High-dose interstitial brachytherapy for accelerated partial-breast irradiation in clinical practice: Preliminary results from a tertiary cancer center in India

Abstract

Introduction: Over the past several years, there has been growing interest in the use of accelerated partial-breast irradiation (APBI) as an alternative to whole-breast radiation in properly selected patients. The use of multicatheter interstitial brachytherapy (MIB) for APBI is increasing due to better availability of expertise and experience than other forms of APBI. The use of APBI outside the framework of a clinical trial has markedly increased. We report the efficacy and safety of APBI through high-dose-rate (HDR) MIB for early-stage breast cancer. Materials and Methods: Between 2008 and 2017, 20 prospectively selected patients with early-stage breast cancer received APBI using MIB following breast-conserving surgery. The mean age was 62.85 years (range: 41–80). Mean size of the tumor was 2.04 cm. The dose of 34 Gy in 10 fractions given twice daily (3.4 Gy) over 5 days was delivered to the tumor bed plus a 2-cm margin. The mean follow-up was 57.75 months (range: 12–100). Ten (50%) patients received adjuvant chemotherapy. Thirteen (65%) patients received hormonal therapy. Results: A total of 18 (90%) patients reported having excellent-to-good cosmesis, while 2 (10%) had fair-to-poor cosmesis. All patients (100%) were clinically controlled at follow-up, i.e., no locoregional recurrence. Only three (15%) had distant metastasis on follow-up. Conclusion: APBI using HDR-MIB was associated with excellent local control, acceptable toxicity, and cosmesis for early-stage breast cancer patients.

Keywords

• Accelerated partial-breast irradiation
• breast cancer
• cosmesis