Advantages of intraoperative implant for interstitial brachytherapy for accelerated partial breast irradiation either frail patients with early-stage disease or in locally recurrent breast cancer

Salvatore Cozzi; Maria Laplana; Dina Najjari; Andrea Slocker; Xavier Encinas; Joan Pera; Ferran Guedea; Cristina Gutierrez

doi:10.5114/jcb.2018.75594

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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abstract:

Original paper

Advantages of intraoperative implant for interstitial brachytherapy for accelerated partial breast irradiation either frail patients with early-stage disease or in locally recurrent breast cancer

Salvatore Cozzi

,

Maria Laplana

,

Dina Najjari

,

Andrea Slocker

,

Xavier Encinas

,

Joan Pera

,

Ferran Guedea

,

Cristina Gutierrez

J Contemp Brachytherapy 2018; 10, 2: 97–104

DOI: https://doi.org/10.5114/jcb.2018.75594

Online publish date: 2018/04/30

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AMA

Cozzi S, Laplana M, Najjari D, et al. Advantages of intraoperative implant for interstitial brachytherapy for accelerated partial breast irradiation either frail patients with early-stage disease or in locally recurrent breast cancer. Journal of Contemporary Brachytherapy. 2018;10(2):97-104. doi:10.5114/jcb.2018.75594.

APA

Cozzi, S., Laplana, M., Najjari, D., Slocker, A., Encinas, X.,  & Pera, J. et al. (2018). Advantages of intraoperative implant for interstitial brachytherapy for accelerated partial breast irradiation either frail patients with early-stage disease or in locally recurrent breast cancer. Journal of Contemporary Brachytherapy, 10(2), 97-104. https://doi.org/10.5114/jcb.2018.75594

Chicago

Cozzi, Salvatore, Maria Laplana, Dina Najjari, Andrea Slocker, Xavier Encinas, Joan Pera,  and Ferran Guedea et al. 2018. "Advantages of intraoperative implant for interstitial brachytherapy for accelerated partial breast irradiation either frail patients with early-stage disease or in locally recurrent breast cancer". Journal of Contemporary Brachytherapy 10 (2): 97-104. doi:10.5114/jcb.2018.75594.

Harvard

Cozzi, S., Laplana, M., Najjari, D., Slocker, A., Encinas, X., Pera, J., Guedea, F.,  and Gutierrez, C. (2018). Advantages of intraoperative implant for interstitial brachytherapy for accelerated partial breast irradiation either frail patients with early-stage disease or in locally recurrent breast cancer. Journal of Contemporary Brachytherapy, 10(2), pp.97-104. https://doi.org/10.5114/jcb.2018.75594

MLA

Cozzi, Salvatore et al. "Advantages of intraoperative implant for interstitial brachytherapy for accelerated partial breast irradiation either frail patients with early-stage disease or in locally recurrent breast cancer." Journal of Contemporary Brachytherapy, vol. 10, no. 2, 2018, pp. 97-104. doi:10.5114/jcb.2018.75594.

Vancouver

Cozzi S, Laplana M, Najjari D, Slocker A, Encinas X, Pera J et al. Advantages of intraoperative implant for interstitial brachytherapy for accelerated partial breast irradiation either frail patients with early-stage disease or in locally recurrent breast cancer. Journal of Contemporary Brachytherapy. 2018;10(2):97-104. doi:10.5114/jcb.2018.75594.

Purpose
To describe the intraoperative multicatheter implantation technique for accelerated partial breast irradiation (APBI) delivered with high-dose-rate brachytherapy (HDR-BT). Secondarily, to evaluate outcomes and toxicity in a series of 83 patients treated with this technique at our institution.

Material and methods
Retrospective analysis of a series of patients treated with HDR-BT APBI after intraoperative multicatheter interstitial implant between November 2006 and June 2017 at our institution. We assessed cosmesis, toxicity, overall survival (OS), and disease-free survival (DFS).

Results
Eighty-three patients were included: 59 patients (71.1%) with primary early-stage breast cancer and 24 (28.9%) with locally recurrent breast cancer. Tumorectomy was performed in all cases, with intraoperative tumor margin assessment and sentinel node biopsy. Median age was 82 years (range, 44-92). The total prescribed dose was 32 Gy (8 treatment fractions) in 60 patients (72.3%), and 34 Gy (10 fractions) in 23 patients (27.7%). Median follow-up was 40 months (range, 1-136 months). Three-year OS and DFS in the recurrent and primary cancer groups were 87% vs. 89%, and 96 % vs. 97.8%, respectively. Five patients died from non-cancer related causes. No local relapses were observed. Rates of acute and late toxicity were low in both groups. The cosmesis was good or excellent in most of patients treated for primary disease; in patients who underwent salvage brachytherapy for local recurrence, cosmesis was good in 49 patients and fair in 6.

Conclusions
This technique, although time-consuming, achieves good local disease control with a satisfactory toxicity profile in both early-stage and local recurrent breast cancer patients. It may be especially suitable for frail patients.

keywords:

Advantages of intraoperative implant for interstitial brachytherapy for accelerated partial breast irradiation either frail patients with early-stage disease or in locally recurrent breast cancer

Salvatore Cozzi , Maria Laplana , Dina Najjari , Andrea Slocker , Xavier Encinas , Joan Pera , Ferran Guedea , Cristina Gutierrez

APBI, brachytherapy, breast cancer, intraoperative, multicatheter technique, relapse, second treatment

Salvatore Cozzi

,

Maria Laplana

,

Dina Najjari

,

Andrea Slocker

,

Xavier Encinas

,

Joan Pera

,

Ferran Guedea

,

Cristina Gutierrez