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Díaz-Gavela AA, Cerro Peñalver ED, Sanchez-Garcia S, Pardo-Perez E, Thuissard-Vasallo IJ, Andreu-Vázquez C, Molina López MY, Pena Huertas M, Guerrero-Gómez LL, Sanz-Rosa D, Lorenzo FC. Hypofractionated whole breast IMRT with HDR brachytherapy boost in early-stage breast cancer: Long-term results from a single-center. Brachytherapy 2024; 23:342-354. [PMID: 38522961 DOI: 10.1016/j.brachy.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/18/2024] [Accepted: 02/24/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION/OBJECTIVES The addition of a boost to the lumpectomy bed after whole-breast (WB) radiotherapy plays a key role in the treatment of patients with breast cancer (BC). The clinical benefits of a boost with high-dose-rate brachytherapy (HDR-BT) after conventional fractionation is supported by a large body of evidence. However, few studies have described its outcomes after a hypofractionated scheme. MATERIALS AND METHODS We included all patients treated with adjuvant WB-IMRT in 15 sessions followed by a single-session HDR-BT boost with local anesthesia on an outpatient basis. RESULTS Between 2009 and 2017, 638 patients with early-stage BC were treated according to the aforementioned protocol after breast-conserving surgery. Median follow-up was 6 years (4-11). Despite the low incidence of side effects and their slightness, we did identify an impact of breast volume on the risk of acute radiodermatitis, fibrosis, pain and edema. However, we did not identify any relationship between the volume in cubic centimeters of the BT-implant with acute or long-term side effects. 2.2% patients had an actual local relapse, 2.4% a 2nd primary in the same breast and 2.39% were diagnosed with contralateral BC. Event-free survival at 11 years was 85.5% with an overall survival of 95.7%. CONCLUSION Adjuvant hypofractionated whole-breast IMRT followed by a single dose HDR-BT boost has a low incidence of acute and chronic toxicity and excellent oncological outcomes. However, it may be worthwhile to intensify self-care protocols and surveillance in women with large breasts who may be at increased risk of side effects.
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Affiliation(s)
- Ana Aurora Díaz-Gavela
- Radiation Therapy Department, Quironsalud Madrid University Hospital, Pozuelo de Alarcón, Madrid, Spain; Medicine Department, School of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain; Radiation Therapy Department, Quironsalud La Luz Hospital, Madrid, Spain.
| | - Elia Del Cerro Peñalver
- Radiation Therapy Department, Quironsalud Madrid University Hospital, Pozuelo de Alarcón, Madrid, Spain; Medicine Department, School of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain; Radiation Therapy Department, Quironsalud La Luz Hospital, Madrid, Spain
| | | | - Eduardo Pardo-Perez
- Radiophysics Department, Quironsalud Madrid University Hospital, Pozuelo de Alarcón, Madrid, Spain
| | - Israel John Thuissard-Vasallo
- Medicine Department, School of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Cristina Andreu-Vázquez
- Medicine Department, School of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | | | - Marina Pena Huertas
- Radiation Therapy Department, Quironsalud Madrid University Hospital, Pozuelo de Alarcón, Madrid, Spain; Medicine Department, School of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | | | - David Sanz-Rosa
- Medicine Department, School of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Felipe Counago Lorenzo
- Radiation Therapy Department, Quironsalud Madrid University Hospital, Pozuelo de Alarcón, Madrid, Spain; Medicine Department, School of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain; Radiation Therapy Department, Quironsalud La Luz Hospital, Madrid, Spain; Present address: Department of Radiation Oncology, San Francisco de Asís Hospital, Madrid, Spain; Department of Radiation Oncology, La Milagrosa Hospital, Madrid, Spain
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Chicheł A, Burchardt WM, Kluska A, Chyrek AJ. Thermally boosted interstitial high-dose-rate brachytherapy in high-risk early-stage breast cancer conserving therapy - large cohort long-term results. Rep Pract Oncol Radiother 2023; 28:661-670. [PMID: 38179295 PMCID: PMC10764043 DOI: 10.5603/rpor.97510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/18/2023] [Indexed: 01/06/2024] Open
Abstract
