Accelerated partial breast irradiationAccelerated partial-breast irradiation using high-dose-rate interstitial brachytherapy: 12-year update of a prospective clinical study
Section snippets
Eligibility criteria, patient and tumour characteristics
The study population consisted of 45 consecutive patients with invasive, early-stage breast cancer who were prospectively treated at the Hungarian National Institute of Oncology (HNIO) between 1996 and 1998 with APBI using multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT) after BCS. During surgery, the boundaries of the excision cavity were marked with titanium clips. The excision cavities were not closed by the surgeons. However, seroma fluids were punctured in the
Treatment outcome
Overall, four patients (8.9%) developed ipsilateral breast failure and all LR occurred as a first event. All LRs were classified as elsewhere breast failures. Characteristics of patients developing LR are detailed in Table 2. The crude rates of first events are summarized in Table 3. The 5-, 10-, and 12-year actuarial rate of LR was 4.4% (95% CI, 0–10.6%), 9.3% (95% CI, 0.6–18.0%), and 9.3% (95% CI, 0.6–18.0%), respectively (Fig. 1). A total of two regional nodal failures were observed for a
Discussion
Following the general acceptance of breast-conserving therapy including elective WBI, several centres have pioneered APBI, limiting radiotherapy to the immediate vicinity of the primary tumour site [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39]. The majority of these trials using strict patient selection criteria and appropriate treatment technique were
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 comparable to those achieved with conventional WBI in selected low-risk patients. However, long-term data from ongoing prospective randomized trials are needed to establish the equivalence of this treatment approach compared with standard WBI.
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