Ashwini Budrukkar1, Prakash Pandit2, Tabassum Wadasadawala2, Ritu Raj Upreti3, Rakesh Jalali2, Sudeep Gupta4, Tanuja Shet5, Vani Parmar6, Rajendra Badwe6, Rajiv Sarin2. 1. Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. Electronic address: ashwininb@yahoo.com. 2. Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. 3. Department Medical Physics, Tata Memorial Hospital, Mumbai, India. 4. Department Medical Oncology, Tata Memorial Hospital, Mumbai, India. 5. Department Pathology, Tata Memorial Hospital, Mumbai, India. 6. Department Surgical Oncology, Tata Memorial Hospital, Mumbai, India.
Abstract
PURPOSE: To evaluate the impact of timing of adjuvant chemotherapy on wound healing and cosmetic outcome in women treated with accelerated partial breast irradiation (APBI). METHODS AND MATERIALS: Between August 2000 to December 2011, 224 women were treated with APBI using multicatheter interstitial high-dose-rate brachytherapy. Patients were treated to a dose of 34 Gy/10#/5-7 days with bid regimen. Systemic chemotherapy was administered as per the standard guidelines. RESULTS: Multicatheter interstitial brachytherapy technique was open cavity in 136 (60%) and closed cavity in 88 (40%). Adjuvant chemotherapy was given in 117 (52%). Wound complications (WCs) were observed in 24 patients (11%), which included wound infections (WIs) in 20 and wound dehiscence in 14. The median gap between chemotherapy and APBI was 13 days in women who developed WCs, 20 days for prechemo, and 32 days for postchemo APBI in its absence. On multivariate analysis, gap between APBI and chemotherapy of ≤3 weeks was the only significant factor (p = 0.03) affecting WCs. Acute WI (p = 0.01) and two-dimensional planning (p = 0.04) had significant impact on cosmesis resulting in fair to poor cosmetic outcome. CONCLUSIONS: Gap of ≤3 weeks between APBI and chemotherapy resulted in increased WCs. WI and two-dimensional planning resulted in poorer cosmetic outcome. We recommend gap of at least 3 weeks for optimal outcome.
PURPOSE: To evaluate the impact of timing of adjuvant chemotherapy on wound healing and cosmetic outcome in women treated with accelerated partial breast irradiation (APBI). METHODS AND MATERIALS: Between August 2000 to December 2011, 224 women were treated with APBI using multicatheter interstitial high-dose-rate brachytherapy. Patients were treated to a dose of 34 Gy/10#/5-7 days with bid regimen. Systemic chemotherapy was administered as per the standard guidelines. RESULTS: Multicatheter interstitial brachytherapy technique was open cavity in 136 (60%) and closed cavity in 88 (40%). Adjuvant chemotherapy was given in 117 (52%). Wound complications (WCs) were observed in 24 patients (11%), which included wound infections (WIs) in 20 and wound dehiscence in 14. The median gap between chemotherapy and APBI was 13 days in women who developed WCs, 20 days for prechemo, and 32 days for postchemo APBI in its absence. On multivariate analysis, gap between APBI and chemotherapy of ≤3 weeks was the only significant factor (p = 0.03) affecting WCs. Acute WI (p = 0.01) and two-dimensional planning (p = 0.04) had significant impact on cosmesis resulting in fair to poor cosmetic outcome. CONCLUSIONS: Gap of ≤3 weeks between APBI and chemotherapy resulted in increased WCs. WI and two-dimensional planning resulted in poorer cosmetic outcome. We recommend gap of at least 3 weeks for optimal outcome.
Authors: Ronald P Silverman; John Apostolides; Abhishek Chatterjee; Anthony N Dardano; Regina M Fearmonti; Allen Gabriel; Robert T Grant; Owen N Johnson; Suresh Koneru; Anna A Kuang; Andrea A Moreira; Steven R Sigalove Journal: Int Wound J Date: 2021-08-12 Impact factor: 3.315