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Long-term outcomes of intraoperatively-placed applicator brachytherapy for rapid completion of breast conserving treatment: An analysis of a prospective registry data

BACKGROUND AND PURPOSE: To evaluate the long-term outcome of accelerated partial breast irradiation utilizing intraoperatively placed applicator-based brachytherapy (ABB) in early-stage breast cancer. MATERIALS AND METHODS: From our prospective registry, 223 patients with pTis-T2, pN0/pN1mic breast...

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Detalles Bibliográficos
Autores principales: Kim, Haeyoung, Hieken, Tina J., Abraha, Feven, Jakub, James W., Corbin, Kimberly S., Furutani, Keith M., Boughey, Judy C., Stish, Bradley J., Deufel, Christopher L., Degnim, Amy C., Shumway, Dean A., Ahmed, Safia K., Piltin, Mara A., Sandhu, Nicole P., Conners, Amy L., Ruddy, Kathryn J., Mutter, Robert W., Park, Sean S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10212787/
https://www.ncbi.nlm.nih.gov/pubmed/37251618
http://dx.doi.org/10.1016/j.ctro.2023.100639
Descripción
Sumario:BACKGROUND AND PURPOSE: To evaluate the long-term outcome of accelerated partial breast irradiation utilizing intraoperatively placed applicator-based brachytherapy (ABB) in early-stage breast cancer. MATERIALS AND METHODS: From our prospective registry, 223 patients with pTis-T2, pN0/pN1mic breast cancer were treated with ABB. The median treatment duration including surgery and ABB was 7 days. The prescribed doses were 32 Gy/8 fx BID (n = 25), 34 Gy/10 fx BID (n = 99), and 21 Gy/3 fx QD (n = 99). Endocrine therapy (ET) adherence was defined as completion of planned ET or ≥ 80% of the follow-up (FU) period. Cumulative incidence of ipsilateral breast tumor recurrence (IBTR) was estimated and influencing factors for IBTR-free survival rate (IBTRFS) were analyzed. RESULTS: 218/223 patients had hormone receptor-positive tumors, including 38 (17.0%) with Tis and 185 (83.0%) with invasive cancer. After a median FU of 63 months, 19 (8.5%) patients had recurrence [17 (7.6%) with an IBTR]. Rates of 5-year IBTRFS and DFS were 92.2% and 91.1%, respectively. The 5-year IBTRFS rates were significantly higher for post-menopausal women (93.6% vs. 66.4%, p = 0.04), BMI < 30 kg/m(2) (97.4% vs. 88.1%, p = 0.02), and ET-adherence (97.5% vs. 88.6%, p = 0.02). IBTRFS did not differ with dose regimens. CONCLUSIONS: Postmenopausal status, BMI < 30 kg/m(2), and ET- adherence predicted favorable IBTRFS. Our results highlight the importance of careful patient selection for ABB and encouragement of ET compliance.