Prashant Gabani1, Amy E Cyr2, Jacqueline E Zoberi1, Laura L Ochoa1, Melissa A Matesa1, Maria A Thomas1, Jose Garcia1, Julie A Margenthaler2, Michael J Naughton3, Cynthia Ma3, Souzan Sanati4, Imran Zoberi5. 1. Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO. 2. Department of Surgery, Washington University School of Medicine, Saint Louis, MO. 3. Department of Medicine, Washington University School of Medicine, Saint Louis, MO. 4. Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO. 5. Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO. Electronic address: izoberi@wustl.edu.
Abstract
PURPOSE: Long-term outcome reports of accelerated partial-breast irradiation (APBI) are limited. Here, we report the 10-year outcomes of APBI delivered using multicatheter interstitial implant (ISI) brachytherapy. METHODS AND MATERIALS: Patients with early-stage breast cancer treated with APBI via ISI brachytherapy were enrolled in a prospective registry. Selection criteria included age ≥40 years, ductal carcinoma in situ or invasive tumor ≤3 cm, negative margins (≥2 mm), and negative axillary nodes. 34 Gy in 10 twice-daily fractions was administered to 2 cm of breast tissue surrounding the surgical bed. Toxicity and cosmetic outcomes were collected prospectively. RESULTS: A total of 175 patients were included. The median followup time was 10.0 years. Ten-year ipsilateral breast tumor control, regional control, freedom from distant metastasis, breast cancer-specific survival, and overall survival were 92.1%, 96.9%, 97.4%, 97.1%, and 81.2%, respectively. High-grade disease was correlated with increase in the rate of ipsilateral breast tumor recurrence. Grade 1 or 2 skin toxicity was present in 44 patients, and Grade 3 skin toxicity was present in only 1 patient. There were no Grade 4 or higher toxicities observed. Thirty-seven patients developed fat necrosis. Dose Homogeneity Index of ≤0.85 and integrated reference air-kerma of >3400 cGycm2/h correlated with higher rates of fat necrosis. There were 115 (66%), 51 (29%), 8 (5%), and 0 (0%) patients having excellent, good, fair, and poor cosmetic outcomes, respectively. CONCLUSIONS: APBI using ISI brachytherapy offers excellent clinical outcomes in appropriately selected patients with excellent cosmetic outcomes and low rates of toxicities such as symptomatic fat necrosis.
PURPOSE: Long-term outcome reports of accelerated partial-breast irradiation (APBI) are limited. Here, we report the 10-year outcomes of APBI delivered using multicatheter interstitial implant (ISI) brachytherapy. METHODS AND MATERIALS: Patients with early-stage breast cancer treated with APBI via ISI brachytherapy were enrolled in a prospective registry. Selection criteria included age ≥40 years, ductal carcinoma in situ or invasive tumor ≤3 cm, negative margins (≥2 mm), and negative axillary nodes. 34 Gy in 10 twice-daily fractions was administered to 2 cm of breast tissue surrounding the surgical bed. Toxicity and cosmetic outcomes were collected prospectively. RESULTS: A total of 175 patients were included. The median followup time was 10.0 years. Ten-year ipsilateral breast tumor control, regional control, freedom from distant metastasis, breast cancer-specific survival, and overall survival were 92.1%, 96.9%, 97.4%, 97.1%, and 81.2%, respectively. High-grade disease was correlated with increase in the rate of ipsilateral breast tumor recurrence. Grade 1 or 2 skin toxicity was present in 44 patients, and Grade 3 skin toxicity was present in only 1 patient. There were no Grade 4 or higher toxicities observed. Thirty-seven patients developed fat necrosis. Dose Homogeneity Index of ≤0.85 and integrated reference air-kerma of >3400 cGycm2/h correlated with higher rates of fat necrosis. There were 115 (66%), 51 (29%), 8 (5%), and 0 (0%) patients having excellent, good, fair, and poor cosmetic outcomes, respectively. CONCLUSIONS:APBI using ISI brachytherapy offers excellent clinical outcomes in appropriately selected patients with excellent cosmetic outcomes and low rates of toxicities such as symptomatic fat necrosis.
Authors: Matthew N Mills; Nicholas W Russo; Matthew Fahey; Ronica H Nanda; Sunny Raiker; Jessica Jastrzebski; Lisa L Stout; Jason P Wilson; Taghrid A Altoos; Kathleen G Allen; Peter W Blumencranz; Roberto Diaz Journal: Oncologist Date: 2021-10-04
Authors: Norbert Mészáros; Tibor Major; Gábor Stelczer; Levente Jánváry; Zoltán Zaka; Dávid Pukancsik; Zoltán Takácsi-Nagy; János Fodor Md; Csaba Polgár Journal: Breast Date: 2020-10-30 Impact factor: 4.380