The prognosis of patients with localized NHL involving the thyroid gland appears to be very good, especially when CMT is used. Distant recurrences appear to account for the majority of treatment failures. The IPI was found to be a significant prognostic factor for OS and a marginal one for FFS.
182 Background: The initial single-lumen Mammosite trial has shown that skin spacing had an important implication on cosmetic outcomes. In this study, we reviewed the patients who were treated with APBI using multilumen catheter and assessed the outcomes for patients with minimal TBS of ≤ 7mm. Methods: Between August 2008 and April 2011, 79 patients were treated with breast-conserving therapy and adjuvant APBI using the Contura Multi-Lumen balloon or strut-adjusted volume implant (SAVI) device. All patients received 3,400 cGy in 10 fractions delivered twice daily using high dose rate radiation with Iridium 192. The dose was prescribed to 1 cm from the applicator surface. Thirty-six patients had a TBS of ≤ 7mm. We analyzed the clinical outcomes according to RTOG 9517 and skin toxicities as per RTOG 9804 in this patient subgroup. Results: The median age was 65 years (range, 50-86 years). All patients had Tis-T1N0 carcinomas; 39% had DCIS and the rest had invasive carcinoma. The majority (92%) were treated with Contura Multi-Lumen balloon and 8% with SAVI. Median follow-up was 18 months (range 6-42 months). The average TBS was 4.8 mm (range 1-7). 21 patients (57%) had a TBS of ≤ 5mm. The median maximal skin dose was 116% (range 82-134%). The median V90, V95 and V100 were 98%, 96% and 92% respectively. The average V150 and V200 were 31.2 and 9.6 cc respectively. At a median of 3 weeks after treatment, 95% of the patients had good to excellent cosmetic outcome. 54% had grade 1, 21% patients had grade 2 skin toxicity and 25% did not have any skin reaction. At last follow-up, 82% of the patients did not have any residual late skin reaction. Grade 1 skin toxicity was reported in 13%, and grade 2 in 1 patient. Cosmesis was excellent in 72% and good in 28% of the patients. There was no loco-regional recurrence. Conclusions: In our patient population, APBI proved to be an effective treatment with a good to excellent cosmetic outcome and acceptable toxicity. Further investigation with larger patient populations and longer follow-up is warranted to confirm the safety and efficacy of APBI for patients with small TBS.
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