Abstract
HDR-brachytherapy for accelerated partial breast irradiation: Long-term experience from a Japanese institution
- Department of Radiology, Kansai Medical University Medical Center, Osaka, Japan
- Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
- Department of Radiation Oncology, Osaka Rosai Hospital, Osaka, Japan
- Department of Radiology, Saito Yukoukai Hospital, Osaka, Japan
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Radiation Oncology, Nippon Medical School Tamanagayama Hospital, Tokyo, Japan
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
- Department of Oral radiology, Osaka Dental University, Osaka, Japan
- Department of Radiology, Fukuchiyama City Hospital, Kyoto, Japan
- Division of Radiation Oncology, Kobe University Hospital, Hyogo, Japan
- Department of Radiation Oncology, Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan
- Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
- Department of Pathology, Wakakusa Daiichi Hospital, Osaka, Japan
- Department of Central Laboratory and Surgical Pathology, National Hospital Organization Osaka National Hospital, Osaka, Japan
- Division of Radiation Oncology, Kansai Medical University Hospital, Osaka, Japan
- Department of Radiology, Kansai Medical University Hospital, Osaka, Japan
Purpose:
We investigated the long-term oncological outcome of high-dose-rate (HDR) multicatheter interstitial brachytherapy (MIB) for adjuvant accelerated partial breast irradiation (APBI) after breast conserving surgery in Japanese patients.
Material and methods:
Between June 2002 and October 2011, 86 breast cancer patients were treated at National Hospital Organization Osaka National Hospital (trial number of the local institutional review board, 0329). Median age was 48 years (range, 26-73 years). Eighty patients had invasive and 6 patients non-invasive ductal carcinoma. Tumor stage distribution was pT0 in 2, pTis in 6, pT1 in 55, pT2 in 22, and pT3 in one patient, respectively. Twenty-seven patients had close/positive resection margins. Total physical HDR dose was 36-42 Gy in 6-7 fractions.
Results:
At a median follow-up of 119 months (range, 13-189 months), the 10-year local control (LC) and overall survival rate was 93% and 88%, respectively. Concerning the 2009 Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology risk stratification scheme, the 10-year LC rate was 100%, 100%, and 91% for patients considered as low-risk, intermediate-risk, and high-risk, respectively. According to the 2018 American Brachytherapy Society risk stratification scheme, the 10-year LC rate was 100% and 90% for patients ‘acceptable’ and ‘unacceptable’ for APBI, respectively. Wound complications were observed in 7 patients (8%). Risk factors for wound complications were the omission of prophylactic antibiotics during MIB, open cavity implantation, and V100 ≥ 190 cc. No grade ≥ 3 late complications (CTCVE version 4.0) were observed.
Conclusions:
Adjuvant APBI using MIB is associated with favorable long-term oncological outcomes in Japanese patients for low-risk, intermediate-risk, and acceptable groups of patients.
Keywords
APBI, breast conserving surgery, wound complication
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