title: Accelerated partial-breast irradiation using high-dose-rate interstitial brachytherapy: 12-year update of a prospective clinical study.
abstract: OBJECTIVE
  To report the 12-year updated results of accelerated partial-breast irradiation (APBI) using multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT).
  
  
  METHODS
  Forty-five prospectively selected patients with T1N0-N1mi, nonlobular breast cancer without the presence of an extensive intraductal component and with negative surgical margins were treated with APBI after breast-conserving surgery (BCS) using interstitial HDR BT. A total dose of 30.3 Gy (n=8) and 36.4 Gy (n=37) in seven fractions within 4 days was delivered to the tumour bed plus a 1-2 cm margin. The median follow-up time was 133 months for surviving patients. Local and regional control, disease-free (DFS), cancer-specific (CSS), and overall survival (OS), as well as late side effects, and cosmetic results were assessed.
  
  
  RESULTS
  Four (8.9%) ipsilateral breast tumour recurrences were observed, for a 5-, 10-, and 12-year actuarial rate of 4.4%, 9.3%, and 9.3%, respectively. A total of two regional nodal failures were observed for a 12-year actuarial rate of 4.4%. The 12-year DFS, CSS, and OS was 75.3%, 91.1%, and 88.9%, respectively. Grade 3 fibrosis was observed in one patient (2.2%). No patient developed grade 3 teleangiectasia. Fat necrosis requiring surgical intervention occurred in one woman (2.2%). Cosmetic results were rated excellent or good in 35 patients (77.8%).
  
  
  CONCLUSIONS
  Twelve-year results with APBI using HDR multicatheter interstitial implants continue to demonstrate excellent long-term local tumour control, survival, and cosmetic results with a low-rate of late side effects.
authors.affiliation: Department of Radiotherapy, National Institute of Oncology, Budapest, Hungary. polgar@oncol.hu
authors.forename: Csaba
authors.initials: C
authors.lastname: Polgár
authors.forename: Tibor
authors.initials: T
authors.lastname: Major
authors.forename: János
authors.initials: J
authors.lastname: Fodor
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Sulyok
authors.forename: András
authors.initials: A
authors.lastname: Somogyi
authors.forename: Katalin
authors.initials: K
authors.lastname: Lövey
authors.forename: György
authors.initials: G
authors.lastname: Németh
authors.forename: Miklós
authors.initials: M
authors.lastname: Kásler
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000592:standards; D008875:Middle Aged; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D013997:Time Factors; D016896:Treatment Outcome