Current status and perspectives of brachytherapy for breast cancer

Abstract

Before the era of breast-conserving therapy, brachytherapy implants were used to treat large inoperable breast tumors. In later years, interstitial brachytherapy with rigid needles or multiple flexible catheters has been used to deliver an additional (boost) dose to the tumor bed after breast-conserving surgery and whole-breast irradiation. Reexcision followed by reirradiation using interstitial breast implants has also been implemented as an alternative to mastectomy to treat ipsilateral breast local recurrence after previous breast-conserving therapy. In the past two decades, the new concept of accelerated partial breast irradiation opened a new perspective for breast brachytherapy. The first technique utilized in early accelerated partial breast irradiation studies was multicatheter interstitial brachytherapy. Beyond classical interstitial brachytherapy, recently, new intracavitary applicators have been developed in the United States to decrease the existing barriers against the widespread use of multicatheter brachytherapy. Furthermore, interstitial low-dose-rate seed implants have also been implemented as an alternative for stepping-source multicatheter brachytherapy. In this article, we give an overview of the past achievements, current status, and future perspectives of breast brachytherapy.

Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement

“…In this trial, patients younger than age 40 were excluded after 2001 because of an early analysis that reported unacceptably high IBTR risk in these patients. 2 At a median follow-up of 10.2 years, 5.5% had an in-breast recurrence, but no further analysis by age was done. 3 In the University of Florence trial, 15.8% of the 260 randomized to intensity modulated radiation therapy (IMRT) APBI were b50 years old.…”

Rapid, one-pot procedure to synthesise103Pd:Pd@Au nanoparticles en route for radiosensitisation and radiotherapeutic applications

“…Charge neutralisation was not applied for either analysis. The detection was performed at 45° with respect to the surface normal and the analysed area was 0.005 cm 2 . The spectrometer work function was adjusted to give 285.0 eV for the main C (1s) peak.…”

“…[1][2][3][4] In such procedures, the permanent seed implants (5 mm) containing low-energy gamma photon emitters, are directly inserted in tumours, where they deliver a radiotherapeutic dose during a prolonged period of time. In this application, the radioisotope 103 Pd is widely used.…”

Partial-Breast Irradiation or Whole-Breast Radiotherapy for Early Breast Cancer: a Meta-Analysis of Randomized Trials

“…However, the necessity of giving WBI to all patients after BCS has been questioned, and several centers have evaluated the feasibility and efficacy of partial-breast irradiation (PBI) [1,2,4,5,7,[9][10][11]14]. Parallel with the growing evidence obtained from phase I-II studies supporting the use of PBI for selected early stage breast cancer patients, three early phase III trials comparing different techniques of PBI to conventional WBI have been conducted in the early 1980s and 1990s [3,6,8,12].…”

“…On the contrary, in the Hungarian phase III PBI study (conducted between 1998 and 2004) the boundaries of the excision cavity were marked with titanium clips and a preimplant radiographic simulation was performed in order to determine planning target volume (PTV) [8,9,11]. The PTV was defined as the excision cavity (delineated by the surgical clips) plus a margin of 1-2 cm.…”