rate of late side effects.