Background Early-stage high-risk breast cancer (BC) is standardly treated with breast-conserving therapy (BCT), combined with systemic therapy and radiotherapy (RT) ± tumor bed boost, e.g., with interstitial high-dose-rate brachytherapy (HDR-BT). To improve local recurrence rate (LRR), BT radiosensitization (thermal boost, TB) with interstitial microwave hyperthermia (MWHT) may be an option. The paper aims to report a retrospective single-institutional study on 5- and 10-year local control (LC), distant metastasis-free survival (DMFS), disease-free survival (DFS), overall survival (OS), cosmetic outcome (CO), and late toxicity (fibrosis, fat necrosis) after thermally enhanced HDR-BT boost to the BC tumor bed. Materials and methods In 2006-2018, 557 early-stage (I-IIIA) high-risk BC patients were treated with BCT. If indicated, they were administered systemic therapy, then referred for 40.0-50.0 Gy whole breast irradiation (WBI) and 10 Gy interstitial HDR-BT boost (group A). Eligible patients had a single MWHT session preceding BT (group B). Based on present risk factors (RF), medium-risk (1-2 RF) and high-risk subgroups (≥ 3 RF) were formed. Patients were standardly checked, and control mammography (MMG) was performed yearly. Breast cosmesis (Harvard scale) and fibrosis were recorded. LC, DMFS, DFS, and OS were statistically analyzed. Results Out of 557 patients aged 57 years (26-84), 364 (63.4%) had interstitial HDR-BT boost (group A), and 193 (34.6%) were preheated with MWHT (group B). Patients in group B had a higher clinical stage and had more RFs. The median follow-up was 65.9. Estimated 5-year and 10-year LC resulted in 98.5% and 97.5%, respectively. There was no difference in LC, DMFS, DFS, and OS between groups A and B and between extracted high-risk subgroups A and B. Five- and ten-year OS probability was 95.4% and 88.0%, respectively, with no difference between groups A and B. Harvard criteria-based CO assessment revealed good/excellent cosmesis in 74.9-79.1%. Tumor bed hardening was present in 40.1-42.2%. Asymptomatic fat necrosis-related macrocalcifications were detected in 15.6%, more frequently in group B (p = 0.016). Conclusions Thermally boosted or not, HDR-BT was locally highly effective as part of combined treatment. Five- and ten-year LC, DMFS, DFS, and OS were high and equally distributed between the groups, although TB was prescribed in more advanced one with more RFs. TB did not influence CO and fibrosis. TB added to late toxicity regarding asymptomatic fat necrosis detected on MMG.
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Affiliation(s)
- Adam Chicheł
- Brachytherapy Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Wojciech Maria Burchardt
- Brachytherapy Department, Greater Poland Cancer Centre, Poznan, Poland
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Adam Kluska
- Brachytherapy Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Artur Jan Chyrek
- Brachytherapy Department, Greater Poland Cancer Centre, Poznan, Poland
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
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Chicheł A, Burchardt W, Chyrek AJ, Bielęda G. Thermal Boost Combined with Interstitial Brachytherapy in Early Breast Cancer Conserving Therapy—Initial Group Long-Term Clinical Results and Late Toxicity. J Pers Med 2022; 12:jpm12091382. [PMID: 36143167 PMCID: PMC9504368 DOI: 10.3390/jpm12091382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022] Open
Abstract
(1) In breast-conserving therapy (BCT), adjuvant radiation, including tumor bed boost, is mandatory. Safely delivered thermal boost (TB) based on radio-sensitizing interstitial microwave hyperthermia (MWHT) preceding standard high-dose-rate (HDR) brachytherapy (BT) boost has the potential for local control (LC) improvement. The study is to report the long-term results regarding LC, disease-free survival (DFS), overall survival (OS), toxicity, and cosmetic outcome (CO) of HDR-BT boost ± MWHT for early breast cancer (BC) patients treated with BCT. (2) In the years 2006 and 2007, 57 diverse stages and risk (IA-IIIA) BC patients were treated with BCT ± adjuvant chemotherapy followed by 42.5–50.0 Gy whole breast irradiation (WBI) and 10 Gy HDR-BT boost. Overall, 25 patients (group A; 43.9%) had a BT boost, and 32 (group B; 56.1%) had an additional pre-BT single session of interstitial MWHT on a tumor bed. Long-term LC, DFS, OS, CO, and late toxicity were evaluated. (3) Median follow-up was 94.8 months (range 1.1–185.5). LC was 55/57, or 96.5% (1 LR in each group). DFS was 48/57, or 84.2% (4 failures in group A, 5 in B). OS was 46/57, or 80.7% (6 deaths in group A, 5 in B). CO was excellent in 60%, good in 36%, and satisfactory in 4% (A), and in 53.1%, 34.4%, and 9.4% (B), respectively. One poor outcome was noted (B). Late toxicity as tumor bed hardening occurred in 19/57, or 33.3% of patients (9 in A, 10 in B). In one patient, grade 2 telangiectasia occurred (group A). All differences were statistically insignificant. (4) HDR-BT boost ± TB was feasible, well-tolerated, and highly locally effective. LC, DFS, and OS were equally distributed between the groups. Pre-BT MWHT did not increase rare late toxicity.
