Neoplasma Vol.52, p.292-296, 2005
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| Title: Pilot study of sole conformal peroperative interstitial
brachyradiotherapy of early stage breast carcinoma using high-dose
rate afterloading*
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| Author: P., SLAMPA
; R., SOUMAROVA
; J., RUZICKOVA
; V., CHRENKO
; V., FAIT
; R., BARTLOVA
; H., TICHA
; J., ZALOUDIK
; |
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Abstract: In this study of high-dose-rate brachyradiotherapy to the
lumpectomy site as the sole radiation are documented a three-
dimensional
treatment planning and preliminary results of accelerated partial-
breast irradiation. From March 2002 to July
2004 25 patients were prospectively included in this study. Six
patients were excluded becuase of definitive histology of
lobular carcinoma or positive margin. The median age was 63.2
years (range: 44–77 years). Median follow-up of all patients
is 11 months (range: 3–25 months) with a minimum follow-up of 3
months. Radiation was delivered using the high-dose-rate
remote afterloader VariSource with 192Ir source. The patients
received radiation twice a day at least 6 hours apart for a total
of 10 fractions over five days with a single dose of 3.4 Gy. The
total dose was 34.0 Gy prescribed as a minimum peripheral
dose to match or minimally exceed the volume defined by the
surgical clips as seen on CT scans. Freehand technique allows
conformal placement of the catheters to the shape of the
lumpectomy cavity. We use the method of geometric optimalisation
which allows the calculations of dose distribution in relation to
target. At a median follow-up of 11 months none of patients
developed in-field breast recurrences, one patient had out-of-
field recurrences. There were no regional nodal recurrences. At
each patient, there was calculated target volume size in cm3
(median 91.3 cm3) dose volume histogram (DVH), dose
homogenity index (DHI). Median DHI was 0.42. Median volume of
breast tissue getting 100% of the prescription dose,
V100, is 87%; and V15048.5%. We have noticed two treatment
complications: hematoma and abscess in the place of tumorous
bed after exstirpation. At last follow-up, patients rated the
overall cosmetic outcome excellent.
This method is suitable just for patients with histologically
confirmed small tumors (<3 cm in diameter) without negative
prognostic factors for local recurrence (age at least 40 years,
negative surgical margins, nodal involvement – maximum
three positive nodes without extracapsular extension).
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| Keywords: breast cancer, radiotherapy, peroperative radiation, interstitial
brachytherapy
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| Year: 2005, Volume: 52, Issue: |
Page From: 292, Page To: 296 |
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