title: Experience with an electronic brachytherapy technique for intracavitary accelerated partial breast irradiation.
abstract: OBJECTIVE
  Phase IV study evaluated the safety and device performance of an electronic brachytherapy system (Axxent Electronic Brachytherapy System) as adjuvant therapy for early-stage breast cancer.
  
  
  METHODS
  Patients were > or =50 years of age and had completely resected invasive ductal carcinoma or ductal carcinoma in situ (<2.0 cm), with N0 M0 and negative microscopic margins of > or =1 mm. The balloon applicator was placed in a closed cavity with a balloon surface to skin distance of > or =7 mm. The prescribed dose was 3.4 Gy/fraction prescribed to 1 cm beyond the balloon surface twice daily (BID) for 10 fractions.
  
  
  RESULTS
  Of 65 patients consented, 21 (32%) were not eligible for treatment, and 44 (68%) were treated, with 6-months follow-up in 43 and 1-year follow-up in 36. The prescribed radiation treatment was successfully delivered in 42/44 (95.4%) patients; one was unsuccessful due to a controller issue and the other declined the final fraction following a balloon deflation. Side effects were as anticipated and generally manageable. Four CTCAE v3 grade 3 toxicities were reported: blistering (1), breast tenderness (1), and moist desquamation (2); all have resolved. The most common grade 2 toxicity was erythema. There were no device-related serious adverse events.
  
  
  CONCLUSIONS
  Early experience demonstrates that the electronic brachytherapy system performed as expected. Electronic brachytherapy has similar acute toxicity profiles to other high dose rate approaches for accelerated partial breast irradiation and offers the convenience of having the treatment in an unshielded room.
authors.affiliation: Department of Radiation Oncology, Swedish Cancer Institute, Seattle, WA 98104, USA. vivek.mehta@swedish.org
authors.forename: Vivek K
authors.initials: VK
authors.lastname: Mehta
authors.forename: Ozer
authors.initials: O
authors.lastname: Algan
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Griem
authors.forename: Adam
authors.initials: A
authors.lastname: Dickler
authors.forename: Kenneth
authors.initials: K
authors.lastname: Haile
authors.forename: David E
authors.initials: DE
authors.lastname: Wazer
authors.forename: Randy E
authors.initials: RE
authors.lastname: Stevens
authors.forename: Manjeet
authors.initials: M
authors.lastname: Chadha
authors.forename: Steve
authors.initials: S
authors.lastname: Kurtzman
authors.forename: Sheela D
authors.initials: SD
authors.lastname: Modin
authors.forename: Kambiz
authors.initials: K
authors.lastname: Dowlatshahi
authors.forename: Kelly W
authors.initials: KW
authors.lastname: Elliott
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Rusch
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001940:Breast / Q000473:pathology / Q000528:radiation effects; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D004581:Electronics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D012449:Safety