Efficacy of single-stage breast-conserving treatment using multicatheter partial breast brachytherapy evaluated by GEC-ESTRO phase 3 trial.
Conclusions: Single-stage BCT using MCB-PBI offered similar tumor control rates compering to WBI. However, further research is needed to define the benefit for patients with an exclusion criteria. PMID: 29204163 [PubMed]
Breast conserving surgery followed by postoperative breast irradiation is the treatment of choice for early stage breast cancers. Four phase III trials have demonstrated equal survival and non-inferior local tumor control with partial breast irradiation (PBI) in comparison to standard 5-6 week whole breast irradiation (WBI) in appropriately selected patients. Less favorable tumor biology is associated with higher local and systemic failures with all local therapy options. Current Next Generation Sequencing assays have empowered in-depth signatures of these cancers, providing hope for further customization of care.
Permanent breast seed implant (PBSI) is a novel brachytherapy technique in which 103Pd seeds are implanted in and around the seroma cavity following breast-conserving surgery. There are institutional reports of post-implant seed positional accuracy but additional classifying information of the implant geometry, including needle trajectory and impact of strand length, is unavailable. The purpose of this study is to characterize post-implant seed positional accuracy and implanted needle trajectory according to the anatomical location of the implanted seed and to develop a robust geometric analysis methodology for inclusion i...
To improve breast cosmetic outcome and prevent post-operative complications including seroma, breast conserving surgery (BCS) often includes oncoplastic techniques and more specifically full-thickness closure (FTC). This creates challenges for radiotherapy target definition when a boost is planned or partial breast irradiation is needed. Our team showed that the target definition FTC is inaccurate, with a median conformity index (Cx) of 0.44. We hypothesize that injection of a radiopaque hydrogel in the lumpectomy cavity before FTC can reduce inter-observer variability.
To report the long-term results of 449 patients treated with APBI using interstitial multicatheter high-dose-rate brachytherapy (HDR-BT) after breast-conserving surgery in a single institution.
Following breast conserving surgery, accelerated partial breast irradiation (APBI) is a convenient alternative that allows for reduced normal tissue irradiation as compared to whole breast RT. Toxicity from APBI is related to dose-volume parameters. Non-invasive image-guided breast brachytherapy (NIBB) APBI is associated with reductions in target volumes and normal tissue dose-volume histogram parameters compared to 3D-APBI. Delivery of 3D-APBI in the preoperative (preop) setting allows for reductions in target volumes and sparing of normal tissue.
A series of clinical trials and prospective studies investigating intraoperative radiation therapy as a safe modality following breast conserving surgery has led to single institution studies of electronic brachytherapy for low risk breast cancer patients. Despite minimal data on the clinical effectiveness of electronic brachytherapy as a safe modality or alternative to whole breast radiation following breast conserving surgery, the adoption of this technology appears to account for the rise in intraoperative radiation therapy in the 21st century.
Outcomes for ductal carcinoma in situ (DCIS) treated with breast-conserving therapy using accelerated partial breast irradiation (APBI) with interstitial multicatheter brachytherapy are reported by a cooperative multi-institutional group.
Breast conserving therapy is frequently used to treat early stage breast cancer but the protracted length of whole breast irradiation has made it an unattractive option for some patients. Accelerated partial breast irradiation (APBI) is used to treat the lumpectomy cavity alone in a shorter amount of time, conventionally in 10 fractions twice daily over 5 days. The SenoRx study opened by Contura, was a multi-site prospective phase II non-randomized dose-escalation trial for APBI using a multi-lumen balloon 3 or 4 fractions over 2 days.
The composite therapy concept consisting of breast-conserving surgery (BCS) followed by whole-breast irradiation (WBI) is an appropriate and established therapy for UICC (Union International Cancer Centre) Stage I and II breast cancer (BC) according to several mature randomized trials: Protocol B-06, the Milan trial, and EORTC 10801 trial. In addition, the recently published randomized GEC-ESTRO trial demonstrated equivalence between the established WBI and the concept of accelerated partial breast irradiation (APBI) by interstitial multicatheter brachytherapy (mBT) in low-risk early breast cancer.
Breast cancer typically represents ∼30% of patients under treatment in a radiation oncology department. Currently, there are 2 options for breast conservation therapy in early stage breast cancer: 5 weeks of whole breast irradiation (WBI) plus a 1 week electron beam boost to the original tumor site, or 5-day 10-fraction accelerated partial breast irradiation (APBI). We studied how a shift in the distribution breast cancer treatments would influence departmental operations and revenues.