title: Four-year results using balloon-based brachytherapy to deliver accelerated partial breast irradiation with a 2-day dose fractionation schedule.
abstract: OBJECTIVE
  We present 4-year results from a Phase I/II trial using balloon-based brachytherapy to deliver accelerated partial breast irradiation in 2 days.
  
  
  METHODS
  Forty-five patients received breast-conserving surgery followed by adjuvant radiation therapy using a balloon-based brachytherapy applicator delivering 2800 cGy in four fractions over 2 days. Outcomes analyzed include toxicities scored using the NCI Common Toxicity Criteria v3.0 scale, ipsilateral breast tumor recurrence, regional nodal failure, distant metastasis, disease-free survival, cause-specific survival, and overall survival.
  
  
  RESULTS
  Median age was 66 years (range, 48-83 years) and median tumor size was 0.6 cm (range, 0.2-2.3 cm). Five percent of patients were node positive (n=2), whereas 73% was estrogen receptor positive (n=33). Median followup was 3.7 years (2.4-7.0 years) with greater than 2 years of followup for all patients. Only Grades 1 and 2 chronic toxicities were noted with fat necrosis (18%) and asymptomatic seromas (42%) being the most common toxicities. Seven percent of patients developed ipsilateral rib fractures (n=3), although this was not statistically associated with maximum rib dose (p=0.31). Ninety-eight percent of patients had a good or excellent radiation-related cosmetic outcome at the time of last followup. There were no ipsilateral breast tumor recurrences or regional nodal failures; however, 2 patients developed distant metastases. Four-year actuarial disease-free survival, cause-specific survival, and overall survival were 96%, 100%, and 93%, respectively.
  
  
  CONCLUSIONS
  Treatment of early-stage breast cancer patients with breast-conserving therapy using a 2-day radiation dose schedule resulted in acceptable chronic toxicity and similar clinical outcomes as standard 5-day fractionation.
authors: Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, MI 48073, USA.
authors: J Ben
authors: JB
authors: Wilkinson
authors: Alvaro A
authors: AA
authors: Martinez
authors: Peter Y
authors: PY
authors: Chen
authors: Mihai I
authors: MI
authors: Ghilezan
authors: Michelle F
authors: MF
authors: Wallace
authors: Inga S
authors: IS
authors: Grills
authors: Chirag S
authors: CS
authors: Shah
authors: Christina K
authors: CK
authors: Mitchell
authors: Evelyn
authors: E
authors: Sebastian
authors: Amy S
authors: AS
authors: Limbacher
authors: Pamela R
authors: PR
authors: Benitez
authors: Eric A
authors: EA
authors: Brown
authors: Frank A
authors: FA
authors: Vicini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D001940:Breast / Q000528:radiation effects* / Q000601:surgery; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged