eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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3/2020
vol. 12
 
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abstract:
Original paper

High-dose-rate Brachytherapy as Adjuvant Local rEirradiation for Salvage Treatment of Recurrent breAst cancer (BALESTRA): a retrospective mono-institutional study

Andrea Vavassori
1
,
Giulia Riva
1, 2
,
Iacopo Cavallo
1, 3
,
Ruggero Spoto
1
,
Samantha Dicuonzo
1
,
Cristiana Fodor
1
,
Stefania Comi
4
,
Raffaella Cambria
4
,
Federica Cattani
4
,
Anna Morra
1
,
Maria Cristina Leonardi
1
,
Roberta Lazzari
1
,
Mattia Intra
5
,
Alberto Luini
5
,
Viviana Enrica Galimberti
5
,
Paolo Veronesi
5
,
Roberto Orecchia
6
,
Barbara Alicja Jereczek-Fossa
1, 3

1.
Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
2.
Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
3.
University of Milan, Department of Oncology and Hemato-Oncology, Milan, Italy
4.
Unit of Medical Physics, IEO European Institute of Oncology IRCCS, Milan, Italy
5.
Department of Breast Surgery, IEO European Institute of Oncology IRCCS, Milan, Italy
6.
Scientific Directorate, IEO European Institute of Oncology IRCCS, Milan, Italy
J Contemp Brachytherapy 2020; 12, 3: 207–215
Online publish date: 2020/06/30
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Introduction
To evaluate clinical results of catheter-based interstitial high-dose-rate (HDR) brachytherapy (BT) as adjuvant treatment in previously irradiated recurrent breast cancer.

Material and methods
Between January 2011 and September 2015, 31 consecutive patients with histologically confirmed recurrent breast cancer after conservative surgery and conventional whole breast radiotherapy, were retreated with a second conservative surgical resection and reirradiated with adjuvant interstitial HDR-BT. None of the brachytherapy implant was performed during the quadrantectomy procedure. A dose of 34 Gy in 10 fractions, 2 fractions per day, with a minimal interval of 6 hours was delivered.

Results
At the time of the implant, the median age of patients was 59.7 years (range, 39.3-74.9 years). The median time from first treatment until BT for local recurrence was 11.9 years (range, 2.5-27.8 years). The median interval between salvage surgery and BT was 3.6 months (range, 1-8.2 months). No acute epidermitis or soft tissue side effects higher than grade 2 were recorded, with good cosmetic results in all patients. Most of the patients presented grade 1-2 late side effects. Only one patient developed grade 3 liponecrosis. After a median follow-up of 73.7 months (range, 28.8-102.4 months), the overall survival and cancer specific survival were 87.1% and 90.3%, respectively; 5-year local control and 5-year progression-free survival rate were 90.3% and 83.9%, respectively.

Conclusions
Our preliminary analysis showed that HDR-BT is a feasible treatment for partial breast reirradiation offering very low complications rate and fast procedure. Higher patients’ cohort is warranted in order to define the role of this treatment modality in the breast conservative management of local recurrence.

keywords:

interstitial HDR brachytherapy, breast cancer recurrence, reirradiation

 
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