Interstitial multicatheter HDR-brachytherapy as accelerated partial breast irradiation after second breast-conserving surgery for locally recurrent breast cancer

被引:5
作者
Chatzikonstantinou, Georgios [1 ]
Strouthos, Iosif [2 ]
Scherf, Christian [1 ]
Koehn, Janett [1 ]
Solbach, Christine [3 ]
Roedel, Claus [1 ]
Tselis, Nikolaos [1 ]
机构
[1] Goethe Univ Frankfurt Main, Univ Hosp, Dept Radiotherapy & Oncol, Frankfurt, Germany
[2] German Oncol Ctr, Limassol, Cyprus
[3] Goethe Univ Frankfurt Main, Univ Hosp, Dept Gynecol & Obstet, Frankfurt, Germany
关键词
breast cancer; local recurrence; salvage mastectomy; interstitial multicatheter brachytherapy; SENTINEL-NODE BIOPSY; TUMOR RECURRENCE; CONSERVATIVE TREATMENT; REPEAT IRRADIATION; TARGET DELINEATION; RADIATION-THERAPY; RECOMMENDATIONS; MASTECTOMY; LUMPECTOMY; CARCINOMA;
D O I
10.1093/jrr/rrab004
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Our aim was to evaluate the efficacy and toxicity of interstitial multicatheter high dose rate brachytherapy (imHDR-BRT) as accelerated partial breast irradiation (APBI) after second breast-conserving surgery (BCS) in patients with ipsilateral breast tumor recurrence (IBTR). Between January 2010 and December 2019, 20 patients with IBTR who refused salvage mastectomy (sMT) were treated with second BCS and post-operative imHDR-BRT as APBI. All patients had undergone primary BCS followed by adjuvant external beam radiotherapy. Median imHDR-BRT dose was 32 Gy delivered in twice-daily fractions of 4 Gy. Five-year IBTR-free survival, distant metastasis-free survival (DMFS), overall survival (OS) as well as toxicity and cosmesis were evaluated in the present retrospective analysis. Median age at recurrence and median time from the first diagnosis to IBTR was 65.1 years and 12.2 years, respectively. After a median follow-up of 69.9 months, two patients developed a second local recurrence resulting in 5-year IBTR free-survival of 86.8%. Five-year DMFS and 5-year OS were 84.6% and 92.3%, respectively. Grade 1-2 fibrosis was noted in 60% of the patients with no grade 3 or higher toxicity. Two (10%) cases of asymptomatic fat necrosis were documented. Cosmetic outcome was classified as excellent in 6 (37.5%), good in 6 (37.5%), fair in 3 (18.75%) and poor in 1 (6.25%) patient, respectively. We conclude that imHDR-BRT as APBI re-irradiation is effective and safe for IBTR and should be considered in appropriately selected patients.
引用
收藏
页码:465 / 472
页数:8
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