Accelerated partial breast irradiation using multicatheter brachytherapy for select early-stage breast cancer: local control and toxicity

Yeo, Seung‐Gu; Kim, Juree; Kwak, Geum-Hee; Kim, Jiyoung; Park, Kyeongmee; Kim, Eun Seok; Han, Sehwan

doi:10.1186/1748-717x-5-56

Cited by 32 publications

(21 citation statements)

References 28 publications

(46 reference statements)

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“…We compared our study with a recent study conducted by Yeo et al [11]. The previous study included 10 patients with replacement of over three-quarters of normal liver by metastatic tumors and Child-Pugh classification B or C. The serum levels of AST, ALP, and TB were higher in the previous study (median of 118 IU/L, 583 IU/L, and 6.5 mg/dL, respectively) than in our study (median of 94 IU/L, 364 IU/L, and 2.6 mg/dL, respectively).…”

Section: Discussionmentioning

confidence: 99%

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Prognostic and predictive value of liver volume in colorectal cancer patients with unresectable liver metastases

Park

Choi

et al. 2014

Radiat Oncol J

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PurposeTo determine the prognostic and predictive value of liver volume in colorectal cancer patients with unresectable liver metastases.Materials and MethodsSixteen patients received whole liver radiotherapy (WLRT) between January 1997 and June 2013. A total dose of 21 Gy was delivered in 7 fractions.ResultsThe median survival time after WLRT was 9 weeks. In univariate analysis, performance status, serum albumin and total bilirubin level, liver volume and extrahepatic metastases were associated with survival. The mean liver volume was significantly different between subgroups with and without pain relief (3,097 and 4,739 mL, respectively; p = 0.002).ConclusionA larger liver volume is a poor prognostic factor for survival and also a negative predictive factor for response to WLRT. If patients who are referred for WLRT have large liver volume, they should be informed of the poor prognosis and should be closely observed during and after WLRT.

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Section: Discussionmentioning

confidence: 99%

“…The median dose was 21 Gy in 7 fractions. Four of 10 patients who had improvement in liver function after WLRT received further chemotherapy and showed better survival, with a mean survival time of 143 days [11]. …”

Section: Introductionmentioning

confidence: 99%

Prognostic and predictive value of liver volume in colorectal cancer patients with unresectable liver metastases

Park

Choi

et al. 2014

Radiat Oncol J

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“…However, compared with studies in European countries and the United States, few studies have evaluated this technique in Asian patients with breast cancer (Mitsumori, & Hiraoka, 2008;Yeo et al, 2010). To our knowledge, this is one of the largest prospective observational studies from Asia, demonstrating the feasibility of BCT using multicatheter brachytherapy and showing acceptable clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Individualized Case–Control Study of Accelerated Partial Breast Irradiation by Multicatheter Intertstitial Brachytherapy in Japanese Patients with Breast Cancer

