Strut-based accelerated partial breast irradiation: Report of treatment results for 250 consecutive patients at 5 years from a multicenter retrospective study

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• 作者：Catheryn Yashar¹ ; ^{cyashar@ucsd.edu} ; Deanna Attai² ; Ernest Butler³ ; John Einck¹ ; Steven Finkelstein⁴ ; Ben Han⁵ ; Robert Hong⁶ ; Lydia Komarnicky⁷ ; Maureen Lyden⁸ ; Constantine Mantz⁹ ; Serban Morcovescu¹⁰ ; Stephen Nigh¹¹ ; Kerri Perry¹² ; Jondavid Pollock³ ; Jay Reiff⁷ ; Daniel Scanderbeg¹ ; Margaret Snyder¹³ ; Robert Kuske¹³
• 关键词：Breast brachytherapy ; APBI ; Brachytherapy ; SAVI ; Strut based ; Strut ; Balloon based ; Multilumen ; Interstitial ; Breast conservation
• 刊名：Brachytherapy
• 出版年：2016
• 出版时间：November-December 2016
• 年：2016
• 卷：15
• 期：6
• 页码：780-787
• 全文大小：321 K
• 卷排序：15

文摘

This registry trial studied the long-term outcomes of women receiving accelerated partial breast irradiation (APBI) using strut-based applicators and reports on the local control, toxicity, and survival for the first 250 patients treated with this device.Methods and MaterialsPatients were treated using the strut-based brachytherapy device with conventional dose and fractionation of 34 Gy in 10 twice-daily fractions. Planning goals for the planning target volume were V90 > 90%, V150 < 50 cc, and V200 < 20 cc. Toxicity was graded based on the Common Terminology Criteria for Adverse Events v3.0. Recurrence rates were also calculated.ResultsMedian followup was 59.5 months for the 250 patients. Grade 2 or higher adverse events at any time for hyperpigmentation, induration, erythema, telangiectasia, breast pain, seroma, and fat necrosis were 0.4%, 3.0%, 3.0%, 3.0%, 3.9%, 4.8%, and 1.3%, respectively. The median V90 was 97%, V95 was 95.1%, V150 was 28.7 cc, and V200 was 14.2 cc. For those patients with a less than a 5-mm or 3-mm-skin bridge, the median skin max doses were 272 and 289 cGy, respectively. The 4-year actuarial recurrence rates for true recurrence/marginal miss and ipsilateral breast tumor recurrence were 2.3% and 3.6%, respectively. The 4-year actuarial rates for overall survival, cause-specific survival, and disease-free survival were 97%, 98%, and 92%, respectively.ConclusionsThe strut-based applicator was designed to simplify APBI compared to interstitial brachytherapy. This report confirms excellent tumor control and survival with low toxicity and supports the evidence that brachytherapy has less normal tissue toxicity than APBI with external beam irradiation.