Postoperative Accelerated Partial Radiotherapy for Breast Cancer

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Klin Onkol 2010; 23(6): 433-438.

Summary
Backgrounds: Interstitial accelerated partial breast irradiation is generally limited to patients with extremely low risk of local recurrence. Materials and Methods: Between 2004 and 2008, 53 women in the early-stage of breast cancer were treated with multicatheter interstitial brachytherapy in very short general anaesthesia. All patients had T1 (1–22 mm) tumour with no positive auxiliary node and with negative surgical margins. Implants were positioned using a template guide. The dose was prescribed to the tumour bed plus 2 cm margin. A total of 32.0 Gy was delivered in 8 fractions of 4.0 Gy, each given twice a day over a 4–5 day period, using high-dose-rate 192Ir brachytherapy. The follow up of all patients was 2–50 months (median 40 months). Results: Preoperative morbidity: bacterial infection of the implant in 3 patients, haematoma in 43 patients. Acute toxicity: radio dermatitis – no patients. Late toxicity: mild breast pain in two patients, fat necrosis in 1 patient, oil cyst in 1 patient, dis-pigmentation in no patients, fi brosis in no patients. Cosmetic results: Excellent and good in 50 patients. Conclusion: This analysis indicates that accelerated partial breast irradiation with 192-iridium interstitial multicatheter HDR-implants is feasible with low preoperative morbidity, low acute and mild late toxicity at a median follow up of 40 months. The cosmetic result is not significantly affected. Our short-term results with multicatheter interstitial brachytherapy continue to demonstrate excellent local and regional control rates and cosmetic results.