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Affiliation(s)
- Adam Chicheł
- Department of Brachytherapy, Greater Poland Cancer Center, 61-866 Poznan, Poland
- Correspondence: ; Tel.: +48-618-850-818 or +48-600-687-369
| | - Wojciech Burchardt
- Department of Brachytherapy, Greater Poland Cancer Center, 61-866 Poznan, Poland
- Department of Electroradiology, Poznan University of Medical Sciences, 61-866 Poznan, Poland
| | - Artur J. Chyrek
- Department of Brachytherapy, Greater Poland Cancer Center, 61-866 Poznan, Poland
| | - Grzegorz Bielęda
- Department of Electroradiology, Poznan University of Medical Sciences, 61-866 Poznan, Poland
- Department of Medical Physics, Greater Poland Cancer Center, 61-866 Poznan, Poland
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Cozzi S, Augugliaro M, Ciammella P, Botti A, Trojani V, Najafi M, Blandino G, Ruggieri MP, Giaccherini L, Alì E, Iori F, Sardaro A, Finocchi Ghersi S, Deantonio L, Gutierrez Miguelez C, Iotti C, Bardoscia L. The Role of Interstitial Brachytherapy for Breast Cancer Treatment: An Overview of Indications, Applications, and Technical Notes. Cancers (Basel) 2022; 14:cancers14102564. [PMID: 35626168 PMCID: PMC9139312 DOI: 10.3390/cancers14102564] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Breast cancer is the most common cancer in the female population. Adjuvant radiotherapy has become increasingly important as conservative treatment. Muticatheter interstitial brachytherapy is a type of radiation technique wherein the radioactive sources are directly implanted into or close to the target tissue and may be considered an extremely precise, versatile, and variable radiation technique. Literature data support muticatheter interstitial brachytherapy as the only method with strong scientific evidence to perform partial breast irradiation and reirradiation after previous conservative surgery and external beam radiotherapy. The aim of our work is to provide a comprehensive view of the use of interstitial brachytherapy, with particular focus on the implant description, limits, and advantages of the technique. Abstract Breast cancer represents the second leading cause of cancer-related death in the female population, despite continuing advances in treatment options that have significantly accelerated in recent years. Conservative treatments have radically changed the concept of healing, also focusing on the psychological aspect of oncological treatments. In this scenario, radiotherapy plays a key role. Brachytherapy is an extremely versatile radiation technique that can be used in various settings for breast cancer treatment. Although it is invasive, technically complex, and requires a long learning curve, the dosimetric advantages and sparing of organs at risk are unequivocal. Literature data support muticatheter interstitial brachytherapy as the only method with strong scientific evidence to perform partial breast irradiation and reirradiation after previous conservative surgery and external beam radiotherapy, with longer follow-up than new, emerging radiation techniques, whose effectiveness is proven by over 20 years of experience. The aim of our work is to provide a comprehensive view of the use of interstitial brachytherapy to perform breast lumpectomy boost, breast-conserving accelerated partial breast irradiation, and salvage reirradiation for ipsilateral breast recurrence, with particular focus on the implant description, limits, and advantages of the technique.
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Affiliation(s)
- Salvatore Cozzi
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.A.); (P.C.); (G.B.); (M.P.R.); (L.G.); (E.A.); (F.I.); (C.I.)
- Correspondence: ; Tel.: +39-329-731-7608
| | - Matteo Augugliaro
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.A.); (P.C.); (G.B.); (M.P.R.); (L.G.); (E.A.); (F.I.); (C.I.)
| | - Patrizia Ciammella
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.A.); (P.C.); (G.B.); (M.P.R.); (L.G.); (E.A.); (F.I.); (C.I.)
| | - Andrea Botti
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (V.T.)
| | - Valeria Trojani
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (V.T.)
| | - Masoumeh Najafi
- Department of Radiation Oncology, Shohadaye Haft-e-Tir Hospital, Iran University of Medical Science, Teheran 1997667665, Iran;
| | - Gladys Blandino
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.A.); (P.C.); (G.B.); (M.P.R.); (L.G.); (E.A.); (F.I.); (C.I.)
