Abstract
Purpose
This is a multicenter Phase I–II trial endorsed by the GEC-ESTRO Breast Working Group,
to analyze if very accelerated partial breast irradiation (VAPBI) with multicatheter
interstitial brachytherapy is feasible and safe compared with the standard APBI treatment
in 4–5 days for early stage breast carcinomas.
Methods and Materials
We have included 81 patients with pT1-2 pN0 invasive carcinomas after breast-conserving
surgery. Between August 2017 and July 2019, 33 women received high-dose-rate brachytherapy,
four fractions of 6.25 Gy in 2–3 days, and 48 patients received three fractions of
7.45 Gy in 2 days. Thirty-six patients were implanted perioperatively and 45 postoperatively.
Mean age was 68 (51–90). Free surgical margins were of 2 mm or greater.
Results
Acute effects were 11% dermatitis, 18.5% hematoma, 3.7% infection, and 14.8% pain.
At a median followup of 20 months (range 8–35), no relapse has occurred. Pigmentation
changes in the entrance and exit of tubes were visible in 16%, but 1 year later, few
cases remained. Patients developed G1-2 induration or fibrosis in 18.5% and 2.5%,
respectively. No patient developed telangiectasia. The cosmetic outcome was good/excellent
in 97.5% and fair in 2.5%.
Conclusions
VAPBI with multicatheter interstitial brachytherapy using four fractions of 6.25 Gy
or three fractions of 7.45 Gy in two or 3 days is feasible. No excess has been observed
in acute effects. At a mean followup of 20 months, late side effects seem to be similar
to standard fractionation. VAPBI in two to 3 days is beneficial for the patients and
reduces the workload of the brachytherapy units.
Keywords
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Article info
Publication history
Published online: November 19, 2020
Accepted:
October 20,
2020
Received in revised form:
October 19,
2020
Received:
September 5,
2020
Footnotes
Disclosures: All authors have nothing to disclose.
Identification
Copyright
© 2020 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
