eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
Current Issue Archive Supplements Articles in Press Journal Information Aims and Scope Editorial Office Editorial Board Register as Author Register as Reviewer Instructions for Authors Abstracting and indexing Subscription Advertising Information Links
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Search
5/2022
vol. 14
 
Share:
Send email
Share:
abstract:
Original paper

Predictors of poor cosmesis in breast cancer patients treated with adjuvant whole breast radiation therapy plus high-dose-rate interstitial brachytherapy boost after breast conservation surgery

Nasim Feizi
1
,
Shole Arvandi
1
,
Maryam Feli
2
,
Fatemeh Mohammadian
2
,
Ziba Zahiri
1
,
Azin Shamsi
1
,
Ali Bagheri
2

  1. Department of Radiation Oncology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  2. Interventional Radiotherapy Ward, Department of Radiation Oncology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
J Contemp Brachytherapy 2022; 14, 5: 429–437
DOI: https://doi.org/10.5114/jcb.2022.121403
Online publish date: 2022/11/21
View full text Get citation
 
Purpose
To identify patient, tumor, and treatment-related factors, which predict cosmesis in breast cancer survivors treated with adjuvant whole breast irradiation (WBI) plus high-dose-rate (HDR) multicatheter interstitial brachytherapy (MIBT) boost after breast conservation surgery.

Material and methods
At least 12 months after completion of radiotherapy, cosmetic outcomes were measured both objectively with BCCT.core software (using a front view digital photograph), and subjectively according to Harvard’s criteria. MIBT dose fractionation regimen was 13.6 Gy/4 fractions (bid). To evaluate the correlation between cosmetic scores and dose-volume histogram (DVH) parameters, WBI and MIBT plans were retrospectively analyzed, and ipsilateral skin and breast biologically equivalent dosimetric indices were recorded (α/β = 3 Gy). A multivariate ordinal logistic regression model was used for statistical analysis.

Results
Twenty-eight consecutive patients were enrolled into this study. The median time from completion of radiation therapy to cosmesis scoring was 18 months. In evaluation with BCCT.core software, no patient was scored as excellent. Cosmesis was good in 18%, fair in 50%, and poor in 32% of patients. According to Harvard’s scale, 10.5% of patients had excellent cosmesis, and 43%, 28.5%, and 18% of patients had good, fair, and poor scores, respectively. In univariate analysis, patients with higher absolute MIBT V29Gy (cc), those treated with irradiation of regional lymphatics (odds ratio ≈ 5), and patients with larger breast volumes had statistically significant lower Harvard’s scores. In the multivariate model, none of the mentioned factors remained statistically significant, except for a trend for poorer cosmesis in patients with higher absolute MIBT V29Gy (p-value = 0.066).

Conclusions
Based on the results of this study, MIBT breast V29Gy, regional nodal irradiation, and larger breast volumes are the potential factors, which could predict cosmesis.

keywords:

radiation therapy, breast cancer, brachytherapy, boost, cosmetic outcome

  
Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2024 Termedia Sp. z o.o.
Developed by Bentus.