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• W2059092241 abstract "PurposeTo report results/outcomes of use of multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT) to deliver accelerated partial breast irradiation (APBI) in a large cohort of women treated in a three physician private practice setting over 10 years 9 months.Materials and MethodsTwo hundred forty-one selected patients with Tis-2 N0-1mic breast cancer without an extensive intraductal component and with negative surgical margins were treated after breast conserving surgery (BCS) with APBI using HDR BT. Three physicians performed the procedures as part of a comprehensive radiation oncology practice. Median patient age was 61. Dosage regimen was initially 34Gy in 10 fractions over 4 elapsed days; subsequently 32Gy in 8 fractions over 3-4 elapsed days was used. Target volume was the surgical resection bed with 1.5-2.0 cm margin. Ultrasound guidance was used in 231 cases and mammographic stereotactic guidance in 10 cases. Overall median followup was 67.8 months and 67.4 months in surviving patients. Local breast and regional control, cancer specific survival (CSS), disease -free survival (DFS), overall survival (OS), late effects, and cosmesis were evaluated.ResultsFour (1.54%) local recurrences were observed. Four (1.54%) “elsewhere” breast failures (different quadrant) were observed. All local and elsewhere failures recurred 18 to 42 months after treatment. Twenty patients are dead of intercurrent disease, 5 dead of breast cancer, and 1 is alive with metastatic breast cancer. Overall and cancer specific survival rates were 89.6% and 97.9% with a median followup of 67.4 Months. Cosmesis was excellent or good 96.7% of cases. Fat necrosis requiring surgical intervention occurred in 28 patients (10.8%). Median V200 in patients who developed necrosis was 13.6cc; median V200 in those without development of necrosis was 12.0cc. Five (2.1%) patients developed telangiectasia > 1 cmˆ2. Three (1.25%) patients developed breast abcess requiring surgical intervention.ConclusionsAPBI using HDR multicatheter interstitial implants is feasible in small private practice with dedicated brachytherapists, yielding excellent long-term results comparable to large academic institution series and clinical trials and also comparing favorably to the more common external beam regimens. PurposeTo report results/outcomes of use of multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT) to deliver accelerated partial breast irradiation (APBI) in a large cohort of women treated in a three physician private practice setting over 10 years 9 months. To report results/outcomes of use of multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT) to deliver accelerated partial breast irradiation (APBI) in a large cohort of women treated in a three physician private practice setting over 10 years 9 months. Materials and MethodsTwo hundred forty-one selected patients with Tis-2 N0-1mic breast cancer without an extensive intraductal component and with negative surgical margins were treated after breast conserving surgery (BCS) with APBI using HDR BT. Three physicians performed the procedures as part of a comprehensive radiation oncology practice. Median patient age was 61. Dosage regimen was initially 34Gy in 10 fractions over 4 elapsed days; subsequently 32Gy in 8 fractions over 3-4 elapsed days was used. Target volume was the surgical resection bed with 1.5-2.0 cm margin. Ultrasound guidance was used in 231 cases and mammographic stereotactic guidance in 10 cases. Overall median followup was 67.8 months and 67.4 months in surviving patients. Local breast and regional control, cancer specific survival (CSS), disease -free survival (DFS), overall survival (OS), late effects, and cosmesis were evaluated. Two hundred forty-one selected patients with Tis-2 N0-1mic breast cancer without an extensive intraductal component and with negative surgical margins were treated after breast conserving surgery (BCS) with APBI using HDR BT. Three physicians performed the procedures as part of a comprehensive radiation oncology practice. Median patient age was 61. Dosage regimen was initially 34Gy in 10 fractions over 4 elapsed days; subsequently 32Gy in 8 fractions over 3-4 elapsed days was used. Target volume was the surgical resection bed with 1.5-2.0 cm margin. Ultrasound guidance was used in 231 cases and mammographic stereotactic guidance in 10 cases. Overall median followup was 67.8 months and 67.4 months in surviving patients. Local breast and regional control, cancer specific survival (CSS), disease -free survival (DFS), overall survival (OS), late effects, and cosmesis were evaluated. ResultsFour (1.54%) local recurrences were observed. Four (1.54%) “elsewhere” breast failures (different quadrant) were observed. All local and elsewhere failures recurred 18 to 42 months after treatment. Twenty patients are dead of intercurrent disease, 5 dead of breast cancer, and 1 is alive with metastatic breast cancer. Overall and cancer specific survival rates were 89.6% and 97.9% with a median followup of 67.4 Months. Cosmesis was excellent or good 96.7% of cases. Fat necrosis requiring surgical intervention occurred in 28 patients (10.8%). Median V200 in patients who developed necrosis was 13.6cc; median V200 in those without development of necrosis was 12.0cc. Five (2.1%) patients developed telangiectasia > 1 cmˆ2. Three (1.25%) patients developed breast abcess requiring surgical intervention. Four (1.54%) local recurrences were observed. Four (1.54%) “elsewhere” breast failures (different quadrant) were observed. All local and elsewhere failures recurred 18 to 42 months after treatment. Twenty patients are dead of intercurrent disease, 5 dead of breast cancer, and 1 is alive with metastatic breast cancer. Overall and cancer specific survival rates were 89.6% and 97.9% with a median followup of 67.4 Months. Cosmesis was excellent or good 96.7% of cases. Fat necrosis requiring surgical intervention occurred in 28 patients (10.8%). Median V200 in patients who developed necrosis was 13.6cc; median V200 in those without development of necrosis was 12.0cc. Five (2.1%) patients developed telangiectasia > 1 cmˆ2. Three (1.25%) patients developed breast abcess requiring surgical intervention. ConclusionsAPBI using HDR multicatheter interstitial implants is feasible in small private practice with dedicated brachytherapists, yielding excellent long-term results comparable to large academic institution series and clinical trials and also comparing favorably to the more common external beam regimens. APBI using HDR multicatheter interstitial implants is feasible in small private practice with dedicated brachytherapists, yielding excellent long-term results comparable to large academic institution series and clinical trials and also comparing favorably to the more common external beam regimens." @default.
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• W2059092241 date "2014-03-01" @default.
• W2059092241 modified "2023-09-26" @default.
• W2059092241 title "Accelerated Partial Breast Irradiation with Multicatheter High-Dose-Rate Brachytherapy: Feasibility and Results in a Private Practice Cohort" @default.
• W2059092241 doi "https://doi.org/10.1016/j.brachy.2014.02.349" @default.
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