Uncertainty of cosmetic evaluation after accelerated partial breast irradiation: interim analysis of a Japanese prospective multi-institutional feasibility study

Yoden, Eisaku; Nose, Takayuki; Otani, Yuki; Asahi, Shuuji; Tsukiyama, Iwao; Dokiya, Takushi; Sendo, Toshiaki; Fukuda, Ichirou; Shinmoto, Hiroshi; Shikama, Naoto; Kumazaki, Yu; Takahashi, Tsuyoshi; Yoshida, Ken; Kotsuma, Tadayuki; Masuda, Norikazu; Nakashima, Kenichiro; Matsumura, Taisei; Nakagawa, Shino; Tachiiri, Seiji; Moriguchi, Yoshio; Itami, Jun; Oguchi, Masahiko

doi:10.1007/s11604-017-0640-0

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…In Korea (37) and our previous report (27) regarding MIB-PBI, excellent or good cosmetic outcomes were achieved in 89.6% and 90.1%, respectively, because target volume was strictly limited, as the V 100 was 44.7 and 43.7 cm 3 , respectively. In a Japanese study involving a larger radiation volume, 70% of the patients achieved an excellent or good cosmesis, while Grade 2 or 3 breast fibrosis was observed in 26.1% of the patients (38,39). However, only Grade 2 breast fibrosis was observed in 2.5% patients in the Singaporean study also targeting a larger volume (40).…”

Section: Discussionmentioning

confidence: 93%

Predicting adherence of dose–volume constraints for personalized partial-breast irradiation technique

et al. 2021

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PURPOSE: Multicatheter interstitial brachytherapy (MIB) and external-beam (EB) radiotherapy are established partial-breast irradiation (PBI) techniques. Although EB-PBI is widely available, it requires extra irradiated margins for target uncertainties. We examined the impact of EB-PBI on doseevolume constraints as compared to MIB-PBI. METHODS AND MATERIALS: Among 653 patients receiving MIB-PBI between October 2008 and April 2020, consequent 159 patients after September 2018 were examined. Clinical target volume (CTV) included the lumpectomy cavity plus 1.0 cm. Planning target volume (PTV) for EB-PBI was defined as CTV with 1.0-cm expansion. Because the ratio of PTV to breast volume (RPB) was related to cosmesis, !25% of RPB was defined as suitable for the ipsilateral breast constraints. Preoperative breast size was classified as very small (!350 cm 3 ), small (350e699 cm 3 ), and medium or large ($700 cm 3 ). According to each category, the doseevolume constraints of the organs at risk were compared between the two PBI techniques. RESULTS: Patients including 84 very small, 59 small, and 16 moderate to large breasts were examined. Although RPB was suitable in all patients receiving MIB-PBI, it was achieved in 74 patients (46.5%) receiving EB-PBI ( p ! 0.0001). The suitable RPB in patients with very small, small, and moderate to large breast was 32.1%, 55.9%, and 100%, respectively ( p ! 0.0001). Normaltissue constraints for the other organs could be satisfied in patients with moderate to large breasts. CONCLUSION: Although EB-PBI may be an appropriate option for patients with moderate to large breasts, MIB-PBI could still be a crucial technique, especially for patients with small breasts.

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Section: Discussionmentioning

confidence: 93%

Predicting adherence of dose–volume constraints for personalized partial-breast irradiation technique

et al. 2021

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“…However, the complication rate was higher, with overall 16% of wound complications and 4% of rib fractures. Based on these preliminary results, we conducted the first multi-institutional prospective study in Japan using 36 Gy in six fractions [11], with a LC rate of 100% at a short-term follow-up of median 42 months [12]. At present, the longest follow-up MIB results in Japan were reported by Sato et al The authors reported on 516 MIB patients using a dose-fraction schedule of 32 Gy in eight fractions, achieving a LC rate of 97.5% with a median follow-up of 53.1 months [13].…”

Section: Purposementioning

confidence: 99%

HDR-brachytherapy for accelerated partial breast irradiation: Long-term experience from a Japanese institution

Yoshida¹,

Kotsuma²,

Takaoka³

et al. 2023

jcb

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Purpose We investigated the long-term oncological outcome of high-dose-rate (HDR) multicatheter interstitial brachytherapy (MIB) for adjuvant accelerated partial breast irradiation (APBI) after breast conserving surgery in Japanese patients. Material and methods Between June 2002 and October 2011, 86 breast cancer patients were treated at National Hospital Organization Osaka National Hospital (trial number of the local institutional review board, 0329). Median age was 48 years (range, 26-73 years). Eighty patients had invasive and 6 patients non-invasive ductal carcinoma. Tumor stage distribution was pT0 in 2, pTis in 6, pT1 in 55, pT2 in 22, and pT3 in one patient, respectively. Twenty-seven patients had close/positive resection margins. Total physical HDR dose was 36-42 Gy in 6-7 fractions. Results At a median follow-up of 119 months (range, 13-189 months), the 10-year local control (LC) and overall survival rate was 93% and 88%, respectively. Concerning the 2009 Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology risk stratification scheme, the 10-year LC rate was 100%, 100%, and 91% for patients considered as low-risk, intermediate-risk, and high-risk, respectively. According to the 2018 American Brachytherapy Society risk stratification scheme, the 10-year LC rate was 100% and 90% for patients ‘acceptable’ and ‘unacceptable’ for APBI, respectively. Wound complications were observed in 7 patients (8%). Risk factors for wound complications were the omission of prophylactic antibiotics during MIB, open cavity implantation, and V 100 ≥ 190 cc. No grade ≥ 3 late complications (CTCVE version 4.0) were observed. Conclusions Adjuvant APBI using MIB is associated with favorable long-term oncological outcomes in Japanese patients for low-risk, intermediate-risk, and acceptable groups of patients.

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“…83,84 Similar outcomes have been seen in smaller institutional series as well, with multilumen and strut applicators demonstrating the potential for improved toxicity profiles. [85][86][87][88][89][90] Outcomes for patients with ductal carcinoma in situ (DCIS) treated with applicator brachytherapy have been evaluated; although smaller studies suggested potentially increased rates of IBTR, the MammoSite Registry data demonstrated low rates of local recurrence in patients with DCIS. 84,91 Although traditionally delivered in 8 to 10 fractions over 4 to 5 days, shorter regimens with applicator brachytherapy have been evaluated.…”

Section: Ultrashort Partial Breast Irradiationmentioning

confidence: 99%

Delivery of Adjuvant Radiation in 5 Days or Less After Lumpectomy for Breast Cancer: A Systematic Review

Vicini

Broughman

Halima

et al. 2022

International Journal of Radiation Oncology*Biology*Physics

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Uncertainty of cosmetic evaluation after accelerated partial breast irradiation: interim analysis of a Japanese prospective multi-institutional feasibility study

Abstract: UMIN000001677.

Cited by 7 publications

References 22 publications

Predicting adherence of dose–volume constraints for personalized partial-breast irradiation technique

Predicting adherence of dose–volume constraints for personalized partial-breast irradiation technique

HDR-brachytherapy for accelerated partial breast irradiation: Long-term experience from a Japanese institution

Delivery of Adjuvant Radiation in 5 Days or Less After Lumpectomy for Breast Cancer: A Systematic Review

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