Preliminary result of accelerated partial breast irradiation after breast-conserving surgery.
OBJECTIVE
To investigate the feasibility of accelerated partial breast irradiation (APBI) for Japanese patients, we started high-dose-rate interstitial brachytherapy (HDR-ISBT) as monotherapy after breast-conserving surgery (BCS).


METHODS
We implanted 45 Tis-2 breast cancer patients at National Hospital Organization Osaka National Hospital between June 2002 and June 2006. Our eligibility criteria were broader than the ones used previously in western countries. We included margin-positive cases and younger patients (median age: 44; range: 26-68) to adapt the criteria for Japanese women. Total prescribed doses were 36-42 Gy in six to seven fractions, and the volumes encompassed by 100% prescribed dose (V100) were 38.5-315.1 cc. Fifteen patients received chemotherapy.


RESULTS
Treatment could be completed for all patients. Two local failures (4%) and two distant metastases were observed, while one patient died of liver metastasis. Seven wound complications, four with and three without infection, and two rib fractures occurred. The significant risk factors for wound complications were non-administration of prophylactic antibiotics during ISBT (P < 0.01), open cavity implant (P < 0.05), large V100 (P < 0.01), V150 (P < 0.05), and V200 (P < 0.05).


CONCLUSIONS
APBI after BCS for Japanese women with relatively small breasts was well tolerated, but special care should be taken with treatment technique.
Yoshida
Ken
K
Department of Radiology, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan. kyoshida@onh.go.jp
Nose
Takayuki
T
Masuda
Norikazu
N
Yamazaki
Hideya
H
Kotsuma
Tadayuki
T
Yoshida
Mineo
M
Yamamura
Jun
J
Masuda
Hiroko
H
Shin
Eisei
E
Nakaba
Hiroyuki
H
Komoike
Yoshifumi
Y
Tokuda
Yukiko
Y
Takeda
Masashi
M
Kuriyama
Keiko
K
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D018275:Carcinoma, Lobular / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome