open access

Vol 15, No 1 (2010)
Published online: 2010-01-01
Submitted:
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The role of high-dose-rate brachytherapy boost in breast-conserving therapy: Long-term results of the Hungarian National Institute of Oncology

Csaba Polgár, Levente Jánváry, Tibor Major, András Somogyi, Zoltán Takácsi-Nagy, Georgina Fröhlich, János Fodor
DOI: 10.1016/j.rpor.2010.01.002
·
Rep Pract Oncol Radiother 2010;15(1):1-7.

open access

Vol 15, No 1 (2010)
Published online: 2010-01-01
Submitted:

Abstract

Aim

To report the long-term results of high-dose-rate (HDR) brachytherapy (BT) boost for breast cancer patients treated with conservative surgery and radiotherapy.

Materials and methods

Between 1995 and 2007, 100 early-stage breast cancer patients received an HDR BT boost after conservative surgery and whole breast irradiation. Ten patients (10%) received a single-fraction HDR boost of 8–10.35[[ce:hsp sp="0.25"/]]Gy using rigid needles, while 90 (90%) were treated with a fractionated multi-catheter HDR BT boost. The latter consisted of 3[[ce:hsp sp="0.25"/]]×[[ce:hsp sp="0.25"/]]4[[ce:hsp sp="0.25"/]]Gy (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]19), 3[[ce:hsp sp="0.25"/]]×[[ce:hsp sp="0.25"/]]4.75[[ce:hsp sp="0.25"/]]Gy (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]70), and 2[[ce:hsp sp="0.25"/]]×[[ce:hsp sp="0.25"/]]6.4[[ce:hsp sp="0.25"/]]Gy (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]1). Breast cancer related events, cosmetic results and side effects were assessed.

Results

At a median follow-up time of 94 months (range: 8–152) only 7 (7%) ipsilateral breast failures were observed for a 5- and 8-year actuarial rate of 4.5 and 7.0%, respectively. The 8-year disease-free, cancer-specific, and overall survival was 76.1, 82.8, and 80.4%, respectively. Cosmetic outcome was rated excellent in 17%, good in 39%, fair in 33%, and poor in 11%. Data on late radiation side effects were available for 91 patients (91%). Grade 3 fibrosis and grade 3 telangiectasia occurred in 6 (6.6%) and 2 (2.2%) patients, respectively. In univariate analysis only positive margin status had a significant negative effect on local control.

Conclusions

HDR BT boost using multi-catheter implants produce excellent long-term local tumour control with acceptable cosmetic outcome and low rate of grade 3 late radiation side effects.

Abstract

Aim

To report the long-term results of high-dose-rate (HDR) brachytherapy (BT) boost for breast cancer patients treated with conservative surgery and radiotherapy.

Materials and methods

Between 1995 and 2007, 100 early-stage breast cancer patients received an HDR BT boost after conservative surgery and whole breast irradiation. Ten patients (10%) received a single-fraction HDR boost of 8–10.35[[ce:hsp sp="0.25"/]]Gy using rigid needles, while 90 (90%) were treated with a fractionated multi-catheter HDR BT boost. The latter consisted of 3[[ce:hsp sp="0.25"/]]×[[ce:hsp sp="0.25"/]]4[[ce:hsp sp="0.25"/]]Gy (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]19), 3[[ce:hsp sp="0.25"/]]×[[ce:hsp sp="0.25"/]]4.75[[ce:hsp sp="0.25"/]]Gy (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]70), and 2[[ce:hsp sp="0.25"/]]×[[ce:hsp sp="0.25"/]]6.4[[ce:hsp sp="0.25"/]]Gy (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]1). Breast cancer related events, cosmetic results and side effects were assessed.

Results

At a median follow-up time of 94 months (range: 8–152) only 7 (7%) ipsilateral breast failures were observed for a 5- and 8-year actuarial rate of 4.5 and 7.0%, respectively. The 8-year disease-free, cancer-specific, and overall survival was 76.1, 82.8, and 80.4%, respectively. Cosmetic outcome was rated excellent in 17%, good in 39%, fair in 33%, and poor in 11%. Data on late radiation side effects were available for 91 patients (91%). Grade 3 fibrosis and grade 3 telangiectasia occurred in 6 (6.6%) and 2 (2.2%) patients, respectively. In univariate analysis only positive margin status had a significant negative effect on local control.

Conclusions

HDR BT boost using multi-catheter implants produce excellent long-term local tumour control with acceptable cosmetic outcome and low rate of grade 3 late radiation side effects.

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Keywords

Breast-conserving therapy; Radiotherapy; High-dose-rate brachytherapy; Boost

About this article
Title

The role of high-dose-rate brachytherapy boost in breast-conserving therapy: Long-term results of the Hungarian National Institute of Oncology

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 15, No 1 (2010)

Pages

1-7

Published online

2010-01-01

DOI

10.1016/j.rpor.2010.01.002

Bibliographic record

Rep Pract Oncol Radiother 2010;15(1):1-7.

Keywords

Breast-conserving therapy
Radiotherapy
High-dose-rate brachytherapy
Boost

Authors

Csaba Polgár
Levente Jánváry
Tibor Major
András Somogyi
Zoltán Takácsi-Nagy
Georgina Fröhlich
János Fodor

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