Eisaku Yoden1, Takayuki Nose2, Yuki Otani3, Shuuji Asahi4, Iwao Tsukiyama5, Takushi Dokiya6, Toshiaki Saeki7, Ichirou Fukuda8, Hiroshi Sekine9, Naoto Shikama10, Yu Kumazaki10, Takao Takahashi7, Ken Yoshida11, Tadayuki Kotsuma12, Norikazu Masuda13, Kazutaka Nakashima14, Taisei Matsumura15, Shino Nakagawa16, Seiji Tachiiri17, Yoshio Moriguchi18, Jun Itami19, Masahiko Oguchi20. 1. Department of Radiation Oncology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. ydn@med.kawasaki-m.ac.jp. 2. Department of Radiation Oncology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan. 3. Department of Radiology, Kaizuka City Hospital, Kaizuka, Japan. 4. Department of Surgery, Aidu Chuo Hospital, Aizuwakamatsu, Japan. 5. Department of Radiology, Aidu Chuo Hospital, Aizuwakamatsu, Japan. 6. Department of Radiology, Kyoundo Hospital, Tokyo, Japan. 7. Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan. 8. Department of Radiology, National Disaster Medical Center, Tokyo, Japan. 9. Department of Radiology, The Jikei University Daisan Hospital, Tokyo, Japan. 10. Department of Radiation Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan. 11. Department of Radiation Oncology, Osaka Medical Collage, Takatsuki, Japan. 12. Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan. 13. Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan. 14. Department of General Surgery, Kawasaki Medical School, Okayama, Japan. 15. Department of Radiology, National Hospital Organization National Kyushu Medical Center, Fukuoka, Japan. 16. Department of Surgery, National Hospital Organization National Kyushu Medical Center, Fukuoka, Japan. 17. Department of Radiation Oncology, Kyoto City Hospital, Kyoto, Japan. 18. Department of Breast Surgery, Kyoto City Hospital, Kyoto, Japan. 19. Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan. 20. Department of Radiation Oncology, Cancer Institute Hospital, The Japanese Foundation for Cancer Research, Tokyo, Japan.
Abstract
PURPOSE: We conducted a multi-institutional prospective study on accelerated partial breast irradiation (APBI) using interstitial brachytherapy. The clinical results over a minimum follow-up period of 30 months are presented here. MATERIALS AND METHODS: Forty-six patients with breast cancer were treated with breast-conserving surgery and postoperative APBI. After confirmation of negative surgical margins and negative lymph nodes, a high-dose-rate brachytherapy protocol of 36 Gy/6 fractions was carried out. All clinical data were prospectively collected using the Common Terminology Criteria for Adverse Events ver. 3.0. RESULTS: No recurrence was observed. Cumulative rates of grade 2 or higher late sequelae were 25% for fibrosis, 2% for fractures, 9% for pain, and 9% for soft tissue necrosis. Rates of excellent or good cosmetic results as assessed by the physician and patient were 93 and 89% at the 12-month follow-up and 76 and 74% at the 30-month follow-up, respectively. Large volumes of resected tissue in small breasts were associated with fibrosis of grade 2 or higher. CONCLUSION: APBI in Japanese women provides satisfactory clinical results except for cosmetic outcomes. There is some difficulty with the assessment of fibrosis and cosmetic outcomes, especially in patients with small breasts. CLINICAL TRIAL REGISTRATION NUMBER: UMIN000001677.
PURPOSE: We conducted a multi-institutional prospective study on accelerated partial breast irradiation (APBI) using interstitial brachytherapy. The clinical results over a minimum follow-up period of 30 months are presented here. MATERIALS AND METHODS: Forty-six patients with breast cancer were treated with breast-conserving surgery and postoperative APBI. After confirmation of negative surgical margins and negative lymph nodes, a high-dose-rate brachytherapy protocol of 36 Gy/6 fractions was carried out. All clinical data were prospectively collected using the Common Terminology Criteria for Adverse Events ver. 3.0. RESULTS: No recurrence was observed. Cumulative rates of grade 2 or higher late sequelae were 25% for fibrosis, 2% for fractures, 9% for pain, and 9% for soft tissue necrosis. Rates of excellent or good cosmetic results as assessed by the physician and patient were 93 and 89% at the 12-month follow-up and 76 and 74% at the 30-month follow-up, respectively. Large volumes of resected tissue in small breasts were associated with fibrosis of grade 2 or higher. CONCLUSION: APBI in Japanese women provides satisfactory clinical results except for cosmetic outcomes. There is some difficulty with the assessment of fibrosis and cosmetic outcomes, especially in patients with small breasts. CLINICAL TRIAL REGISTRATION NUMBER: UMIN000001677.
Entities:
Keywords:
Accelerated partial breast irradiation; Brachytherapy; Breast cancer; Breast-conserving therapy; Cosmetic outcome
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