Pulsed-dose-rate peri-operative brachytherapy as an interstitial boost in organ-sparing treatment of breast cancer
Identifieur interne : 000C13 ( Main/Exploration ); précédent : 000C12; suivant : 000C14Pulsed-dose-rate peri-operative brachytherapy as an interstitial boost in organ-sparing treatment of breast cancer
Auteurs : Krystyna Serkies ; Janusz Ja Kiewicz [Pologne] ; Rafał Dziadziuszko ; Jacek JassemSource :
- Journal of Contemporary Brachytherapy [ 1689-832X ] ; 2016.
Abstract
To evaluate peri-operative multicatheter interstitial pulsed-dose-rate brachytherapy (PDR-BT) with an intra-operative catheter placement to boost the tumor excision site in breast cancer patients treated conservatively.
Between May 2002 and October 2008, 96 consecutive T1-3N0-2M0 breast cancer patients underwent breast-conserving therapy (BCT) including peri-operative PDR-BT boost, followed by whole breast external beam radiotherapy (WBRT). The BT dose of 15 Gy (1 Gy/pulse/h) was given on the following day after surgery.
No increased bleeding or delayed wound healing related to the implants were observed. The only side effects included one case of temporary peri-operative breast infection and 3 cases of fat necrosis, both early and late. In 11 patients (11.4%), subsequent WBRT was omitted owing to the final pathology findings. These included eight patients who underwent mastectomy due to multiple adverse prognostic pathological features, one case of lobular carcinoma
Peri-operative PDR-BT boost with intra-operative tube placement followed by EBRT is feasible and devoid of considerable toxicity, and provides excellent long-term local control. However, this strategy necessitates careful patient selection and histological confirmation of primary diagnosis.
Url:
DOI: 10.5114/jcb.2016.64512
PubMed: 28115954
PubMed Central: 5241379
Affiliations:
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type="main">Pulsed-dose-rate peri-operative brachytherapy as an interstitial boost in organ-sparing treatment of breast cancer</title><author><name sortKey="Serkies, Krystyna" sort="Serkies, Krystyna" uniqKey="Serkies K" first="Krystyna" last="Serkies">Krystyna Serkies</name><affiliation><nlm:aff id="aff0001">Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk</nlm:aff><wicri:noCountry code="subfield">Gdańsk</wicri:noCountry></affiliation></author><author><name sortKey="Ja Kiewicz, Janusz" sort="Ja Kiewicz, Janusz" uniqKey="Ja Kiewicz J" first="Janusz" last="Ja Kiewicz">Janusz Ja Kiewicz</name><affiliation wicri:level="1"><nlm:aff id="aff0002">Department of Plastic Surgery, Medical University of Gdańsk, Gdańsk, Poland</nlm:aff><country xml:lang="fr">Pologne</country><wicri:regionArea>Department of Plastic Surgery, Medical University of Gdańsk, Gdańsk</wicri:regionArea><wicri:noRegion>Gdańsk</wicri:noRegion></affiliation></author><author><name sortKey="Dziadziuszko, Rafal" sort="Dziadziuszko, Rafal" uniqKey="Dziadziuszko R" first="Rafał" last="Dziadziuszko">Rafał Dziadziuszko</name><affiliation><nlm:aff id="aff0001">Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk</nlm:aff><wicri:noCountry code="subfield">Gdańsk</wicri:noCountry></affiliation></author><author><name sortKey="Jassem, Jacek" sort="Jassem, Jacek" uniqKey="Jassem J" first="Jacek" last="Jassem">Jacek Jassem</name><affiliation><nlm:aff id="aff0001">Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk</nlm:aff><wicri:noCountry code="subfield">Gdańsk</wicri:noCountry></affiliation></author></analytic><series><title level="j">Journal of Contemporary Brachytherapy</title><idno type="ISSN">1689-832X</idno><idno type="eISSN">2081-2841</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="s1"><title>Purpose</title><p>To evaluate peri-operative multicatheter interstitial pulsed-dose-rate brachytherapy (PDR-BT) with an intra-operative catheter placement to boost the tumor excision site in breast cancer patients treated conservatively.</p></sec><sec id="s2"><title>Material and methods</title><p>Between May 2002 and October 2008, 96 consecutive T1-3N0-2M0 breast cancer patients underwent breast-conserving therapy (BCT) including peri-operative PDR-BT boost, followed by whole breast external beam radiotherapy (WBRT). The BT dose of 15 Gy (1 Gy/pulse/h) was given on the following day after surgery.</p></sec><sec id="s3"><title>Results</title><p>No increased bleeding or delayed wound healing related to the implants were observed. The only side effects included one case of temporary peri-operative breast infection and 3 cases of fat necrosis, both early and late. In 11 patients (11.4%), subsequent WBRT was omitted owing to the final pathology findings. These included eight patients who underwent mastectomy due to multiple adverse prognostic pathological features, one case of lobular carcinoma <italic>in situ</italic>, and two cases with no malignant tumor. With a median follow-up of 12 years (range: 7-14 years), among 85 patients who completed BCT, there was one ipsilateral breast tumor and one locoregional nodal recurrence. Six patients developed distant metastases and one was diagnosed with angiosarcoma within irradiated breast. The actuarial 5- and 10-year disease free survival was 90% (95% CI: 84-96%) and 87% (95% CI: 80-94%), respectively, for the patients with invasive breast cancer, and 91% (95% CI: 84-97%) and 89% (95% CI: 82-96%), respectively, for patients who completed BCT. Good cosmetic outcome by self-assessment was achieved in 58 out of 64 (91%) evaluable patients.</p></sec><sec id="s4"><title>Conclusions</title><p>Peri-operative PDR-BT boost with intra-operative tube placement followed by EBRT is feasible and devoid of considerable toxicity, and provides excellent long-term local control. 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uniqKey="Grantzau T">T Grantzau</name></author><author><name sortKey="Overgaard, J" uniqKey="Overgaard J">J Overgaard</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mery, Cm" uniqKey="Mery C">CM Mery</name></author><author><name sortKey="George, S" uniqKey="George S">S George</name></author><author><name sortKey="Bertagnolli, Mm" uniqKey="Bertagnolli M">MM Bertagnolli</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Pologne</li></country></list><tree><noCountry><name sortKey="Dziadziuszko, Rafal" sort="Dziadziuszko, Rafal" uniqKey="Dziadziuszko R" first="Rafał" last="Dziadziuszko">Rafał Dziadziuszko</name><name sortKey="Jassem, Jacek" sort="Jassem, Jacek" uniqKey="Jassem J" first="Jacek" last="Jassem">Jacek Jassem</name><name sortKey="Serkies, Krystyna" sort="Serkies, Krystyna" uniqKey="Serkies K" first="Krystyna" last="Serkies">Krystyna Serkies</name></noCountry><country name="Pologne"><noRegion><name sortKey="Ja Kiewicz, Janusz" sort="Ja Kiewicz, Janusz" uniqKey="Ja Kiewicz J" first="Janusz" last="Ja Kiewicz">Janusz Ja Kiewicz</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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