title: Perioperative high-dose-rate interstitial brachytherapy boost for patients with early breast cancer.
abstract: OBJECTIVE
  To evaluate the clinical results of perioperative high-dose-rate interstitial brachytherapy boost treatment preceding whole breast external beam radiation therapy in patients with early breast cancer.
  
  
  METHODS
  From 2005-2010, 100 patients with early breast cancer who met the eligibility criteria were enrolled in the study. Brachytherapy implant was performed during the breast-conserving surgery procedure. The boost treatment was started on the 3rd postoperative day to deliver a dose of 15 Gy in 6 fractions over 3 days. Three weeks later, external beam radiation therapy to the whole breast was started for a prescription dose of 50 Gy. The study end points were local recurrence, acute toxicity and cosmetic outcome.
  
  
  RESULTS
  Median age of the patients was 46 years, and median follow-up was 52 months. No patient developed a local recurrence but 5 patients developed distant metastases. The 5-year overall survival and disease-free survival were 86% and 77%, respectively. Eleven patients had acute toxicity; 4 wound complications and 7 grade III skin toxicity. Nine of the 11 patients had breast size of more than 1500 cc. Except for the breast volume (>1500 cc), there was no statistically significant correlation between any of the patient or dosimetry-related factors and acute toxicity. Good-excellent cosmesis was observed in 87% of patients.
  
  
  CONCLUSIONS
  Perioperative high-dose-rate interstitial brachytherapy boost followed by whole breast external beam radiation therapy provides excellent local control, acceptable acute toxicity and good-excellent breast cosmesis in patients with early breast cancer.
authors.forename: Daya Nand
authors.initials: DN
authors.lastname: Sharma
authors.forename: S V S
authors.initials: SV
authors.lastname: Deo
authors.forename: Goura Kisor
authors.initials: GK
authors.lastname: Rath
authors.forename: Nootan Kumar
authors.initials: NK
authors.lastname: Shukla
authors.forename: Sanjay
authors.initials: S
authors.lastname: Thulkar
authors.forename: Renu
authors.initials: R
authors.lastname: Madan
authors.forename: Pramod Kumar
authors.initials: PK
authors.lastname: Julka
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology / Q000517:prevention & control / Q000532:radiotherapy* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012867:Skin / Q000528:radiation effects; D016896:Treatment Outcome