Partial breast irradiation as second conservative treatment for local breast cancer recurrence

Hannoun‐Lévi, Jean‐Michel; Houvenaeghel, Gilles; Ellis, Steve; Teissier, É.; Alzieu, Claude; Lallement, M.; Cowen, D.

doi:10.1016/j.ijrobp.2004.05.035

Cited by 97 publications

(48 citation statements)

References 49 publications

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“…Although other authors have confirmed our findings using differing dose regimens [14,15] , our LDR trial represents the largest cohort to date treated with uniform dose and prescription parameters. Our mature data at 67.5 months mean follow up continue to support the use of LDR brachytherapy as an acceptable alternative standard of care in lieu of mastectomy.…”

Section: Discussionsupporting

confidence: 77%

“…The lone recurrence patient was treated with only 3000 cGy in the early arm of the study. These patients exhibited similar local control to that noted in the dose-escalation study of Hannoun-Levi et al [15] , which used the same dose limits. Currently, the Radiation Therapy Oncology Group (RTOG) has opened protocol 1014 to study partial breast re-treatment radiotherapy [16] .…”

Section: Introductionsupporting

confidence: 74%

“…We and other groups have reported our initial experience with retreatment low-dose rate interstitial brachytherapy (LDR) following IBTR [13][14][15] which demonstrated acceptable local control rates and cosmesis in properly selected patients.…”

Section: Introductionmentioning

confidence: 99%

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Mature follow-up of Low-dose rate interstitial brachytherapy following ipsilateral breast tumor recurrence in patients initially treated with breast conservation therapy

Trombetta

Julian

Kim

et al. 2012

JST

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Objective: To evaluate our mature follow-up data in women who have developed IBTR following conservation surgery and post-operative external radiotherapy retreated by lumpectomy followed by interstitial brachytherapy in lieu of salvage mastectomy. Methods:Between 1/1998 and 10/2006, twenty-two patients with TIS or T1 IBTR were offered interstitial low-dose rate brachytherapy following tumor re-excision as an alternative to salvage mastectomy. All patients had failed lumpectomy followed by standard postoperative external beam radiotherapy (range 5000-6480cGy). The recurrent tumors were excised with final margins of resection free of residual disease. Tumor bed implantation was then carried out with an interstitial technique utilizing 192 Iridium with the target volume consisting of the tumor bed plus a minimum 1.0 centimeter margin (minimum standard dose 4500cGy). Results:With a mean follow up of 67.5 months (range 17-115 months) Twenty-one of 22 patients maintained local control at the time of last follow-up or at the time of their death. The single patient who developed a second local recurrence was treated successfully with mastectomy. Three patients succumbed to systemic disease. Two patients developed localized skin breakdown. One patient developed a contralateral breast cancer. Long-term cosmetic results as defined by the Harvard cosmesis scale and the Allegheny General modification were acceptable. Conclusions:These long-term data suggest that lumpectomy followed by brachytherapy is feasible and may be an acceptable alternative to salvage mastectomy in patients who locally fail conservation breast therapy. The upcoming RTOG retreatment trial (RTOG 1014) should help define the role of repeat conservation therapy in IBTR.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionsupporting

confidence: 74%

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Mature follow-up of Low-dose rate interstitial brachytherapy following ipsilateral breast tumor recurrence in patients initially treated with breast conservation therapy

Trombetta

Julian

Kim

et al. 2012

JST

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“…Az ismételt emlőmegtartó műtét utáni reirradiáció té-májában a legtöbb közlemény a szövetközi sugárkezelés módszerének alkalmazásával született [35][36][37][38][39][40][41][42][43][44]. Ezen vizsgálatok eredményeit az 5. táblázatban foglaltuk ösz-sze.…”

Section: Eredeti Közleményunclassified

Második emlőmegtartó műtét és szövetközi sugárkezelés az emlődaganat lokális kiújulásának kezelésére. Ötéves eredmények

et al. 2018

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Second breast conserving therapy with perioperative high-dose-rate interstitial brachytherapy is a safe and feasible option for the management of ipsilateral breast tumor recurrences. Interstitial brachytherapy may decrease the risk of second local relapse with acceptable cosmetic results and low rate of late side effects. Hence, in selected cases it can provide a feasible alternative to salvage mastectomy. Orv Hetil. 2018; 159(11): 430-438.

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“…Brachytherapy is becoming more widespread in PBI after conservative surgery, in patients at low-risk earlystage breast cancer and there are even some reports of using brachytherapy for PBI in patients with isolated breast relapse (28)(29)(30).…”

Section: Introductionmentioning

confidence: 99%

Interstitial high-dose-rate brachytherapy after breast conserving surgery

Rulli¹,

Barberini²,

Scialpi³

et al. 2010

Oncol Rep

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Abstract. We evaluated local recurrence, toxicity rate and cosmetic outcome in 72 patients treated with high-doserate (HDR) brachytherapy after breast conserving surgery. HDR brachytherapy was administered: i) as partial breast irradiation (PBI) in 64 patients with low-risk early stage breast cancer, enrolled in a phase II prospective study; ii) as PBI after a second conservative surgery as treatment of local relapse in 3 patients; iii) for delivering a boost after whole breast external beam radiotherapy in 5 patients. Implantation was done during surgery (breast conserving or re-excision to achieve adequate surgical margins), with the wound open, or postoperatively. The implant was well tolerated in all patients, so no premature catheter removal was required. At a median follow-up of 32 months (range 5-52) no local recurrence has been observed. Toxicity was very low. Cosmetic outcome was excellent/good in a high percentage of patients. Our results suggest that PBI administered with HDR brachytherapy is feasible in selected patients with low risk early stage breast carcinoma. PBI seems feasible to repeat radiotherapy after a salvage breast conserving surgery for local relapse in a second attempt to preserve the breast.

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Partial breast irradiation as second conservative treatment for local breast cancer recurrence

Cited by 97 publications

References 49 publications

Mature follow-up of Low-dose rate interstitial brachytherapy following ipsilateral breast tumor recurrence in patients initially treated with breast conservation therapy

Mature follow-up of Low-dose rate interstitial brachytherapy following ipsilateral breast tumor recurrence in patients initially treated with breast conservation therapy

Második emlőmegtartó műtét és szövetközi sugárkezelés az emlődaganat lokális kiújulásának kezelésére. Ötéves eredmények

Interstitial high-dose-rate brachytherapy after breast conserving surgery

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