Prospective analysis of toxicity in patients treated with strut-adjusted volume implant for early-stage breast cancer.
We report the toxicity of patients treated with strut-adjusted volume implant (SAVI) for accelerated partial breast irradiation treated at our institution.



Patients treated from January 2013 to July 2015 with SAVI planned for 10 b.i.d. fractions for a total dose of 34 Gy were included. Acute and late toxicities were prospectively collected on patients in followup and graded by the Common Terminology Criteria for Adverse Events, version 4.0.



A total of 132 patients were included, with 1 patient having synchronous breast cancer treated in each breast. Median followup was 20.0 months (range, 2.7-37.4 months). The median age at diagnosis was 61 years (range, 41-83 years). Forty-two lesions (32%) were in situ, 88 lesions (66%) were Stage 1, and 3 (2%) lesions were Stage 2. The median planning target volume was 58.2 cc (range, 24.2-109.9 cc), median V150 was 26.3 cc (range, 11.5-47.5 cc), and median V200 was 13.0 cc (range, 6.3-26.1 cc). On a pain scale of 0-10 (10 = worst pain), pain was worst on Day 2 of treatment, with an average score of 0.46. There was one acute skin infection; there were three late skin infections, two of which was Grade 3. Other late toxicities were Grade 1 or 2: hyperpigmentation (44%), telangiectasia (0.8%), seroma (9%), fat necrosis (5%), and fibrosis (12%). Crude local recurrence rate was 4%.



SAVI is a safe treatment option for patients who are candidates for accelerated partial breast irradiation. Local control seems to be excellent, but longer followup is needed.
Department of Radiation Oncology, Siteman Cancer Center, Washington University/Barnes-Jewish Hospital, Saint Louis, MO.
Sana
S
Rehman
Department of Radiation Oncology, Siteman Cancer Center, Washington University/Barnes-Jewish Hospital, Saint Louis, MO.
Reema
R
Agarwal
Department of Radiation Oncology, Siteman Cancer Center, Washington University/Barnes-Jewish Hospital, Saint Louis, MO.
Laura
L
Ochoa
Department of Radiation Oncology, Siteman Cancer Center, Washington University/Barnes-Jewish Hospital, Saint Louis, MO.
Pippa
P
Cosper
Department of Radiation Oncology, Siteman Cancer Center, Washington University/Barnes-Jewish Hospital, Saint Louis, MO.
Jacqueline
J
Zoberi
Department of Surgery, Siteman Cancer Center, Washington University/Barnes-Jewish Hospital, Saint Louis, MO.
Amy
A
Cyr
Department of Surgery, Siteman Cancer Center, Washington University/Barnes-Jewish Hospital, Saint Louis, MO.
Julie
J
Margenthaler
Department of Radiation Oncology, Siteman Cancer Center, Washington University/Barnes-Jewish Hospital, Saint Louis, MO.
Maria
M
Thomas
Department of Radiation Oncology, Siteman Cancer Center, Washington University/Barnes-Jewish Hospital, Saint Louis, MO. Electronic address: izoberi@radonc.wustl.edu.
Imran
I
Zoberi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects* / Q000295:instrumentation; D000071960:Breast Carcinoma In Situ / Q000473:pathology / Q000532:radiotherapy*; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005218:Fat Necrosis / Q000209:etiology; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D019736:Prostheses and Implants; D011832:Radiation Injuries / Q000209:etiology*; D049291:Seroma / Q000209:etiology; D012874:Skin Diseases, Infectious / Q000209:etiology; D013684:Telangiectasis / Q000209:etiology
Accelerated partial breast irradiation; Breast cancer; Strut-adjusted volume implant