Sato¹,

Mizuno²,

Fuchikami³

et al. 2013

CCO

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AbbreviationsBCS, breast-conserving surgery; WBI, whole-breast irradiation; APBI, accelerated partial breast irradiation; ICC, individualized case-control; CT, computed tomography; MRI, magnetic resonance imaging; IBTR, ipsilateral breast tumor recurrence. AbstractBackground: Breast-conserving surgery (BCS) followed by whole-breast irradiation (WBI) are the standard of care for treating early-stage breast cancer. The efficacy of accelerated partial breast irradiation (APBI) has recently been investigated as an alternative to WBI. Although we previously reported that multicatheter brachytherapy in APBI is feasible in Japanese patients, long-term data of several APBI techniques have not yet been obtained. Here we estimated the long-term efficacy of multicatheter brachytherapy in Japanese patients with breast cancer to validate its use an individualized case-control (ICC) analysis. Method: From October 2008 to March 2013, a total of 184 consequent patients with 188 tumors underwent BCS followed by multicatheter brachytherapy. A total of 120 consecutive patients (mean age, 55.1 years) with 122 tumors (pN0) who had at least 1 year of follow-up were enrolled in this analysis. Before lumpectomy, the insertion of applicators and delivery doses were simulated by computed tomography. After confirming the free margins and negative sentinel node metastases by frozen section analysis, the applicators were inserted. APBI therapy was initiated on the same day of surgery on the basis of the dose distribution analysis, at 32 Gy in 8 fractions over 5-6 days with a 2-cm tumor margin coverage. Regarding our prospective follow-up policy in this observational study, all patients had a predefined schedule including clinical examination every 3-4 months and mammography and breast magnetic resonance imaging (MRI) every 12 months. We performed ICC analysis to estimate the number of patients with ipsilateral breast tumor recurrence (IBTR). The 10-year risk of IBTR for each patient when undergoing with WBI was calculated using the web-based decision-making tool IBTR! and was adjusted during the real-time follow-up period using data obtained from an overview by the Early Breast Cancer Trialists' Collaborative Group. Results: The median follow-up period was 3.1 years (range, 1.1-4.4 years). Most tumors (92.6%) were ≤2 cm in diameter, and 89.4% were estrogen receptor-positive. Hormone therapy was administered in 86.7% and adjuvant chemotherapy in 20.0% patients. If all patients received WBI after BCS, we estimated www.ccsenet.org/cco Cancer and Clinical Oncology Vol. 2, No. 1; 2013 128 IBTR in this group to be 1.1-2.8. Although 1 IBTR was observed, no tumor bed recurrence was recorded. Conclusions: Although this study involved only a small number of patients and short follow-up period, only 1 IBTR case was recorded, which was within the estimated range of local recurrence. Multicatheter brachytherapy using this technique may offer the same rates of local control as WBI in Japanese patients.

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“…[3] Late toxicity of the skin and subcutaneous tissue was scored according to the Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer late radiation morbidity scoring scheme. [4,6] …”

Section: Methodsmentioning

confidence: 99%

“…Besides BT has the added advantage of partial breast irradiation (PBI) sparing lots of normal tissue from unnecessary irradiation with shortened duration of treatment. [4][5][6] With this background, our experience in the long term follow-up are discussed. In BCT besides organ preservation, cosmesis is considered an important factor.…”

Section: Introductionmentioning

confidence: 99%

Interstitial HDR Brachytherapy in BCT: A Case Series Study from a Single Institute

Nirpendra¹,

Singh²,

Sharma³

et al. 2017

Ann. Int. Med. Den. Res.

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Background: Radiotherapy (RT) plays an integral part in the management of breast cancer. In BCT there is 20% reduction in loco regional failure and 15 years breast cancer mortality reduction by 5% when RT is used as adjuvant therapy. Adjuvant radiation therapy can be delivered by External Beam Radiotherapy (EBRT) with brachytherapy (BT) or BT alone. Aims: Loco regional control of disease with good cosmesis. Primary end point is loco regional failure. Methods: A total of 30 cases of early breast cancers (T1, T2 N0M0) treated during May 2008 to Dec 2012 and followed up till July 2015 were studied. External radiation dose of 45 to 50 Gy by Telecobalt-60 followed by boost implant BT with dose of 15 to 20Gy in 3 to 4 fractions was used (BED = 84.4 ± 1.1 Gy) for combined external plus BT as per departmental protocol. A total of 30 Gy in 6 fractions was used (BED = 47.8 Gy) for BT alone as per departmental protocol. Ir-192 Micro selectron HDR rigid needle template or flexible catheter implant to primary site was used. Dosimetry was done with Plato sunrise treatment planning System. Results: Age ranges from 23 to 50 years. Median follow up was 54 months. None had local recurrence. Only 1 had mild needle wound sepsis and all had good to excellent acceptable cosmetic results. Radiation skin reaction and sub cutaneous fibrosis were grade I and 2. Three had disease recurrence at distant sites and one patient had moderate telangiectasia at the irradiated site. Conclusion: BCT with EBRT and HDR BT boost or HDR BT alone has shown good results in both loco regional control of disease with good to excellent cosmesis.

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Accelerated partial breast irradiation using multicatheter brachytherapy for select early-stage breast cancer: local control and toxicity

Cited by 32 publications

References 28 publications

Prognostic and predictive value of liver volume in colorectal cancer patients with unresectable liver metastases

Prognostic and predictive value of liver volume in colorectal cancer patients with unresectable liver metastases

Individualized Case–Control Study of Accelerated Partial Breast Irradiation by Multicatheter Intertstitial Brachytherapy in Japanese Patients with Breast Cancer

Interstitial HDR Brachytherapy in BCT: A Case Series Study from a Single Institute

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