| | - Maria Paola Ruggieri
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.A.); (P.C.); (G.B.); (M.P.R.); (L.G.); (E.A.); (F.I.); (C.I.)
| | - Lucia Giaccherini
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.A.); (P.C.); (G.B.); (M.P.R.); (L.G.); (E.A.); (F.I.); (C.I.)
| | - Emanuele Alì
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.A.); (P.C.); (G.B.); (M.P.R.); (L.G.); (E.A.); (F.I.); (C.I.)
| | - Federico Iori
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.A.); (P.C.); (G.B.); (M.P.R.); (L.G.); (E.A.); (F.I.); (C.I.)
| | - Angela Sardaro
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Sebastiano Finocchi Ghersi
- Radiation Oncolgy Unit, AOU Sant’Andrea, Facoltà di Medicina e Psicologia, Università La Sapienza, 00185 Rome, Italy;
| | - Letizia Deantonio
- Radiation Oncology Clinic, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, 6500 Lugano, Switzerland;
| | - Cristina Gutierrez Miguelez
- Brachytherapy Unit, Department of Radiation Oncology, Catalan Institute of Oncology, University of Barcelona, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
| | - Cinzia Iotti
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.A.); (P.C.); (G.B.); (M.P.R.); (L.G.); (E.A.); (F.I.); (C.I.)
| | - Lilia Bardoscia
- Radiation Oncology Unit, S. Luca Hospital, Healthcare Company Tuscany Nord Ovest, 55100 Lucca, Italy;
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Jiang P, Zou L, Wei L, Cheng G, Sun B, Zhang F, Wang R, Wang T, Qu A, Yuan X, Qiu B, Wei S, Liu Z, Zhang Y, Wang J. Chinese Expert Consensus on Iodine 125 Seed Implantation for Recurrent Cervical Cancer in 2021. Front Oncol 2021; 11:700710. [PMID: 34858802 PMCID: PMC8630633 DOI: 10.3389/fonc.2021.700710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 10/14/2021] [Indexed: 01/07/2023] Open
Abstract
The treatment modality for recurrent cervical cancer (rCC) is limited, and the prognosis of these patients is poor. Seed implantation could be an important component of rCC management in the context of dose boost or salvage therapy after surgery or radiotherapy, which is characterized by a minimally invasive, high local dose, and rapidly does fall, sparing normal tissue. For patients with good performance status and lateral pelvic wall recurrence with an available puncture path, seed implantation was recommended, as well as for selected central pelvic recurrence and extra-pelvic recurrence. The combination of brachytherapy treatment planning system and CT guidance was needed, and three-dimensional printing templates could greatly improve the accuracy, efficiency, and quality of seed implantation to achieve a potential ablative effect and provide an efficient treatment for rCC. However, the recommendations of seed implantation were mainly based on retrospective articles and lack high-quality evidence, and multicenter prospective randomized studies are needed. In this consensus on iodine125 seed implantation for rCC, indication selection, technical process and requirements, dosimetry criteria, radiation protection, combined systemic therapy, and outcomes of seed implantation for rCC are discussed.
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Affiliation(s)
- Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Lijuan Zou
- Department Radiation Oncology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lichun Wei
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Guanghui Cheng
- Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Baosheng Sun
- Department of Radiation Oncology, Jilin Cancer Hospital, Changchun, China
| | - Fuquan Zhang
- Department of Radiation Oncology, Peking Union Medical College Hospital, Beijing, China
| | - Ruoyu Wang
- Department of Radiation Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Tiejun Wang
- Department of Radiation Oncology, The Second Hospital of Jilin University, Changchun, China
| | - Ang Qu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Xiangkun Yuan
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Cangzhou, China
| | - Bin Qiu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Shuhua Wei
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Zi Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian, China
| | - Yunyan Zhang
- Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
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Image-guided interstitial high-dose-rate brachytherapy for dose escalation in the radiotherapy treatment of locally advanced lung cancer: A single-institute experience. Brachytherapy 2019; 18:829-834. [DOI: 10.1016/j.brachy.2019.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/02/2019] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
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Frasson AL, Filho AB, Lichtenfels M, de Souza ABA, Vollbrecht B, Zerwes F. Effect of intraoperative radiotherapy for early breast cancer on 10-year recurrence rates and overall survival. Breast J 2019; 26:427-432. [PMID: 31538696 DOI: 10.1111/tbj.13502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 01/24/2023]
Abstract
The aim of this study was to evaluate 10-year local control and overall survival of IORT for early breast cancer treatment. We analyzed 68 patients submitted to breast conservative surgery and IORT, in the accelerator room of the Radiotherapy Service in South Brazil. In the long-term follow-up, we had 17.6% of patients with ipsilateral breast cancer recurrence, 2.9% with regional recurrence, 2.9% with contralateral breast recurrence, and 5.9% with distant metastasis. The 10-year overall survival was 82.8%. Our data show high local recurrence rates, however, good overall survival in early breast cancer patients treated with breast-conserving surgery and intraoperative radiotherapy with electron beams in the long-term follow-up.
