title: A Japanese prospective multi-institutional feasibility study on accelerated partial breast irradiation using interstitial brachytherapy: clinical results with a median follow-up of 26 months.
abstract: BACKGROUND
  A Japanese prospective multi-institutional feasibility study on accelerated partial breast irradiation using interstitial brachytherapy was performed. The first clinical results were reported with a median follow-up of 26 months.
  
  
  METHODS
  Forty-six female breast cancer patients with positive hormone receptors and tumors ≤3 cm, pN0M0, completed the protocol treatment. After breast-conserving surgery and histological confirmation of negative surgical margins and pN0, brachytherapy applicators were implanted either postoperatively (n = 45) or intraoperatively (n = 1). High-dose-rate brachytherapy of 36 Gy/6 fractions was delivered. All clinical data were prospectively collected using case report forms and the Common Terminology Criteria for Adverse Events ver.3.0.
  
  
  RESULTS
  At the median follow-up of 26 months, no breast cancer recurrence of any type was observed. Sequelae ≥G2 were dermatitis (G2, 7 %), fibrosis (G2, 11 %; G3, 4 %), fracture (G2, 2 %), pain (G2, 7 %; G3, 2 %), and soft tissue necrosis (G2, 6 %). Cosmetic outcomes evaluated by excellent/good scores were 100 % at pre-therapy (n = 46), 94 % at 12 months (n = 46), and 81 % at 24 months (n = 36), respectively.
  
  
  CONCLUSIONS
  Disease control and sequelae were satisfactory due to the strict eligibility and protocol-defined treatment parameters. The cosmetic outcomes were comparable to those of previous Japanese breast-conserving therapy series.
authors.affiliation: Department of Radiation Oncology, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo, 206-8512, Japan. nose-takayuki@nms.ac.jp.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nose
authors.affiliation: Department of Radiology, Kaizuka City Hospital, Kaizuka, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Otani
authors.affiliation: Departments of Surgery, Aidu Chuo Hospital, Aiduwakamatsu, Japan.
authors.forename: Shuuji
authors.initials: S
authors.lastname: Asahi
authors.affiliation: Departments of Radiology, Aidu Chuo Hospital, Aiduwakamatsu, Japan.
authors.forename: Iwao
authors.initials: I
authors.lastname: Tsukiyama
authors.affiliation: Departments of Radiation Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan.
authors.forename: Takushi
authors.initials: T
authors.lastname: Dokiya
authors.affiliation: Departments of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Saeki
authors.affiliation: Departments of Radiation Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan.
authors.forename: Ichirou
authors.initials: I
authors.lastname: Fukuda
authors.affiliation: Departments of Radiation Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sekine
authors.affiliation: Departments of Radiation Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Shikama
authors.affiliation: Departments of Radiation Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Kumazaki
authors.affiliation: Departments of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Departments of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Departments of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Kotsuma
authors.affiliation: Departments of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Norikazu
authors.initials: N
authors.lastname: Masuda
authors.affiliation: Departments of Radiation Oncology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Eisaku
authors.initials: E
authors.lastname: Yoden
authors.affiliation: Departments of Surgery, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Nakashima
authors.affiliation: Departments of Radiology, National Hospital Organization, National Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Taisei
authors.initials: T
authors.lastname: Matsumura
authors.affiliation: Departments of Surgery, National Hospital Organization National Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Shino
authors.initials: S
authors.lastname: Nakagawa
authors.affiliation: Departments of Radiation Oncology, Kyoto City Hospital, Kyoto, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Tachiiri
authors.affiliation: Departments of Breast Surgery, Kyoto City Hospital, Kyoto, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Moriguchi
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Itami
authors.affiliation: Department of Radiation Oncology, Cancer Institute Hospital, The Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Oguchi
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
keywords: Accelerated partial breast irradiation; Brachytherapy; Breast cancer; Radiotherapy