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Affiliation(s)
- Antônio Luiz Frasson
- Breast Cancer Center, Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Breast Cancer Group, Albert Einstein Hospital, São Paulo, Brazil.,Brazilian Society of Mastology, São Paulo, Brazil
| | - Aroldo Braga Filho
- Radiotherapy Department, Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Martina Lichtenfels
- Breast Cancer Center, Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Betina Vollbrecht
- Breast Cancer Center, Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Felipe Zerwes
- Breast Cancer Center, Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Pinheiro J, Rodrigues D, Fernandes P, Pereira A, Trigo L. Synchronous bilateral breast cancer patients submitted to conservative treatment and brachytherapy - The experience of a service. Rep Pract Oncol Radiother 2018; 23:322-330. [PMID: 30127671 DOI: 10.1016/j.rpor.2018.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 02/15/2018] [Accepted: 06/23/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction The incidence of breast carcinoma (BC) has increased in the last years. Between 2 and 12% of patients diagnosed with BC will develop bilateral breast carcinoma (BBC). The treatment of these carcinomas is more aggressive than unilateral BC. Purpose To perform a retrospective qualitative analysis of BBC patients whose treatment has included brachytherapy (BT) and to present a revised literature on this issue. Material and methods The cases of BBC whose treatment included brachytherapy were revised. The literature on this issue was refreshed. Results Five women, aged between 54 and 78 at the time of the diagnosis, submitted to conservative surgery followed by external radiotherapy (RT) with boost of BT or exclusive BT (APBI), in the IPO-P BT Service between 2003 and 2016. Discussion The patients with BBC have slightly higher rates of local recurrences, mostly in the tumor bed, where there is a higher risk of local recurrence. Patients treated with BT had lower rates of recurrences than those treated with photons and electrons. Conclusions BBC represents a complex challenge for doctors, because in some cases there is a tendency to use more aggressive treatments and, at the same time, it is not easy to achieve the timing for the correct treatment.
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Affiliation(s)
- Joana Pinheiro
- Radiotherapy Service of the Centro Hospitalar de Trás-os-Montes e Alto Douro, Portugal
| | - Darlene Rodrigues
- Radiotherapy Service of the Centro Hospitalar de Trás-os-Montes e Alto Douro, Portugal
| | - Pedro Fernandes
- Brachytherapy Service of the Instituto Português de Oncologia do Porto, Portugal
| | - Alexandre Pereira
- Medical Physics Service of the Instituto Português de Oncologia do Porto, Portugal
| | - Lurdes Trigo
- Brachytherapy Service of the Instituto Português de Oncologia do Porto, Portugal
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Multicatheter interstitial brachytherapy for breast cancer. Cancer Radiother 2018; 22:341-344. [DOI: 10.1016/j.canrad.2018.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/26/2018] [Accepted: 01/30/2018] [Indexed: 11/17/2022]
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10
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Kauer-Dorner D, Berger D. The Role of Brachytherapy in the Treatment of Breast Cancer. Breast Care (Basel) 2018; 13:157-161. [PMID: 30069174 DOI: 10.1159/000489638] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Radiotherapy plays an important part in the management of breast cancer. Especially after breast-conserving surgery, external whole breast irradiation, occasionally with an additional local boost, is an integral part of breast conservation. Besides external radiation techniques, brachytherapy (BT) has long been among the treatment options, especially with regard to local boost application. With the emerging implementation of accelerated partial breast irradiation (APBI), BT in general and interstitial multi-catheter BT in particular, are gaining an increasing role in the management of a selected group of early breast cancer patients. APBI is an approach to reduce the irradiated area to the former tumor bed rather than treating the whole breast tissue in patients with a low baseline local recurrence risk. After a variety of phase I-III clinical studies, it is clearly evident that APBI will play a role in the treatment of this selected patient group. In this review, we focus on the clinical development and different available techniques of breast BT and provide a preview of prospects for its use.
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Affiliation(s)
| | - Daniel Berger
- Department of Radiotherapy, Medical University of Vienna, Vienna, Austria
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